{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T18:20:38Z","timestamp":1792174838752,"version":"4.4.0"},"reference-count":56,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2018,3,23]],"date-time":"2018-03-23T00:00:00Z","timestamp":1521763200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004505","name":"University of Catania","doi-asserted-by":"publisher","award":["21040100"],"award-info":[{"award-number":["21040100"]}],"id":[{"id":"10.13039\/501100004505","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Minimization of post-cessation weight gain in quitters is important, but existing approaches (e.g., antismoking medications) shows only limited success. We investigated changes in body weight in smokers who quit or reduced substantially their cigarette consumption by switching to electronic cigarettes (ECs) use. Body weight and smoking\/vaping history were extracted from medical records of smokers and ex-smokers to match three study groups: (1) regular EC users on at least two consecutive follow-up visits; (2) regular smokers (and not using ECs); (3) subjects who reported sustained smoking abstinence after completing a cessation program. Review of their medical records was conducted at two follow-up visits at 6- (F\/U 6m) and 12-months (F\/U 12m). A total of 86 EC users, 93 regular smokers, and 44 quitters were studied. In the EC users study group, cigarettes\/day use decreased from 21.1 at baseline to 1.8 at F\/U 12m (p &lt; 0.0001). Dual usage was reported by approximately 50% of EC users. Both within factor (time, p &lt; 0.0001) and between factor (study groups, p &lt; 0.0001) produced significant effect on weight (% change from baseline), with a significant 4.8% weight gain from baseline in the quitters study group at F\/U 12m. For the EC users, weight gain at F\/U 12m was only 1.5% of baseline. There was no evidence of post-cessation weight increase in those who reduced substantially cigarette consumption by switching to ECs (i.e., dual users) and only modest post-cessation weight increase was reported in exclusive EC users at F\/U 12m. By reducing weight gain and tobacco consumption, EC-based interventions may promote an overall improvement in quality of life.<\/jats:p>","DOI":"10.3390\/ijerph15040581","type":"journal-article","created":{"date-parts":[[2018,3,27]],"date-time":"2018-03-27T23:37:17Z","timestamp":1522193837000},"page":"581","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Lack of Substantial Post-Cessation Weight Increase in Electronic Cigarettes Users"],"prefix":"10.3390","volume":"15","author":[{"given":"Cristina","family":"Russo","sequence":"first","affiliation":[{"name":"MCAU ARNAS Garibaldi, 95123 Catania, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1674-2263","authenticated-orcid":false,"given":"Fabio","family":"Cibella","sequence":"additional","affiliation":[{"name":"National Research Council of Italy, Institute of Biomedicine and Molecular Immunology, 90100 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enrico","family":"Mondati","sequence":"additional","affiliation":[{"name":"Institute of Internal and Emergency Medicine, Azienda Ospedaliero-Universitaria \u201cPoliclinico-V. Emanuele\u201d, University of Catania, 95123 Catania, Italy"},{"name":"Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pasquale","family":"Caponnetto","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy"},{"name":"Centro per la Prevenzione e Cura del Tabagismo (CPCT), Azienda Ospedaliero-Universitaria \u201cPoliclinico-V. Emanuele\u201d, University of Catania, 95123 Catania, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evelise","family":"Frazzetto","sequence":"additional","affiliation":[{"name":"Institute of Internal and Emergency Medicine, Azienda Ospedaliero-Universitaria \u201cPoliclinico-V. Emanuele\u201d, University of Catania, 95123 Catania, Italy"},{"name":"Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4412-2080","authenticated-orcid":false,"given":"Massimo","family":"Caruso","sequence":"additional","affiliation":[{"name":"Institute of Internal and Emergency Medicine, Azienda Ospedaliero-Universitaria \u201cPoliclinico-V. Emanuele\u201d, University of Catania, 95123 Catania, Italy"},{"name":"Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1325-0466","authenticated-orcid":false,"given":"Grazia","family":"Caci","sequence":"additional","affiliation":[{"name":"Institute of Internal and Emergency Medicine, Azienda Ospedaliero-Universitaria \u201cPoliclinico-V. Emanuele\u201d, University of Catania, 95123 Catania, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8450-5721","authenticated-orcid":false,"given":"Riccardo","family":"Polosa","sequence":"additional","affiliation":[{"name":"Institute of Internal and Emergency Medicine, Azienda Ospedaliero-Universitaria \u201cPoliclinico-V. Emanuele\u201d, University of Catania, 95123 Catania, Italy"},{"name":"Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy"},{"name":"Centro per la Prevenzione e Cura del Tabagismo (CPCT), Azienda Ospedaliero-Universitaria \u201cPoliclinico-V. Emanuele\u201d, University of Catania, 95123 Catania, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2018,3,23]]},"reference":[{"key":"ref_1","unstructured":"US Department of Health and Human Services (2014). The Health Consequences of Smoking\u201450 Years of Progress: A Report of the Surgeon General."