Weight control smoking among sedentary women

doi:10.1016/S0306-4603(98)00034-3

Addictive Behaviors

Volume 24, Issue 1, January–February 1999, Pages 75-86

https://doi.org/10.1016/S0306-4603(98)00034-3 Get rights and content

Abstract

This study examined characteristics associated with weight control smoking among 281 sedentary women enrolled in a smoking cessation trial. A series of regression models were developed to identify predictors of weight control smoking as measured by the Smoking Situations Questionnaire. Predictor variables included demographic variables, dietary intake, weight gain following previous quit attempts, dietary restraint, self-efficacy for weight management, smoking behavior, exercise behavior, negative affect and psychological constructs relevant to smoking cessation, and exercise adoption. In the final predictor model, anticipation of weight gain in the current quit attempt, higher dietary restraint, younger age, greater Fagerstrom scores, greater number of pounds gained in previous quit attempts, and lower levels of self-efficacy to manage weight in negative affect situations were associated with smoking for weight control. Treatment implications for women who smoke for weight control reasons are discussed.

Section snippets

Method

Data for the present investigation comprise part of the baseline data from a larger study designed to compare the efficacy of a 12-session cognitive-behavioral smoking cessation treatment plus supervised vigorous exercise with the same cessation treatment plus contact control (Marcus et al., 1997).

Demographic factors

In the stepwise multiple regression model, demographic variables such as race, occupation, marital status, and education did not significantly enter the model over and above age and baseline BMI, which were forced into the equation first and second, respectively. Both age and BMI significantly entered the model (F = 10.2, df = 2,268, p < .0001), such that older age was associated with lower levels of smoking for weight control (β = .14) and greater BMI was associated with higher levels of

Discussion

Our primary purpose in this study was to examine the characteristics associated with smoking for weight control among women enrolled in a smoking cessation program. In our final model we found that several variables were independently associated with greater levels of smoking for weight control: anticipation of postcessation weight gain, higher levels of dietary restraint, younger age, greater number of pounds gained during previous quit attempts, higher Fagerstrom scores, and lower

Acknowledgements

This project was supported in part through grants from the National Cancer Institute (KO7CA01757 and R29CA59660) and a supplement to R29CA59660 from the Office of Research on Women’s Health, to Dr. Marcus.

We acknowledge and thank David Abrams, PhD, Anna Albrecht, RN, MS, and Alfred Parisi, MD, for their contributions to this trial. We thank Regina Traficante, MA, and Janice Tripolone, BS, for their numerous contributions to the implementation of this study. We also thank Barbara Doll for her

References (52)

K.O. Fagerstrom
Measuring degree of physical dependence to tobacco smoking with reference to individualization of treatment
Addictive Behaviors
(1978)
S.A. French et al.
Do weight concerns hinder smoking cessation efforts?
Addictive behaviors
(1992)
B.H. Marcus et al.
Rationale, design, and baseline data for Commit to QuitAn exercise efficacy trial for smoking cessation in women
Preventive Medicine
(1997)
C.S. Pomerleau et al.
The female weight-control smokerA profile
Journal of Substance Abuse
(1993)
J.A. Streater et al.
A study of factors associated with weight change in women who attempt smoking cessation
Addictive Behaviors
(1989)
C.K. Weekley et al.
Smoking as a weight control strategy and its relationship to smoking status
Addictive Behaviors
(1992)
J.J. Wurtman
Depression and weight gainThe serotonin connection
Journal of Affective Disorders
(1993)
S.N. Zulkifli et al.
The food frequency method for dietary assessment
Journal of the American Dietetic Association
(1992)
D.B. Abrams et al.
Psychosocial stress and coping in smokers who relapse or quit
Health Psychology
(1987)
American Psychiatric Association. (1987). Diagnostic and statistical manual of mental disorders (3d ed. rev.)....

A.W. Bendig

The development of a short form of the manifest anxiety scale

Journal of Consulting & Clinical Psychology

(1956)

S.N. Blair et al.

Assessment of habitual physical activity by seven-day recall in a community survey and controlled experiments

American Journal of Epidemiology

(1985)

G. Block et al.

A data-based approach to diet questionnaire design and testing

American Journal of Epidemiology

(1986)

Borrelli, B., Mermelstein, R., & Shadel, W. G. (1995). The role of weight concern and self-efficacy in smoking...

