Smoking cessation is difficult for anyone, but those who are overweight or obese face additional challenges due to their fear of further weight gain if they kick the habit.
To address this dynamic, Marney A. White, Ph.D., M.S., associate professor in the Department of Chronic Disease Epidemiology at the Yale School of Public Health, and her research team conducted a randomized control trial of an Internet-administered smoking cessation treatment for overweight and obese smokers.
Smokers who were overweight or obese volunteered for a treatment that consisted of either 12 weeks of nicotine replacement therapy and cognitive behavioral therapy (CBT) or health education. Smoking cessation was measured 12 weeks after smokers’ quit date and then again 24 weeks later.
The study found that CBT was more effective than health education treatment for regulating weight gain among participants who remained tobacco free.
Researchers also found that smokers who are concerned about weight gain are less likely to seek treatment and have reported shorter quit attempts and a higher expectation of relapse if they gain weight. A substantial proportion of smokers reported that a post-quit weight gain caused them to abort their efforts to quit. The findings have implications for clinicians and other researchers working on smoking cessation.
“There is a need for tailored smoking cessation treatments for smokers who are overweight or obese, because the combined effect of smoking and obesity on health outcomes is quite grave,” said White.
While smokers tend to weigh less than their non-smoking peers, the health benefits of lower weight are offset by the negative health consequences of smoking. For example, cardiovascular risk is about 3.5 to 5 times greater for obese individuals who also smoke.
Many smokers are discouraged from trying to quit due to the prospect of gaining weight following cessation, which is associated with modest weight gain. Therefore, the researchers concluded that more treatments that address post-cessation weight gain are needed, particularly for smokers who are at greater health risk due to their overweight/obese status.
Valentina Ivezaj, associate research scientist in psychiatry at the Yale School of Medicine and Carlos M. Grilo, Yale professor of psychiatry and of psychology, co-authored the paper. The study appears in the Journal of Health Psychology.