Comorbid obesity and smoking is responsible for a substantial burden of personal suffering, functional impairment and disease but this risk is significantly lower for obese ex-smokers. Despite the benefits of cessation, smokers may gain 8 pounds after quitting and some may gain more than 20 pounds. Obese smokers tend to gain larger than average amount of weight after quitting and are more concerned about relapse because of cessation-related weight gain. Integrating weight control into cessation treatment can have a negative impact on cessation and does not lessen weight gain but, adding weight control programs or structured exercise following cessation treatment may limit short term weight gain without affecting quit rates. Alternatively, an intervention addressing weight concerns, discouraging dieting and re-framing negative thinking about weight along with cessation treatment can improve cessation and reduce weight gain compared with integrated weight control or tobacco treatment alone. However, these data come primarily from efficacy trials and do not specifically address the needs of obese smokers. Thus, formative research on practical and targeted interventions that can reach large populations of obese smokers and improve quit rates without excessive weight gain is needed. Tobacco quitlines provide a potential avenue for integration of weight based additions to treatment that may be feasible and acceptable to obese smokers. However, prior to development of new or modified treatments there are several important issues which need to be addressed. For example: is there a need to modify existing quitline services to include weight focused components;will obese smokers be receptive to quitline interventions that promote physical activity, dieting or avoiding dieting? We propose a research study that collects qualitative and quantitative information from quitline participants to better understand the concerns of obese smokers regarding weight gain and to provide data where none exists of the use and effectiveness of a standard tobacco cessation program among obese and non- obese smokers. This study aims to: 1. Explore potential avenues for improving cessation services for obese smokers by conducting in-depth phone interviews with 30 smokers enrolled with a quitline. 2. Determine if obese smokers differ from non-obese smokers in process and outcomes of a standard quitline by conducting baseline and follow-up surveys with 600 adults who enroll with a quitline. 3. Develop a treatment manual (or training manual) for a quitline program tailored to the needs of obese smokers.
This study involves in-depth telephone interviews with 30 obese quitline users to inform development of a larger quitline survey and to understand the needs of obese smokers. The use and effectiveness of quitlines among obese and non obese smokers will be assessed with baseline, 3 and 6 month phone interviews with 600 quitline users.
| Bush, Terry; Hsu, Clarissa; Levine, Michele D et al. (2014) Weight gain and smoking: perceptions and experiences of obese quitline participants. BMC Public Health 14:1229 |
| Bush, Terry M; Levine, Michele D; Magnusson, Brooke et al. (2014) Impact of baseline weight on smoking cessation and weight gain in quitlines. Ann Behav Med 47:208-17 |
| Levine, Michele D; Bush, Terry; Magnusson, Brooke et al. (2013) Smoking-related weight concerns and obesity: differences among normal weight, overweight, and obese smokers using a telephone tobacco quitline. Nicotine Tob Res 15:1136-40 |
