Gut microbiota modulates weight gain in mice after discontinued smoke exposure

Cigarette smoking constitutes a leading global cause of morbidity and preventable death 1 , and most active smokers report a desire or recent attempt to quit 2 . Smoking-cessation-induced weight gain (SCWG; 4.5 kg reported to be gained on average per 6–12 months, >10 kg year –1 in 13% of those who stopped smoking 3 ) constitutes a major obstacle to smoking abstinence 4 , even under stable 5 , 6 or restricted 7 caloric intake. Here we use a mouse model to demonstrate that smoking and cessation induce a dysbiotic state that is driven by an intestinal influx of cigarette-smoke-related metabolites. Microbiome depletion induced by treatment with antibiotics prevents SCWG. Conversely, fecal microbiome transplantation from mice previously exposed to cigarette smoke into germ-free mice naive to smoke exposure induces excessive weight gain across diets and mouse strains. Metabolically, microbiome-induced SCWG involves a concerted host and microbiome shunting of dietary choline to dimethylglycine driving increased gut energy harvest, coupled with the depletion of a cross-regulated weight-lowering metabolite, N -acetylglycine, and possibly by the effects of other differentially abundant cigarette-smoke-related metabolites. Dimethylglycine and N -acetylglycine may also modulate weight and associated adipose-tissue immunity under non-smoking conditions. Preliminary observations in a small cross-sectional human cohort support these findings, which calls for larger human trials to establish the relevance of this mechanism in active smokers. Collectively, we uncover a microbiome-dependent orchestration of SCWG that may be exploitable to improve smoking-cessation success and to correct metabolic perturbations even in non-smoking settings.