If you’re a smoker who’s ever expressed concern about gaining weight if you quit, you may have encountered the “rule of thirds” somewhere along the line. The smoking cessation rule of thirds says, essentially, that around a third of quitters gain weight, a third remain the same, and a third actually lose weight.
This pat formula cropped up a few decades ago and no one can say exactly where it came from. Presumably the first person to utter these words meant well and hoped to encourage his (her?) smoking patients to overcome their reluctance to quit because they feared gaining weight. After all, what could be more reassuring than the idea that your chance of gaining weight is only a little over 30% – with an equally good chance that you’ll actually lose weight?
Only one problem: It simply isn’t true. There is no scientific evidence whatsoever to support this breakdown and plenty to refute it. Only a few quitters completely avoid weight gain and even fewer actually lose weight. And I’m convinced that many of those who lose weight have cessation-emergent depression and concomitant loss of appetite, a poor tradeoff! Yet somewhere along the line the rule of thirds became so entrenched that now, even when its “untruthiness” is pretty widely recognized in the research community, it still turns up occasionally, like a bad penny.
What’s wrong with a little white lie if it has the desired effect?
Plenty, in my opinion. Because weight gain often begins as early as the first week after quitting, this particular piece of disinformation is likely to convince women, before their attempt to quit has even gotten off the ground, that they’re in the unlucky third, that they’ve lost the lottery. It’s hard to think of a better formula for early relapse!
The precise distribution of weight gain after quitting is not easy to specify because of methodological issues (e.g., how long after quitting do you measure? how do you factor in normal weight gain over time in nonsmokers? etc.). Based on my own reading of the literature, however, I have developed my own algorithm that I think is a lot closer to the truth:
What does this mean for you? Readers of Life After Cigarettes or of this blog will be well aware of my conviction that it is likely, by definition, that you will be among the large majority of women smokers who do not gain weight in amounts that will require a new wardrobe or increase your health risk when you quit.
The other thing to remember is that whether you will be among those who gain weight in disproportionate amounts is not entirely a matter of chance. There are risk factors for large weight gain, including a history of binge-eating, a personal or family history of large weight gain after previous quit attempts, and a tendency towards depression-induced eating. Having one or more risk factors for excessive weight gain does not mean you shouldn’t quit smoking! It does mean that you should consider taking precautionary measures to counteract these propensities (e.g., using smoking cessation medications that minimize weight gain, such as nicotine replacement therapy or Zyban; reviewing your nutritional and exercise patterns with an eye to identifying realistic changes you can make) and be prepared to seek professional help if weight gain after quitting gets out of hand. Whatever you do, please don’t quit quitting!
Today’s blog post honors Dr. Jean Kilbourne and her work in publicizing the effects of advertising on women and girls. Over the course of her long career as an author, public speaker, media critic, and documentary filmmaker, she has helped us all see what was hidden in plain sight – that Madison Avenue not only sells us consumer goods but, in her words, “changes the way we think and feel.” Much of her work has focused on ads for cigarettes, alcohol, and food using marketing ploys that objectify the female body and glorify a grotesque degree of thinness in ways that encourage self-hatred, eating disorders, and addiction. If her ideas do not sound all that surprising to you, it’s because her original perceptions have now become mainstream.
Many of her insights were rooted in her own early experiences. Born in 1943, she began smoking and drinking in her early teens to cope with her grief at her mother’s death and as an expression of her rebellious nature. Despite these distractions, she was able to maintain good grades in school and went on to graduate from Wellesley, later earning a doctorate in education from Boston University. She then spent three years working in Europe, first for the BBC and then for a French film company. It was in 1968 that she began looking critically at advertisements aimed at women and connecting the dots. Eventually, she concluded that the images of liberation and female beauty portrayed in the media were dangerously deceptive and decided that exposing these untruths would be her life’s work.
Even today, though many are aware of how the tobacco and advertising industries’ efforts to sell cigarettes to women may contribute to poor body image, the full extent of the link between smoking and eating disorders remains underappreciated. Smoking is over-represented among women with diagnosable and subclinical eating disorders. (Indeed, I have often thought that smoking – thanks at least in part to clever advertising that has persuaded so many girls and women it’s an effective way to control weight – should be considered a “compensatory behavior,” along with purging, fasting, and excessive exercise, in diagnosing bulimia and binge-eating disorder.) Credit to Dr. Kilbourne for recognizing the connection between these two serious health hazards and the insidious way in which they have been used to “feed” one another, to the detriment of physical and mental health.
