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.
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