BMJ 1999;319:490-494 ( 21 August )

General Practice

Open randomised trial of intermittent very low energy diet together with nicotine gum for stopping smoking in women who gained weight in previous attempts to quit

Tobias Danielsson, clinical research manager, ^a Stephan Rössner, professor of health behaviour research, Karolinska Institute, ^a Åke Westin, biostatistician. ^b

^a Obesity Unit, Karolinska Hospital, S-171 76 Stockholm, Sweden, ^b Pharmacia and Upjohn Consumer Healthcare, S-251 09 Helsingborg, Sweden

Correspondence to: T Danielsson, Obesity Unit, Huddinge University Hospital, S-141 86 Huddinge, Sweden tobias.danielsson{at}medhs.ki.se

Objective: To determine whether attempts to prevent weight gain will increase success rates for stopping smoking.
Design: 16 week, open, randomised study with 1 year follow up.
Setting: Obesity unit.
Subjects: 287 female smokers who had quit smoking before but started again because of weight concerns.
Intervention: Combination of a standard smoking cessation programme with nicotine gum and a behavioural weight control programme including a very low energy diet. A control group was treated with the identical programme but without the diet.
Main outcome measure: Sustained cessation of smoking.
Results: After 16 weeks, 68/137 (50%) women had stopped smoking in the diet group versus 53/150 (35%) in the control group (P=0.01). Among these women, weight fell by mean 2.1 (95% confidence interval 2.9 to 1.3) kg in the diet group but increased by 1.6 (0.9 to 2.3) kg in the control group (P<0.001). After 1 year the success rates in the diet and control groups were 38/137 (28%) and 24/150 (16%) respectively (P<0.05), but there was no statistical difference in weight gain.
Conclusions: Combining the smoking cessation programme with an intervention to control weight helped women to stop smoking and control weight.

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