CR's Take:
		If you want to quit smoking but worry about piling on the pounds, using nicotine replacement products such as lozenges, patches, and gums may help delay--though not prevent--weight gain while you wean yourself off cigarettes. But you should save real attempts at weight loss for after you've quit.

Smokers don't have to choose between "low riders or lung cancer," "bikinis or bronchitis," or a "size 8 or heart disease," according to TV and Web ads for Commit (4 mg) nicotine lozenges. The lozenges, the commercials say, will help you gain less weight as you quit.

It's savvy marketing. In a 2002 survey of 3,663 smokers, more than half the women ranked weight gain as one of their main reasons for not quitting. And while not every smoker gains weight when she quits, research suggests that most will put on 6 to 8 pounds; a minority will put on 30 pounds or more. A recent report even suggests average weight gain estimates may be modest.

Since nicotine suppresses the appetite and speeds up metabolism, smokers typically weigh less than nonsmokers of comparable size. When a smoker gives up the habit, metabolism returns to normal, usually resulting in some weight gain.

So can Commit lozenges really help, as the ads imply? Yes and no. Research shows that Commit, and other types of nicotine replacement such as gums and patches, can help reduce weight gain, but there are some important caveats attached.

When we asked to see the scientific evidence behind their claims for the Commit spots, manufacturer GlaxoSmithKline sent us a study published in the Journal of the American Medical Association in 2002. In that clinical trial of 1,818 smokers, those who were treated with the 4 mg lozenge reduced weight gain by 45 percent after six weeks and 21 percent after 12 weeks vs. those treated with a placebo.

But no nicotine replacement product completely eliminates weight gain, and the weight-suppressing effect occurs only while using the medicines.

What's more, for any smoker to see any effect on his or her weight, he'd have to take the recommended doses of nicotine replacement medication. And data suggest that most smokers typically use much less than directed. "Most people don't use the recommended levels because they're trying to save money or they don't think they need it," explains Dr. Maxine Stitzer, a professor of psychiatry and behavioral sciences at Johns Hopkins University School of Medicine. "But you can't, for example, chew a few pieces of nicotine gum and think that's going to prevent weight gain."

If you're a smoker worried about weight gain, first stop smoking and use any of the nicotine replacement products or even non-nicotine drugs like bupropion to help your chances of quitting. When your cravings subside, you can then focus on weight loss. "It's a two-step approach because studies have found that it's just too hard to deprive yourself of both food and cigarettes," explains Dr. John Hughes, an addiction specialist and psychiatry professor at the University of Vermont. And try to keep in mind that weight gain will not hurt your health as much as continuing to smoke.