},{"key":"ref_2","unstructured":"World Health Organization (2008). WHO Report on the Global Tobacco Epidemic, 2008\u2014The MPOWER Package."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1519","DOI":"10.1136\/bmj.38142.554479.AE","article-title":"Mortality in relation to smoking: 50 years\u2019 observations on male British doctors","volume":"328","author":"Doll","year":"2004","journal-title":"BMJ"},{"key":"ref_4","unstructured":"U.S. Department of Health and Human Services (1990). The Health Benefits of Smoking Cessation: A Report of the Surgeon General."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1016\/j.tips.2010.12.008","article-title":"Treatment of nicotine addiction: Present therapeutic options and pipeline developments","volume":"32","author":"Polosa","year":"2011","journal-title":"Trends. Pharmacol. Sci."},{"key":"ref_6","first-page":"CD008286","article-title":"Combined pharmacotherapy and behavioural interventions for smoking cessation","volume":"Volume 3","author":"Stead","year":"2016","journal-title":"Cochrane Database of Systematic Reviews"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1037\/0033-2909.106.2.204","article-title":"Smoking, body weight, and their effects on smoking behavior: A comprehensive review of the literature","volume":"106","author":"Klesges","year":"1989","journal-title":"Psychol. Bull."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"188","DOI":"10.1111\/j.1360-0443.2010.03136.x","article-title":"Associations between weight change over 8 years and baseline body mass index in a cohort of continuing and quitting smokers","volume":"106","author":"Lycett","year":"2011","journal-title":"Addiction"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"2255","DOI":"10.1111\/j.1475-6773.2006.00594.x","article-title":"Estimating the effect of smoking cessation on weight gain: An instrumental variable approach","volume":"41","author":"Eisenberg","year":"2006","journal-title":"Health Serv. Res."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1270","DOI":"10.1093\/ntr\/nts159","article-title":"Nicotinic Regulation of Energy Homeostasis","volume":"14","author":"Zoli","year":"2012","journal-title":"Nicot. Tob. Res."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1016\/S1471-0153(00)00014-3","article-title":"\u201cPrequit attrition\u201d among weight-concerned women smokers","volume":"1","author":"Brouwer","year":"2000","journal-title":"Eat. Behav."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1639","DOI":"10.1016\/j.addbeh.2012.09.016","article-title":"Targeting cessation: Understanding barriers and motivations to quitting among urban adult daily tobacco smokers","volume":"38","author":"Rosenthal","year":"2013","journal-title":"Addict. Behav."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1016\/j.jhealeco.2017.10.006","article-title":"The Effect of Smoking on Obesity: Evidence from a Randomized Trial","volume":"57","author":"Courtemanche","year":"2018","journal-title":"J. Health Econ."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"313","DOI":"10.7326\/0003-4819-142-5-200503010-00006","article-title":"Multiple Risk Factor Intervention Trial Research Group Incidence of type 2 diabetes in the randomized multiple risk factor intervention trial","volume":"142","author":"Bracha","year":"2005","journal-title":"Ann. Intern. Med."},{"key":"ref_15","first-page":"101","article-title":"Smoking, Smoking Cessation, and Risk for Type 2 Diabetes Mellitus","volume":"152","author":"Yeh","year":"2010","journal-title":"Ann. Intern. Med."},{"key":"ref_16","first-page":"CD006219","article-title":"Interventions for preventing weight gain after smoking cessation","volume":"Volume 1","author":"Aveyard","year":"2016","journal-title":"Cochrane Database of Systematic Reviews"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"12","DOI":"10.4081\/monaldi.2013.104","article-title":"Electronic cigarette: A possible substitute for cigarette dependence","volume":"79","author":"Caponnetto","year":"2015","journal-title":"Monaldi Arch. Chest Dis."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"4356","DOI":"10.3390\/ijerph110404356","article-title":"Characteristics, perceived side effects and benefits of electronic cigarette use: A worldwide survey of more than 19,000 consumers","volume":"11","author":"Farsalinos","year":"2014","journal-title":"Int. J. Environ. Res. Public Health"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1541","DOI":"10.1093\/ntr\/ntu124","article-title":"E-Cigarette Awareness, Use, and Harm Perceptions in Italy: A National Representative Survey","volume":"16","author":"Gallus","year":"2014","journal-title":"Nicot. Tob. Res."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1989","DOI":"10.1093\/ntr\/ntw102","article-title":"The Potential That Electronic Nicotine Delivery Systems Can be a Disruptive Technology: Results from a National Survey","volume":"18","author":"Pechacek","year":"2016","journal-title":"Nicot. Tob. Res."