Researchers at the University of Pittsburgh School of Medicine found that a treatment program that focuses on reducing women's concerns about weight is the first treatment to significantly improve smoking cessation in weight-concerned women. Previous interventions for weight-concerned women assumed that the best approach to fostering smoking cessation was to help them prevent any weight gain after they quit smoking. This study, as well as other research, indicates that this assumption is not correct, and that directly reducing the concerns about weight, rather than the weight gain itself, is what will help these women quit smoking.
The study, by a research team led by Dr. Kenneth A. Perkins and Dr. Marsha Marcus, is published in the August, 2001 issue of Journal of Consulting and Clinical Psychology.
"Quitting smoking tends to be harder for women than for men, and part of this disparity is attributable to women's greater fear of gaining a lot of weight if they quit, " says NIDA Director Dr. Alan I. Leshner. "It would be an important clinical advance if we find a way to successfully address those concerns, making it easier for more women to stop smoking."
The Pittsburgh investigators randomly assigned 219 women smokers who wanted to stop smoking, but were worried about gaining weight, to one of three smoking cessation groups. One of the groups received standard smoking cessation therapy, where weight gain was not explicitly addressed. Another group received the same smoking cessation program plus diet advice to prevent weight gain (i.e. weight control). The third group received the standard smoking cessation program and therapy to reduce their concern about gaining weight, but dieting was discouraged in this group. Among the factors emphasized in this counseling was that the health benefits of quitting smoking superseded the health risks of even large amounts of weight gain.
In each of the groups, 10 sessions were conducted over 7 weeks. No medication of any kind was provided.One year after treatment, 21 percent of the women who received therapy to allay their concerns about weight gain had completely quit smoking (with no relapses), compared to 13 percent of the weight control group, and 9 percent of the standard therapy group.
The women in the study did gain weight after quitting smoking. Those in the weight control group initially had the smallest weight gain, as expected, but as time went on, their weight gain was comparable to women in the standard therapy group. Surprisingly, the women in the group receiving therapy to allay their concerns about weight gain fared the best in terms of preventing weight gain. At one-year follow-up after treatment, they had gained less weight than women in either the weight control or the standard therapy groups. Women in the weight counseling group gained, on average, 5.5 pounds, while women in the weight control and the standard therapy groups gained on average 11.9 pounds and 16.9 pounds, respectively.
Dr. Perkins says these results indicate that "the critical factor influencing smoking relapse in women concerned about gaining weight may be the women's over-concern about weight gain, rather than the experience of weight gain itself."