Weight Gain After Quitting: Attitudes, Beliefs and Counselling Strategies of Cessation Counsellors

Terry Bush, Michele D Levine, Susan Zbikowski, Mona Deprey, Vance Rabius, Tim McAfee, Dawn E Wiatrek, Terry Bush, Michele D Levine, Susan Zbikowski, Mona Deprey, Vance Rabius, Tim McAfee, Dawn E Wiatrek

Abstract

Postcessation weight gain is common and a frequent cause of relapse. Although interventions to address weight gain and weight gain concerns exist, the experience of telephone cessation coun- sellors in addressing weight concerns is unknown. We surveyed 134 cessation counsellors providing quitlines for 30 states regarding their experiences and attitudes about how to address weight gain concerns among smokers trying to quit. Counsellors estimated they discuss weight in 40% of their calls, primarily discussing concerns about gaining weight. Counsellors estimated that smokers gain about 4.1 kg after quitting and about 48% gain more than 2.3 kg. Most counsellors believed that exercise, education about weight gain and preparing smokers for weight gain would help people quit, which is consistent with current science. A total of 51% of counsellors believed that dieting while quitting would reduce weight gain and only 35% correctly identified that dieting reduces a smokers' ability to quit. Some counsellors believed they needed more training in weight management and may need to be reassured that they are currently following treatment guidelines when confronted with smokers who have concerns about postcessation weight gain.

References

    1. Borrelli B, Spring B, Niaura R, Hitsman B, Papandonatos G. Influences of gender and weight gain on short-term relapse to smoking in a cessation trial. Journal of Consulting & Clinical Psychology. 2001;69:511–515.
    1. Chaney SE, Sheriff S. Weight gain among women during smoking cessation: Testing the effects of a multifac-eted program. AAOHN Journal. 2008;56:99.
    1. Clark MM, Hurt RD, Croghan IT, Patten CA, Novotny P, Sloan JA, et al. The prevalence of weight concerns in a smoking abstinence clinical trial. Addictive Behaviors. 2006;31:1144–1152.
    1. Copeland AL, Martin PD, Geiselman PJ, Rash CJ, Kendzor DE. Smoking cessation for weight-concerned women: Group vs. individually tailored, dietary, and weight-control follow-up sessions. Addictive Behaviors. 2006;31:115–127.
    1. Daniel JZ, Cropley M, Fife C. Acute exercise effects on smoking withdrawal symptoms and desire to smoke are not related to expectation. Psychopharmacology. 2007;195:125–129.
    1. Eisenberg D, Quinn BC. Estimating the effect of smoking cessation on weight gain: An instrumental variable approach. Health Services Research. 2006;41:2255–2267.
    1. Fiore MC, Bailey WC, Cohen SJ, Dorfman SF, Goldstein MG, Gritz ER. Treating tobacco use and dependence. Clinical practice guideline (Rep. No. AHRQ publication no. 000032) Washington, DC: US Department of Health and Human Services, Public Health Service; 2000.
    1. Fiore MC, Jaen CR, Baker TB, et al. Treating tobacco use and dependence: 2008 Update. Clinical practice guideline. Rockville, MD: US Department of Health and Human Services, Public Health Service; 2008.
    1. Hall SM, Tunstall CD. Weight gain prevention and smoking cessation: Cautionary findings. American Journal of Public Health. 1992;82:799.
    1. Hughes JR. Tobacco treatment specialists: A new profession. Journal of Smoking Cessation. 2007;2:2–7.
    1. Jeffery RW, Hennrikus DJ, Lando HA, Murray DM, Liu JW. Reconciling conflicting findings regarding postcessation weight concerns and success in smoking cessation. Health Psychology. 2000;19:242–246.
    1. Kawachi I, Troisi RJ, Rotnitzky AG. Can physical activity minimize weight gain in women after smoking cessation? American Journal of Public Health. 1996;86:999.
    1. King N. Template Analysis. In: Symon G, Canell C, editors. Qualitative methods in organizational research: A practical guide. London: Sage Publications; 1998. pp. 118–134.
    1. King N, Carroll C, Newton P, Dornan T. ‘You can’t cure it so you have to endure it’: The experience of adaptation to diabetic renal disease. Qualitative Health Research. 2002;12:329–346.
    1. Klesges RC, Winders S, Meyers A, Eck L, Ward K, Hultquist C, et al. How much weight gain occurs following smoking cessation? A comparison of weight gain using both continuous and point prevalence abstinence. Journal of Consulting & Clinical Psychology. 1997;65:286–291.
    1. Marcus BH, Lewis BA, Hogan J, King TK, Albrecht AE, Bock B, et al. The efficacy of moderate-intensity exercise as an aid for smoking cessation in women: A randomized controlled trial. Nicotine Tobacco Research. 2005;7:871–880.
    1. Marcus BH, Albrecht AE, King TK, Parisi AF, Pinto BM, Roberts M, et al. The efficacy of exercise as an aid for smoking cessation in women: A randomized controlled trial. Archives of Internal Medicine. 1999;159:1229–1234.
    1. Meyers AW, Klesges RC, Winders SE, Ward KD, Peterson BA, Eck LH. Are weight concerns predictive of smoking cessation? A prospective analysis. Journal of Consulting & Clinical Psychology. 1997;65:448–452.
    1. O’Hara P, Connett JE, Lee WW, Nides M, Murray R, Wise R. Early and late weight gain following smoking cessation in the Lung Health Study. American Journal of Epidemiology. 1998;148:821–830.
    1. Ossip-Klein DJ, McIntosh S. Quitlines in North America: Evidence base and applications. The American Journal of the Medical Sciences. 2003;326:201–205.
    1. Perkins KA, Marcus M, Levine M, D’Amico D, Miller A, Broge M, et al. Cognitive–behavioral therapy to reduce weight concerns improves smoking cessation outcome in weight-concerned women. Journal of Consulting & Clinical Psychology. 2001;69:604–613.
    1. Pirie PL, McBride CM, Hellerstedt W, Jeffery RW, Hatsukami D, Allen S, et al. Smoking cessation in women concerned about weight. American Journal of Public Health. 1992;82:1238–1243.
    1. Spring B, Doran N, Pagoto S, Schneider K, Pingitore R, Hedeker D. Randomized controlled trial for behavioral smoking and weight control treatment: Effect of concurrent versus sequential intervention. Journal of Consulting & Clinical Psychology. 2004;72:785–796.
    1. Williams DM, Lewis BA, Dunsiger S, Marcus BH. The effect of moderate intensity exercise on smoking cessation. Medicine & Science in Sports & Exercise. 2005;37:S175.
    1. Williamson DF, Madans J, Anda RF, Kleinman JC, Giovino GA, Byers T. Smoking cessation and severity of weight gain in a national cohort. The New England Journal of Medicine. 1991;324:739.

Source: PubMed

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