Dr. Kilbourne could have pursued a standard academic career, churning out grant applications and scientific publications. Instead, she has chosen to dedicate her speaking skills and wit to a one-woman crusade for media literacy, raising our consciousness so that we see our everyday environment in a new light. For more information about Dr. Kilbourne and her current projects, visit her website at www.jeankilbourne.com.
It tastes good and lifts our spirits. It comforts us and quells our appetite. Yet we know it’s bad for us and sometimes suspect we may be addicted to it.
I’m talking about sugar – and the love-hate relationship many women have with it. Unfortunately for many of us, Mother Nature didn’t provide us with brakes when it comes to consuming sugar. In the wild, it’s probably a good thing to eat your fill of that berry bush because it may be awhile before you encounter another one. But we’ve become so good at refining and producing the stuff that it’s now freely available to us in virtually unlimited amounts. So we eat…and eat and eat, despite the fact that it’s loaded with empty calories (bad for our waistlines), promotes tooth decay (bad for our looks), and raises triglycerides and releases free radicals (bad for our health). In large amounts it increases insulin levels and in some individuals leads to insulin resistance and eventually Type 2 diabetes.
Three hundred years ago, the average American consumed around four pounds of sugar per year, if that. Today, it’s estimated that we eat 90-180 pounds per year. Much of it is consumed in the form of sugar added to our coffee or in soft drinks, fruit juices, sports drinks, and desserts. But because sugar, in addition to being a sweetening agent, has other properties useful in food-processing (it cuts acidity, increases shelf life, adds bulk and texture, prevents clumping, moisturizes, changes the boiling point of water, caramelizes/browns, and promotes fermentation), it’s also found in foods you might never think of as sources of sugar – tomato-based products, bologna, pretzels, cheese spread, and Worcestershire sauce, to name a few.
You don’t have to be a smoker to love sugar but it helps. In a laboratory study we conducted nearly two decades ago, we found that significantly more smokers than nonsmokers preferred higher sucrose concentrations. And we know that when smokers quit, they tend to eat more – which, for those with a sweet tooth, means more sugar.
The link between smoking and sugar dates back at least to the 17th century, when they were obtained in the West Indies to satisfy the growing demand for both in Europe, in exchange for West Africans sold into slavery – the notorious Triangle Trade. This shameful chapter marks a low point in the shared history of sugar and tobacco, but the two are paired in other ways as well. For many of us, for example, candy cigarettes were our first introduction to “smoking.”
The problem is not sugar per se – as noted above, a little of it is a good thing. It provides a quick boost of energy. It helps the medicine go down. But we’re now in a situation of “too much of a good thing” – and that’s a bad thing. So how can you avoid excessive sugar intake when you quit? Here are a few tips.
Some years ago, after I had given a talk to a group of psychologists on weight concerns as a barrier to quitting smoking, an attractive young woman from the audience approached me to say that in the South American country where she had grown up (I can’t remember which one it was), she had never heard that smoking suppresses weight. Indeed, she hadn’t even put two and two together when she stopped smoking – and gained ten pounds! She was genuinely surprised at the content of my talk.
This woman held a doctorate in psychology. She was neither stupid nor ignorant. But somehow the tobacco companies had failed to find her and warn her, in their own special way, about the dire consequences of quitting. Given the efficiency with which they have managed to spread the word both at home and abroad, it’s hard to see how she could have escaped their notice! But because no one had managed to frame the issue as a choice between being beauty-queen gorgeous, movie-star sexy, and fashion-model slim, on the one hand, and not smoking, on the other, she just up and quit. As for the ten-pound weight gain, she had no idea it had anything to do with quitting, so she just sucked it up and kept moving. After all, “así es la vida” – such is life.
Even if it were possible, I’m certainly not advocating keeping women in the dark about this effect of smoking—any more than I’d favor not telling you that smoking ages your skin, hoarsens your voice, defeminizes your body shape, yellows your teeth, fouls your breath, and burns your clothes. But the tobacco companies go far beyond educating women about the weight-suppressing effects of their product, scaring them with the specter of out-of-control weight gain if they quit and pushing thinness as a cultural value. Somehow they never get to the other part of the message, the part about the other effects of smoking upon appearance, all of them undesirable.
Public health campaigns have done a great job of emphasizing the health hazards of smoking, but less has been said about its detrimental effects on appearance. Absent that information, you only know half the story – the half the tobacco industry wants you to hear.
Cynthia S. Pomerleau, Ph.D., is currently research professor emerita in the University of Michigan Department of Psychiatry. From 1985 to 2009 she served as director of the Nicotine Research Laboratory, where much of her research focused on the impact of smoking on women. She is the author of more than a hundred articles and book chapters on smoking and a contributor to the 2001 Surgeon General’s Report on Women and Smoking.