Despite weight loss, cigarette exposure worsens insulin resistance [73], even with passive exposure, in a dose-dependent manner [74], predisposing to the metabolic syndrome as a consequence [73]; alternatively, smoking cessation may also lead to changes that favor the development of insulin resistance, depending on the resulting variations in body weight [75]. Smoking is also associated with worsening visceral adiposity independently of changes in BMI [76], which helps explain the paradox of increased metabolic risk associated with visceral adiposity, despite overall weight loss. However, the incidence of metabolic syndrome may not be increased if weight loss is associated with a net loss of central adiposity [77]. Other potential mechanisms of nicotine-induced insulin resistance, born out of cell culture, rodent and human studies