Willingness of female smokers to tolerate postcessation weight gain

doi:10.1016/S0899-3289(96)90215-1

Journal of Substance Abuse

Volume 8, Issue 3, 1996, Pages 371-378

https://doi.org/10.1016/S0899-3289(96)90215-1 Get rights and content

When asked how much weight they would be willing to gain if they quit smoking, women smokers replied 5.0 ± 5.8 pounds (2.3 ± 2.6 kg), compared with 10.7 ± 7.6 pounds (4.9 ± 3.5 kg) for men. Seventy-five percent of women, vs. 35% of men, were unwilling to gain more than 5 pounds (2.3 kg). White women were willing to gain 4.2 ± 4.5 pounds (1.9 ± 2.0 kg) compared with 11.1 ± 10.7 pounds (5.0 ± 4.9 kg) for Black women. In women under 25 years of age, 57% were unwilling to gain any weight at all, but even among women older than 40, 39% were unwilling to gain weight. Willingness to gain was negatively correlated with Body Mass Index, but even among nonoverweight women, 33% were unwilling to gain weight. Similarly, willingness to gain was negatively correlated with restrained eating, but even among low-restraint women, 22% were unwilling to gain weight. These findings suggest that unwillingness to gain is endemic among female smokers, that success in persuading them to accept a gain of more than 5 pounds (2.3 kg) as a final outcome is unlikely, and that strategies for postponing gain until cessation is well established, combined with waiting until weight stabilizes before determining what weight-management measures are needed, may be more effective.

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Cited by (76)