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"669","DOI":"10.1111\/add.12807","article-title":"First-versus second-generation electronic cigarettes: Predictors of choice and effects on urge to smoke and withdrawal symptoms","volume":"110","author":"Dawkins","year":"2015","journal-title":"Addiction"},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Etter, J.F. (2017). Gateway effects and electronic cigarettes. Addiction.","DOI":"10.1111\/add.13924"},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Kistler, C., Crutchfield, T., Sutfin, E., Ranney, L., Berman, M., Zarkin, G., and Goldstein, A. (2017). Consumers\u2019 Preferences for Electronic Nicotine Delivery System Product Features: A Structured Content Analysis. Int. J. Environ. Res. Public Health, 14.","DOI":"10.3390\/ijerph14060613"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1037\/adb0000263","article-title":"User identified positive outcome expectancies of electronic cigarette use: A concept mapping study","volume":"31","author":"Soule","year":"2017","journal-title":"Psychol. Addict. Behav."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1177\/2042098614524430","article-title":"Safety evaluation and risk assessment of electronic cigarettes as tobacco cigarette substitutes: A systematic review","volume":"5","author":"Farsalinos","year":"2014","journal-title":"Ther. Adv. Drug Saf."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Caponnetto, P., Campagna, D., Cibella, F., Morjaria, J.B., Caruso, M., Russo, C., and Polosa, R. (2013). EffiCiency and Safety of an eLectronic cigAreTte (ECLAT) as tobacco cigarettes substitute: A prospective 12-month randomized control design study. PLoS ONE, 8.","DOI":"10.1371\/journal.pone.0066317"},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Polosa, R., Caponnetto, P., Maglia, M., Morjaria, J.B., and Russo, C. (2014). Success rates with nicotine personal vaporizers: A prospective 6-month pilot study of smokers not intending to quit. BMC Public Health, 14.","DOI":"10.1186\/1471-2458-14-1159"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"11220","DOI":"10.3390\/ijerph111111220","article-title":"Effectiveness of the Electronic Cigarette: An Eight-Week Flemish Study with Six-Month Follow-up on Smoking Reduction, Craving and Experienced Benefits and Complaints","volume":"11","author":"Adriaens","year":"2014","journal-title":"Int. J. Environ. Res. Public Health"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"j3262","DOI":"10.1136\/bmj.j3262","article-title":"E-cigarette use and associated changes in population smoking cessation: Evidence from US current population surveys","volume":"358","author":"Zhu","year":"2017","journal-title":"BMJ"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1016\/j.ypmed.2017.03.023","article-title":"Does e-cigarette use predict cigarette escalation? A longitudinal study of young adult non-daily smokers","volume":"100","author":"Doran","year":"2017","journal-title":"Prev. Med."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"GBD 2015 Obesity Collaborators (2017). Health Effects of Overweight and Obesity in 195 Countries over 25 Years. N. Engl. J. Med., 377, 13\u201327.","DOI":"10.1056\/NEJMoa1614362"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1144","DOI":"10.1016\/j.addbeh.2005.08.011","article-title":"The prevalence of weight concerns in a smoking abstinence clinical trial","volume":"31","author":"Clark","year":"2006","journal-title":"Addict. Behav."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1134","DOI":"10.1093\/ntr\/ntu277","article-title":"Associations of Weight Concerns With Self-Efficacy and Motivation to Quit Smoking: A Population-Based Study Among Finnish Daily Smokers","volume":"17","author":"Tuovinen","year":"2015","journal-title":"Nicot. Tob. Res."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1169","DOI":"10.1001\/jama.1989.03420080089037","article-title":"Studies in the Distribution of Body Fat","volume":"261","author":"Shimokata","year":"1989","journal-title":"JAMA"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"987","DOI":"10.1037\/0022-006X.66.6.987","article-title":"The prospective relationships between smoking and weight in a young, biracial cohort: The Coronary Artery Risk Development in Young Adults Study","volume":"66","author":"Klesges","year":"1998","journal-title":"J. Consult. Clin. Psychol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"821","DOI":"10.1093\/oxfordjournals.aje.a009706","article-title":"Early and late weight gain following smoking cessation in the Lung Health Study","volume":"148","author":"Connett","year":"1998","journal-title":"Am. J. Epidemiol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"81","DOI":"10.4081\/monaldi.2009.367","article-title":"Weight Gain after Smoking Cessation","volume":"71","author":"Pistelli","year":"2016","journal-title":"Monaldi Arch. Chest Dis."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"e4439","DOI":"10.1136\/bmj.e4439","article-title":"Weight gain in smokers after quitting cigarettes: Meta-analysis","volume":"345","author":"Aubin","year":"2012","journal-title":"BMJ"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"18763","DOI":"10.1038\/srep18763","article-title":"Evaluation of Post Cessation Weight Gain in a 1-Year Randomized Smoking Cessation Trial of Electronic Cigarettes","volume":"6","author":"Russo","year":"2016","journal-title":"Sci. Rep."