Addressing Weight Gain in Smoking Cessation Treatment: A Randomized Controlled Trial

Abstract

Purpose. To evaluate the effectiveness of a cognitive behavioral treatment (CBT) addressing cessation-related weight concerns delivered via a tobacco quitline that does not address weight concerns. Design. Randomized controlled trial, blinded 6-month follow-up. Setting. The Oklahoma Tobacco Helpline (OKHL). Subjects. All 7998 smokers who called the OKHL were screened; 4240 were eligible; 2000 were randomized to the standard quitline (STD) or the brief version of the CBT weight concerns program (WCP). Intervention. Telephone counseling to help people quit smoking and address concerns about cessation-related weight gain. Measures. Demographics, weight, tobacco status, weight concerns, self-efficacy in quitting, and quitting without weight gain. Analysis. Descriptive statistics and logistic regression. Results. Of those randomized, 1002 participants completed the 6-month survey (response rates = 53.2% for STD, 47% for WCP). Compared with STD, WCP led to reduced weight concerns (p < .01) and less weight gain among quitters (1.8 vs. −3.4 pounds; p = .01). Although not significant, participants in the WCP were more likely to report 30-day abstinence (33.3% vs. 36.8%, p = .24; intent to treat = 17.7 vs. 17.3). Conclusion. The WCP was successfully delivered via a quitline and resulted in improved attitudes about weight and decreased cessation-related weight gain without harming quit rates. Promotion of a quitline focused on addressing weight in conjunction with quitline treatment for smoking cessation may improve cessation and weight outcomes. Study limitations include use of self-report and survey response.