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A randomized controlled trial to reduce post-cessation weight gain

International Journal of Obesity volume 47, pages 471–478 (2023)Cite this article

Subjects

Abstract

Background/Objectives

Weight gain is a barrier to smoking cessation. Previous interventions targeting weight gain while quitting smoking have largely been unsuccessful. The current study aimed to assess the efficacy of weight stability and weight loss interventions compared to a low-intensity, self-guided bibliotherapy weight management group.

Subjects/Methods

A randomized controlled trial with 12-month follow-up from 2018 to 2022 was conducted with participants (N = 305) who reported smoking at least five cigarettes per day for the last year and interest in quitting initially recruited from the Memphis, TN, USA area. Recruitment was expanded nationally with the onset of the COVID-19 pandemic. Subsequently, 276 completed 12-month follow-up.

Interventions/Methods

The Bibliotherapy group was provided a weight management book. Both the Stability and Loss groups met via telephone for eight weeks to learn strategies for maintaining/losing weight, respectively. All three groups then received the same six-week smoking cessation intervention, with six months of varenicline provided.

Results

Individuals in the Loss group lost more weight (−2.01 kg, SE = 1.58) than individuals in the Bibliotherapy group (+1.08 kg, SE = 1.49, p = 0.0004), while the Stability group (−0.30 kg, SE = 1.56) was not significantly different from the Bibliotherapy group (p = 0.17). Those in the Stability group did not gain a significant amount of weight. Participants in the Loss group did not gain back all weight lost after smoking cessation and ended the study approximately 2.01 kg lower than baseline. The Bibliotherapy group did not gain the amount of weight expected after cessation. There were no significant differences between groups related to self-reported smoking cessation at each time point except at eight-month follow-up (p = 0.005).

Conclusions and relevance

Results indicated the Stability and the Loss interventions were effective for preventing post-smoking cessation weight gain, with the Loss group having the benefit of sustained weight loss. These interventions may be helpful to implement to combat weight gain and potentially facilitate smoking cessation.

Trial Registration

The trial is registered on clinicaltrials.gov (NCT03156660).

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Fig. 1: CONSORT diagram.
Fig. 2: Self-reported and biochemically-verified abstinence across the follow-up visits.
Fig. 3: Weight change over time by intervention condition.

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Data availability

Data will be made available upon reasonable request. Materials are available upon request from R. Krukowski.

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Funding

NIDDK R01 DK107747.

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Authors and Affiliations

  1. The University of Memphis, Department of Psychology, 400 Innovation Drive, Memphis, TN, 38152, USA

    Kinsey Pebley

  2. Florida International University, Department of Biostatistics, Miami, FL, 33199, USA

    Zoran Bursac

  3. University of Virginia, School of Medicine Department of Public Health Sciences, PO Box 800765, Charlottesville, VA, 22903, USA

    Robert C. Klesges, Melissa A. Little & Rebecca A. Krukowski

  4. Mayo Clinic, Department of Medicine, 200 1st Street SW, Rochester, MN, 55905, USA

    Jon O. Ebbert

  5. University of Tennessee Health Science Center, Department of Preventive Medicine, 66 N Pauline St, Memphis, TN, 38105, USA

    Catherine R. Womack, Julia Graber & Karen J. Derefinko

Authors
  1. Kinsey Pebley
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  2. Zoran Bursac
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  3. Robert C. Klesges
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  4. Jon O. Ebbert
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  5. Catherine R. Womack
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  6. Julia Graber
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  7. Melissa A. Little
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  8. Karen J. Derefinko
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  9. Rebecca A. Krukowski
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Contributions

KP was responsible for writing the original draft of the manuscript and editing. ZB was responsible for conducting statistical analyses and editing the manuscript. RCK, JE, CW, JG, ML, KD, and RAK were responsible for providing edits for the manuscript. RAK also secured funding. KD, RAK, RCK, JE, and CW established study procedures and, along with KP and JG, collected study data.

Corresponding author

Correspondence to Rebecca A. Krukowski.

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The authors declare no competing interests.

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Pebley, K., Bursac, Z., Klesges, R.C. et al. A randomized controlled trial to reduce post-cessation weight gain. Int J Obes 47, 471–478 (2023). https://doi.org/10.1038/s41366-023-01286-5

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