More females are initiating cigarette smoking, and a growing proportion cite fear of gaining weight as a major reason for refusing to even attempt quitting smoking. It has not yet been possible, however, to prevent post- cessation weight gain through dieting or behavioral treatment without undermining abstinence from smoking. We propose that prior interventions have been unsuccessful because: (a) their weight management interventions were too complex; (b)the programs thwarted a need of the patient in nicotine withdrawal to eat hedonically appealing, high-carbohydrate snacks; and (c) the programs heightened patients' emphasis on weight control at the expense of their emphasis on smoking cessation by asking them to initiate weight control before or simultaneously with quitting smoking. We have collected pilot data on a promising 16-week intervention that we call the LATE WEIGHT PLAN because it emphasizes smoking cessation for the first half of treatment and integrates weight management for the last half. The weight management module includes a pre-packaged meal plan; high-carbohydrate, low-fat snacks; and low-intensity aerobic exercise. All patients continue in the weight management phase of treatment, regardless of whether they have succeeded in quitting smoking or are preparing to make new quit attempts. Based on pilot findings, we estimate the point prevalence of smoking cessation for the LATE WEIGHT PLAN group to be 74% at the end of treatment, with weight gain less than 5 lb. An EARLY WEIGHT PLAN group controls for the timing of the intervention, using the same target quit smoking date and 16 week program but integrating the weight management module into the first 8 weeks of treatment. Like others, we are finding that EARLY weight management efforts, while they may prevent weight gain, apparently do so at some cost to smoking cessation, which we estimate to be 42% at 4 months. Finally, a CESSATION ONLY group controls for the presence of a weight management intervention, by dealing exclusively with smoking cessation for the entire 16 week program. The CESSATION ONLY group has, thus far, attained the worst outcome in terms of weight control and an intermediate outcome in terms of abstinence at the end of treatment (50%). By randomizing 300 female smokers to the three treatments and comparing abstinence and weight gain after 4 months of treatment and 6 month follow-up (10 months), we aim to test whether a behavioral intervention can indeed achieve the dual goals of promoting smoking cessation and minimizing weight gain.
| Cook, Jessica; Spring, Bonnie; McChargue, Dennis et al. (2010) Effects of anhedonia on days to relapse among smokers with a history of depression: a brief report. Nicotine Tob Res 12:978-82 |
| Schneider, Kristin L; Hedeker, Donald; Bailey, Katherine C et al. (2010) A comment on analyzing addictive behaviors over time. Nicotine Tob Res 12:445-8 |
| Sanchez-Johnsen, Lisa A P; Spring, Bonnie J; Sommerfeld, Beth Kaplan et al. (2005) Weight concerns and smoking in Black and White female smokers. Addict Behav 30:601-5 |
| Spring, Bonnie; Pagoto, Sherry; Pingitore, Regina et al. (2004) Randomized controlled trial for behavioral smoking and weight control treatment: effect of concurrent versus sequential intervention. J Consult Clin Psychol 72:785-96 |
| Richmond, M; Spring, B; Sommerfeld, B K et al. (2001) Rumination and cigarette smoking: a bad combination for depressive outcomes? J Consult Clin Psychol 69:836-40 |
| Fitzgibbon, M L; Spring, B; Avellone, M E et al. (1998) Correlates of binge eating in Hispanic, black, and white women. Int J Eat Disord 24:43-52 |
