Carole Clair, Nancy A. Rigotti, Bianca Porneala, Caroline S. Fox, Ralph B. D’Agostino, Sr., Michael J. Pencina, , and James B. Meigs
Critique of Association of Smoking Cessation and Weight Change with Cardiovascular Disease Among People With and Without Diabetes
This article presents results of the study investigating the association between weight gain and cardiovascular disease (CVD) among people who have recently stopped smoking. The study made use of data collected FROM 1984 TO 2011 and focused only on very specific categories. These are smoking cessation, cardiovascular disease, and diabetes. The total number of participants has reached 3,251 and follow up was 25 years. The source of the data was the Framingham Offspring Study of Massachusetts which recorded incidence of cardiovascular diseases, including “coronary heart disease, cerebrovascular events, peripheral artery disease, and congestive heart failure” (Clair et al., 2013, Abstract). In particular, the hypothesis of the study was that “weight gain following smoking cessation does not attenuate the benefits of smoking cessation among people with and without diabetes” (Abstract). When people stop smoking they are prone to gain more weight. However, for those with diabetes, weight gain can result in complications. Thus, this study is relevant because it provides scientific evidence of how these different factors (smoking, weight gain, diabetes, and cardiovascular disease) interact and affect each other. Data collection methods as well as data analysis strategies are highly reliable, thus the results can be considered valid. Results of the research showed that “smoking cessation was associated with a lower risk of CVD events among participants without diabetes, and weight gain that occurred following smoking cessation did not modify this association” (Abstract). The research team is also credible because it is comprised of medical doctors and educators with postgraduate degrees. They also come from reputable institutions such as Harvard School of Medicine, Boston University, and Massachusetts General Hospital.
Literature review. The article did not have a separate section with the heading of literature review, however in the introduction and discussion of the results, the authors referred to several related studies. The authors reiterated that there were very few other studies that concentrated on the topic that they were investigating. The researchers claimed that “only one study has indirectly assessed the effect of weight gain following smoking cessation on CVD in people without diabetes” (p.7)
Relevance and timeliness. The research is very much relevant to the health issues of the present society. In the US, ___ of the population are smokers and ___% of smokers start as early as the age of ___. Studies on the effects of tobacco use have proven that this substance is a direct cause of lung cancer, respiratory diseases, and other ailments. There has also been growing evidence of the health effects of second-hand and third-hand smoke. Diabetes, one of the factors investigated in the study currently affects ___ people worldwide. In the US alone ___ Americans are diabetics. Weight gain
Sample size. The number of participants is quite impressive. A large sample size contributes to the validity of the results and it make statistically significant results very trustworthy.
The sample selected was appropriate to the objectives of the study. The authors were looking for evidence that will test their hypothesis and it was necessary to find data that can provide the changes in an individual over a long period of time. To be able to see the effects on CVD, the researchers began with participants with no CVD at examination 3, then they would check the health status of these participants in the succeeding years. The check-ups in the succeeding periods were able to present who developed diseases, such as CVD and diabetes.
Analyzing existing data collected over a long period of time is practical and reliable. However, if the collection of panel data will still commence, it would not be a practical for researchers who are engaged in other fields because of the length of time needed.
Application of research results.
Presentation of data in the article. The information presented in the article is clear and easily understandable. Despite the presence of technical terms, the authors manner of writing was straightforward and there was an effort to explain concepts in lay man’s terms. The tables containing the results of statistical procedures were placed in the appendices. The exclusion of these in the main narrative contributed to the smooth flow of ideas, and enables readers without high mathematical background to understand the meaning of the research.
Further research. More research can be conducted about this subject. First , the factors investigated (weight gain, smoking, CVD, and diabetes) are increasingly becoming health issues for more people. Second, there is a need to provide the public with more information about how these different factors affect the health of an individual and the community. It is also necessary to look at holistic strategies to improve one’s health, and researches like these can facilitate planning and decision-making. Third, this article has emphasized that there is a lack of similar studies, thus academic scholars’ future efforts to conduct research related to the present topic will certainly contribute to the current body of literature.
The reviewed article is very much relevant to the nursing profession. This study has shown that the benefits derived from smoking cessation on cardiovascular diseases is not weakened by the weight gain that quitters may experience. The evidence from this study motivates health practitioners to continue encouraging patients, especially those with diabetes, to stop smoking even if there would be an expected weight gain.
Clair, C., Rigotti, N.A., Porneala, B., Fox,C.S., D’Agostino, R.B. Sr., Pencina,M.J. & Meigs, J.B. (2013). Association of Smoking Cessation and Weight Change with Cardiovascular Disease Among People With and Without Diabetes. Journal of the American Medical Association, 309 (10): 1014-1021. doi:10.1001/jama.20131644. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3791107/pdf/nihms-500750.pdf