Determinants of smoking related weight-concern in smokers participating in a community-based cessation program
2023, Eating Behaviors
Concern about weight gain is a barrier to smoking-cessation, but determinants of postcessation weight-concern have not been comprehensively assessed in the context of community-based cessation programs.
This cross-sectional analysis used baseline data from a cessation trial of 392 adults randomized to physical activity (PA) or general wellness counseling as adjunctive treatment for smoking. Outcomes were 1) smoking behaviors to control weight and 2) anticipating relapse due to weight gain. Independent variables were PA and perceptions, sociodemographics, psychosocial measures, smoking behavior and perceptions, diet, and BMI. From bivariable models examining main and sex interaction effects, significant variables were entered into a linear (control) or logistic (relapse) regression model to identify key determinants.
For both measures, weight-concern was greater (p < .05) for female smokers (standardized b = 0.52, SE = 0.10; OR = 0.29, 95 % CI = 0.17–0.49), White (b = 0.12, SE = 0.05; OR = 0.39, 95 % CI = 0.23–0.66), and less motivated to quit (b = −0.14, SE = 0.05; OR = 0.77, 95 % CI = 0.59–1.0). Higher scores for smoking to control weight were associated with less PA (b = −0.10, SE = 0.05) and higher BMI (b = 0.21, SE = 0.05). For men, higher BMI was associated with greater anticipation of relapse (OR = 2.54, 95 % CI = 1.42–4.56).
Among adults attempting cessation, women, White smokers, and those less motivated to quit were more likely to smoke for weight control and to relapse due to weight gain. Higher BMI was associated with greater anticipation of relapse for men, but not women. Weight-concerns, for both measures, were not related to smoking history, psychosocial functioning, PA engagement or attitudes, or dietary variables. Results suggest potential cessation intervention targets for weight-concerned smokers.
Smoking and Diabetes: Sex and Gender Aspects and Their Effect on Vascular Diseases
2023, Canadian Journal of Cardiology
Smoking and diabetes mellitus (DM) have been identified as 2 major cardiovascular risk factors for many years. In the field of cardiovascular diseases, considering sex differences, or gender differences, or both has become an essential element in moving toward equitable and quality health care. We reviewed the effect of sex or gender on the link between smoking and DM. The risk of type 2 DM due to smoking has been established in both sexes at the same level. As is the case in the general population, the prevalence of smoking in those with DM is higher in men than in women, although the decrease in smoking observed in recent years is more pronounced in men than in women. Regarding chronic DM complications, smoking is an independent risk factor for all-cause mortality, as well as macrovascular and microvascular complications, in both sexes. Nevertheless, in type 2 DM, the burden of smoking appears to be greater in women than in men for coronary heart disease morbidity, with women having a 50% greater risk of fatal coronary event. Women are more dependent to nicotine, cumulate psychosocial barriers to quitting smoking, and are more likely to gain weight, which might make it more difficult for them to quit smoking. Smoking cessation advice and treatments should take into account gender differences to improve the success and long-term maintenance of abstinence in people with and without DM. This might include interventions that address emotions and stress in women or designed to reach specific populations of men.
Le tabagisme et le diabète sucré (DS) sont considérés comme les deux principaux facteurs de risque cardiovasculaire depuis plusieurs années. Dans le domaine des maladies cardiovasculaires, les différences entre les sexes ou les différences entre les genres, ou les deux, sont maintenant des éléments importants à prendre en considération pour évoluer vers des soins de santé équitables et de qualité. Nous passons en revue les effets du sexe ou du genre sur le lien entre le tabagisme et le DS. Le risque de DS de type 2 en raison du tabagisme a été établi au même niveau dans les deux sexes. Comme c’est le cas dans la population générale, la prévalence du tabagisme chez les personnes atteintes du DS est plus élevée chez les hommes que chez les femmes, bien que la diminution observée du tabagisme au cours des dernières années soit plus marquée chez les hommes que chez les femmes. En ce qui concerne les complications à long terme du DS, le tabagisme est un facteur de risque indépendant de la mortalité toutes causes confondues, ainsi que des complications macrovasculaires et microvasculaires, dans les deux sexes. Néanmoins, lors de DS de type 2, le fardeau du tabagisme semble plus important chez les femmes que chez les hommes en ce qui concerne la morbidité liée à la maladie coronarienne, puisque les femmes montrent un risque 50 % plus élevé de subir un événement coronarien mortel. Les femmes sont plus dépendantes à la nicotine, cumulent les obstacles psychosociaux à la cessation du tabagisme et sont plus susceptibles de prendre du poids. Par conséquent, la cessation du tabagisme pourrait être plus difficile pour elles. Dans les conseils et les traitements pour cesser de fumer, il faudrait tenir compte des différences de genre afin d’accroître la réussite et de favoriser le maintien à long terme de l’abstinence chez les personnes qui sont atteintes ou non du DS. Il pourrait s’agir par exemple d’interventions qui portent sur les émotions et le stress chez les femmes, ou qui sont conçues pour rejoindre des populations particulières d’hommes.
Effects of isolated tobacco alkaloids and tobacco products on deprivation-induced food intake and meal patterns in rats
2018, Pharmacology Biochemistry and Behavior
The ability of smoking to reduce body weight serves as motivation for continued smoking. It is unclear to what extent non-nicotine constituents in cigarettes are contributing to the weight-reducing effect of smoking. The purpose of the current study was to examine the effects of nicotine and four minor tobacco alkaloids (nornicotine, cotinine, anatabine, and anabasine) on food intake, one of the key regulators of body weight. In addition, a smokeless tobacco extract (STE) and e-cigarette (EC) refill liquid were used to model the effects of actual tobacco product exposure on food intake. Male Holztman rats were trained to lever press for food pellets during daily 2 h sessions in operant chambers. In Experiment 1, the effects of subcutaneous injections of saline, nicotine (0.25–1.00 mg/kg), nornicotine (0.50–6.00 mg/kg), cotinine (1.00–100.00 mg/kg), anatabine (0.25–3.00 mg/kg), and anabasine (0.50–4.00 mg/kg) were assessed. In Experiment 2, rats from Experiment 1 were used to examine the effects of nicotine, STE, and EC liquid. All alkaloids, except cotinine, produced a dose-dependent reduction in overall food intake. The highest doses of all drugs significantly reduced latency and response rate to obtain the first pellet. At some doses, nicotine, anatabine, and nornicotine reduced food intake within the first 45 min without compensatory increases in intake later in the session. STE and EC liquid produced dose dependent decreases in food intake similar to nicotine alone. These data suggest that minor tobacco alkaloids have appetite suppressant effects and warrant further investigation into their effects on body weight, energy intake, and energy expenditure under free-feeding conditions. However, findings with STE and EC liquid suggest that nicotine is the primary constituent in these products to affect food intake, whereas levels of minor alkaloids in these products may be too low to influence food intake.
Postcessation weight gain concern as a barrier to smoking cessation: Assessment considerations and future directions
2018, Addictive Behaviors
Concern about postcessation weight gain may be one potential barrier to quitting smoking. In this ‘mini-review’ of recent literature, we summarize findings on the relationship between postcessation weight gain concern and smoking cessation, and evaluate varied use of postcessation weight gain concern assessments and potential moderators of the postcessation weight gain concern-cessation association.
We conducted a search using the terms “smoking” OR “smoking cessation” AND “weight concern” for articles published between January 1, 2011 and December 31, 2016. We identified 17 studies assessing postcessation weight gain concern, seven of which evaluated the postcessation weight gain concern-cessation association.
The relationship between postcessation weight gain concern and smoking cessation was mixed. Recent studies varied in their assessments of postcessation weight gain concern, many of which were not validated and assessed correlates of this construct. Studies varied in their adjustment of demographic (e.g., sex), smoking-specific (e.g., smoking level), and weight-specific (e.g., body mass index) variables.
The use of non-validated assessments and variability in testing covariates/moderators may contribute to conflicting results regarding the postcessation weight gain concern-cessation relationship. We recommend validating an assessment of postcessation weight gain concern, maintaining vigilance in testing and reporting covariates/moderators, and investigating trajectories of this construct over time and by smoking status to inform future assessment and intervention efforts.
Smoking relapse and weight gain prevention program for postmenopausal weight-concerned women: A pilot study
2015, Eating Behaviors
Citation Excerpt :
Research has also demonstrated that smoking cessation-specific weight concern is predictive of failing to initiate a quit attempt after enrolling in a cessation program, a phenomena labeled “prequit attrition” (Copeland et al., 2006a; Namenek Brouwer & Pomerleau, 2000). Whereas younger women may have greater levels of weight concern than older women, there is evidence that smoking cessation-related weight concerns remain high in post-menopausal women and may be a serious deterrent to smoking cessation (Pomerleau & Kurth, 1996). Programs aimed at changing health behaviors have proposed that interventions tailored for the individual, rather than targeted solely toward basic skill acquisition, may be effective in changing behavior.
Postmenopausal women have substantial concerns about weight gain when quitting smoking, which may contribute smoking relapse. There is a need for smoking cessation and weight gain prevention programs effective in this population.
Two formats of a smoking cessation/weight gain prevention follow-up intervention in postmenopausal weight concerned women were compared: a minimally-tailored group format and a highly tailored, multidisciplinary individual format. Effects on sustained abstinence and postcessation weight gain were assessed. Postmenopausal smokers received 6 sessions of behavioral counseling over a 2-week period, 8 weeks of the nicotine transdermal patch, and subsequent random assignment to receive follow-up relapse prevention sessions at 1, 3, 8, and 16 weeks postcessation in either group or individual format.
The sample (N = 98) was 67% Caucasian and 33% African-American. Age: m = 52.3 (7.8) years, follicle stimulating hormone: m = 42.6 (25.7), body mass index (BMI): m = 27.4 (6.2), daily smoking rate: m = 20.3 (11.5), for m = 29.4 (10.7) years, Fagerström Test for Nicotine Dependence (FTND): m = 6.4 (2.1), and carbon monoxide: m = 23.8 (13.0) ppm. Abstinence rates in the group condition were significantly higher at 8 weeks posttreatment. Group format significantly predicted abstinence rates at 8 and 16 weeks posttreatment, even while controlling for age, race, BMI, CPD, years smoking, FTND, and weight concern. Weight concern predicted postcessation weight gain at 8 and 16 weeks posttreatment.
Results indicate that smoking cessation programs for postmenopausal women may best be delivered in a group format and that postcessation weight concerns be dealt with prior to a quit date.
A laboratory-based evaluation of exercise plus contingency management for reducing cigarette smoking
2014, Drug and Alcohol Dependence
Both contingency management (CM) and exercise have shown promise as smoking cessation treatments, but their combined effects have not been evaluated. The present study evaluated whether CM (in which motivational incentives are provided for abstinence) plus exercise reduced smoking more than either component alone.
In a within-subjects design, 20 smokers were exposed to exercise plus CM, exercise plus CM-control (non-contingent incentives), inactivity plus CM, and inactivity plus CM-control.
CM increased latencies to smoke and decreased total puffs (Mdns = 39.6 min and .8 puffs, respectively) relative to CM-control (Mdns = 2.5 min and 12.8 puffs). Exercise decreased craving relative to baseline for craving based on both the pleasurable consequences of smoking (D = −10.7 on a 100-point visual analog scale) and anticipated relief from withdrawal (D = −5.9), whereas inactivity increased both components of craving (Ds = 7.6 and 3.5). Exercise had no effect on smoking or a measure of temporal discounting.
Although exercise decreased craving, it did not affect smoking behavior. Exercise plus CM was not more effective than CM alone.

