Addressing weight gain in smoking cessation treatment: a randomized controlled trial.

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.