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.1016\/j.yrtph.2016.10.003","article-title":"A randomised, parallel group study to evaluate the safety profile of an electronic vapour product over 12 weeks","volume":"81","author":"Cravo","year":"2016","journal-title":"Regul. Toxicol. Pharmacol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"739","DOI":"10.1056\/NEJM199103143241106","article-title":"Smoking Cessation and Severity of Weight Gain in a National Cohort","volume":"324","author":"Williamson","year":"1991","journal-title":"N. Engl. J. Med."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1165","DOI":"10.1056\/NEJM199511023331801","article-title":"The Influence of Smoking Cessation on the Prevalence of Overweight in the United States","volume":"333","author":"Flegal","year":"1995","journal-title":"N. Engl. J. Med."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"861","DOI":"10.1056\/NEJM200003233421206","article-title":"A prospective study of holiday weight gain","volume":"342","author":"Yanovski","year":"2000","journal-title":"N. Engl. J. Med."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1186\/1475-2891-5-29","article-title":"The effect of the Thanksgiving holiday on weight gain","volume":"5","author":"Hull","year":"2006","journal-title":"Nutr. J."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"1005","DOI":"10.1183\/09031936.00109610","article-title":"Effect of a nicotine-free inhalator as part of a 605 smoking-cessation programme","volume":"38","author":"Caponnetto","year":"2011","journal-title":"Eur. Respir. J."},{"key":"ref_46","doi-asserted-by":"crossref","unstructured":"Wills, T.A., Sargent, J.D., Gibbons, F.X., Pagano, I., and Schweitzer, R. (2016). E-cigarette use is differentially related to smoking onset among lower risk adolescents. Tob. Control, 26.","DOI":"10.1136\/tobaccocontrol-2016-053116"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"4133","DOI":"10.1038\/srep04133","article-title":"Nicotine absorption from electronic cigarette use: Comparison between first and new-generation devices","volume":"4","author":"Farsalinos","year":"2014","journal-title":"Sci. Rep."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"16","DOI":"10.5993\/AJHB.41.1.2","article-title":"E-cigarette Nicotine Delivery: Data and Learnings from Pharmacokinetic Studies","volume":"41","author":"Fearon","year":"2017","journal-title":"Am. J. Health Behav."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1016\/0899-3289(93)90007-X","article-title":"The female weight-control smoker: A profile","volume":"5","author":"Pomerleau","year":"1993","journal-title":"J. Subst. Abuse"},{"key":"ref_50","first-page":"47","article-title":"Assessment of validity of self-reported smoking status","volume":"23","author":"Wong","year":"2012","journal-title":"Health Rep."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"354","DOI":"10.1037\/0278-6133.13.4.354","article-title":"Weight gain as a function of smoking cessation and 2-mg nicotine gum use among middle-aged smokers with mild lung impairment in the first 2 years of the Lung Health Study","volume":"13","author":"Nides","year":"1994","journal-title":"Health Psychol."},{"key":"ref_52","unstructured":"National Academies of Sciences, Engineering, and Medicine (2018). Public Health Consequences of E-Cigarettes, The National Academies Press."},{"key":"ref_53","unstructured":"(2018, March 02). Evidence Review of E-Cigarettes and Heated Tobacco Products 2018: Executive Summary, Available online: https:\/\/www.gov.uk\/government\/publications\/e-cigarettes-and-heated-tobacco-products-evidence-review\/evidence-review-of-e-cigarettes-and-heated-tobacco-products-2018-executive-summary."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"1629","DOI":"10.1016\/S0140-6736(05)66511-7","article-title":"Smoking cessation, lung function, and weight gain: A follow-up study","volume":"365","author":"Chinn","year":"1998","journal-title":"Lancet"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"2252","DOI":"10.1056\/NEJMsa0900459","article-title":"Forecasting the Effects of Obesity and Smoking on U.S. Life Expectancy","volume":"361","author":"Stewart","year":"2009","journal-title":"N. Engl. J. Med."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1016\/j.atherosclerosis.2009.07.024","article-title":"Effects of smoking cessation and weight gain on cardiovascular disease risk factors in Asian male population","volume":"208","author":"Yoon","year":"2010","journal-title":"Atherosclerosis"}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/15\/4\/581\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T14:58:20Z","timestamp":1760194700000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/15\/4\/581"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,3,23]]},"references-count":56,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2018,4]]}},"alternative-id":["ijerph15040581"],"URL":"https:\/\/doi.org\/10.3390\/ijerph15040581","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,3,23]]}}}