Elsevier

Addictive Behaviors

Volume 23, Issue 5, September–October 1998, Pages 609-622
Addictive Behaviors

The role of weight concern and self-efficacy in smoking cessation and weight gain among smokers in a clinic-based cessation program

https://doi.org/10.1016/S0306-4603(98)00014-8Get rights and content

Abstract

Although the majority of smokers are concerned about postcessation weight gain, few studies have investigated the prospective relationship between weight concern and smoking and weight outcomes, or a mechanism by which concern is related to these outcomes. We investigated the prospective role of smoking-specific weight concern in smoking cessation and weight gain among participants in a smoking-cessation clinic, and we hypothesized that domain-specific self-efficacy would be a mediator of these relationships. While weight concern did not prospectively predict smoking status, increased weight concern predicted weight gain at the end of treatment and at 3-month follow-up. Self-efficacy for preventing postcessation weight gain mediated this relationship; lower levels were related to a greater likelihood of weight gain. Weight gain was found to be associated with subsequent relapse among abstainers. Implications and treatment recommendations are discussed.

Section snippets

Subjects

Subjects were 122 participants (66% female) in a smoking-cessation program, recruited through newspaper advertisements. Eligible subjects were those who were regular, daily smokers over the age of 18. They averaged 43.6 years of age (SD = 9.7), and 14.8 years of education (SD = 2.0). The ethnic composition was 55% Caucasian, 39% African-American, and 3.3% Hispanic. Subjects smoked an average of 23.3 cigarettes per day (SD = 12.7) of moderate nicotine strength (M = .85 mg, SD = .33) and had a

Preliminary analyses

Women reported significantly higher levels of concern about postcessation weight gain both at baseline (M = 5.7, SD = 2.1) and end of treatment (M = 6.1, SD = 3.3) than did men at baseline (M = 3.9, SD = 2.0; t = −4.22, df = 107, p < .0001) and end of treatment (M = 3.2, SD = 2.9; t = −4.36, df = 97, p < .0001). There were no significant differences in the mean level of weight concern between Caucasians and African-Americans at either baseline (t = .08, df = 101, ns) or at week 7 (t = .01, df =

Discussion

The aims of the present study were to (1) examine the role of weight concern in the prediction of smoking and weight outcomes; (2) establish the domain specificity of self-efficacy; and (3) assess the mediational role of self-efficacy in the relationship between weight concern and smoking and weight outcomes. Overall, the results suggest that self-efficacy is best assessed as a domain-specific construct, and concern about postcessation weight gain prospectively predicts weight, but not smoking

Acknowledgements

This research was partly supported by NHLBI Grant RO1-HL42485 and was presented in part at the 16th Annual Meeting of the Society of Behavioral Medicine, San Diego, CA, 1995. We thank David Abrams, Daniel Cervone, Lawrence Grimm, Michele Kelley, Bess Marcus, David McKirnan, Raymond Niaura, and William Shadel for their valuable comments.

References (41)

  • A. Bandura et al.

    Cognitive processes mediating behavioral change

    Journal of Personality and Social Psychology

    (1977)
  • R.M. Baron et al.

    The moderator-mediator variable distinction in social-psychological researchConceptual, strategic, and statistical considerations

    Journal of Personality and Social Psychology

    (1986)
  • Borrelli, B., & Mermelstein, R. (1994a, April). Weight concern, gender differences, and relapse after smoking...
  • B. Borrelli et al.

    Goal setting and behavior change in a smoking cessation program

    Cognitive Therapy and Research

    (1994)
  • K. Brownell

    Understanding and treating a serious prevalent and refractory disorder

    Journal of Consulting and Clinical Psychology

    (1982)
  • T.H. Brandon et al.

    The Smoking Consequences QuestionnaireThe subjective expected utility of smoking in college students

    Psychological Assessment

    (1991)
  • D.E. Camp et al.

    The relationship between body weight concerns and adolescent smoking

    Health Psychology

    (1993)
  • Centers for Disease Control

    Cigarette smoking among adultsUnited States, 1993

    MMWR

    (1994)
  • D. Cervone et al.

    Goal-setting and the differential influence of self-regulatory processes on complex decision-making performance

    Journal of Personality and Social Psychology

    (1991)
  • Cervone, D., & Scott, W. (1995). Self-efficacy theory of behavioral change: Foundations, conceptual issues, and...
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