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: Preparation of this manuscript was supported by Grant HL52981 to Cynthia S. Pomerleau from the National Heart, Lung, and Blood Institute.

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Brief reportWillingness of female smokers to tolerate postcessation weight gain

Journal of American Dietetic Association

Addictive Behaviors

Metabolism

Preventive Medicine

Journal of Substance Abuse

Addictive Behaviors

American Journal of Clinical Nutrition

Journal of Psychosomatic Research

Journal of Clinical Epidemiology

Obese and overweight adults in the United States

Respecting sameness and difference: Taking account of gender in research on smoking

Tobacco Control

The role of weight concern and self-efficacy in smoking cessation and weight gain

Annals of Behavioral Medicine

Smoking cessation in women: Effects of the menstrual cycle

International Journal of the Addictions

The influence of smoking cessation on the prevalence of overweight in the United States

New England Journal of Medicine

Weight concerns and smoking: A literature review

Annals of Behavioral Medicine

Influence of the menstrual cycle on smoking relapse and withdrawal symptoms

Weight change among registered nurses in a self-help smoking cessation program

American Journal of Health Promotion

Nicotine replacement: Effects on postcessation weight gain

Journal of Consulting and Clinical Psychology

Gender differences in tobacco use

Health Psychology

Brief report
Willingness of female smokers to tolerate postcessation weight gain