Different strategies of behavior modification and various treatment modalities often are necessary. Weight gain is a concern, particularly in women, who may use tobacco as a weight control measure because it suppresses appetite and slightly increases the basal metabolic rate. This modest weight gain is not a health hazard compared with the risk of morbidity and premature death from continued tobacco use. Dietary consultation, nicotine replacement, and increased exercise coincident with smoking cessation can help prevent weight gain. Exercise may also reduce the craving for tobacco.
Some smokers use tobacco to combat depression .
Thus, depressed patients who attempt to quit smoking must be counseled, and the physicians and patient need to be alert to the possibility of worsening depression. Bupropion is also widely used as an antidepressant and may be particularly useful in persons who are depressed or at risk of depression. The Merck Manual of Diagnosis and Therapy . Merck Research Laboratories. Whitehouse Station, NJ 1999 Chapter 290, pp 2486-2490.