Brief report
Willingness of female smokers to tolerate postcessation weight gain

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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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      The relationship between smoking status and body weight serves as a primary motivation for continued smoking (Gritz et al., 1989). Weight loss is often given as a rationale for starting to smoke, while weight gain is often cited as a deterrent for quitting (Bush et al., 2014; Pomerleau and Kurth, 1996). The average weight gain among smokers is estimated between 4 and 5 kg, with a significant proportion of the population gaining well above this average (> 15 kg in 13–33% of ex-smokers), making weight gain a major obstacle to smoking cessation (Aubin et al., 2012; Flegal et al., 1995; Williamson et al., 1991).

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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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