D.E. Camp et al.

The relationship between body weight concerns and adolescent smoking

Health Psychology

(1993)

M.M. Clark et al.

Self-efficacy in weight management

Journal of Consulting & Clinical Psychology

(1991)

C.C. DiClemente et al.

The process of smoking cessationAn analysis of precontemplation, contemplation and preparation stages of change

Journal of Consulting & Clinical Psychology

(1991)

C.C. DiClemente et al.

Self-efficacy and the stages of self-change of smoking

Cognitive Therapy & Research

(1985)

J. Duffy et al.

Smoking abstinence, eating style, and food intake

Journal of Consulting & Clinical Psychology

(1988)

M.C. Fiore et al.

Trends in cigarette smoking in the United StatesThe changing influence of gender and race

Journal of the American Medical Association

(1989)

S.A. French et al.

Weight concerns and smokingA literature review

Annals of Behavioral Medicine

(1995)

S.A. French et al.

Weight concerns and change in smoking behavior over two years in a working population

American Journal of Public Health

(1995)

S.A. French et al.

Weight concerns, dieting behavior, and smoking initiation among adolescentsA prospective study

American Journal of Public Health

(1994)

E.R. Gritz et al.

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

American Journal of Health Promotion

(1990)

S.M. Hall et al.

Smoking cessation and weight gain

Journal of Consulting and Clinical Psychology

(1986)

S.M. Hall et al.

Weight gain prevention and smoking cessationCautionary findings

American Journal of Public Health

(1992)

Cited by (41)

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.
Understanding daily life experiences of women who smoke: The role of smoking-related weight control expectancies
2022, Addictive Behaviors
Citation Excerpt :
Scores range from 0 to 10 with higher scores indicating greater cigarette dependence. FTCD was included as a planned covariate given the association of cigarette dependence with weight control motives (Pinto et al, 1999). The 5-item Weight Control subscale (e.g., “Smoking controls my appetite”) of the Smoking Consequence Questionnaire (SCQ; Brandon and Baker, 1991; Wetter et al., 1994) was used to assess smoking-related weight control expectancies.
Smoking-related weight control expectancies are a motivational factor for maintaining cigarette use, particularly among women. Yet, less research has investigated the physiological and behavioral daily life weight-related experiences of women with smoking-related weight control expectancies. Increased research could contribute to understanding of maintenance factors for this group of smokers as well as unique intervention targets. Female smokers completed a baseline survey of smoking-related weight control expectancies and 35-days of ecological momentary assessment of physiological (i.e., smoking-related reduction in hunger, end-of-day perceived weight gain and bloating) and behavioral (i.e., daily exercise and sitting) weight-related experiences. Higher smoking-related weight control expectancies were associated with perceived smoking-related reductions in hunger and end-of-day perceived weight gain. Smoking-related weight control expectancies did not significantly associate with end-of-day bloating, daily exercise, or sitting. Given these findings, smoking-related weight control expectancies may maintain smoking in order to reduce hunger and to cope with perceived fluctuations in weight in daily life. It is critical for smoking cessation programs to assess smoking-related weight control expectancies and implement targeted treatments for these women.
A Cognitive-Behavioral Weight Control Program Improves Eating and Smoking Behaviors in Weight-Concerned Female Smokers
2009, Journal of the American Dietetic Association
Many people use smoking as a weight control mechanism and are averse to quitting for fear of weight gain. These weight-concerned smokers tend to be women, are significantly less likely to stop smoking or to join smoking cessation programs, and will relapse more often than smokers who are not weight-concerned. Research suggests that a woman's motivation to quit smoking correlates positively with her confidence in her ability to control her weight after quitting. Likewise, success in smoking cessation has been associated with increased self-efficacy for weight control. This randomized controlled trial investigated the effects of a weight control program on eating and smoking behaviors in a group of female, weight-concerned smokers from July 2005 to June 2006. Two hundred sixteen subjects who wanted to lose weight but were not yet ready to quit smoking were recruited to participate in a 12-week, cognitive-behavioral weight control program consisting of 12 1-hour sessions. Subjects were randomly assigned to either the weight-control program (intervention group) or the control group. Differences between the intervention and control groups were evaluated using t tests for continuous variables, Wilcoxon rank-sum tests for ordinal variables and χ² tests for categorical variables. The intervention group had a 14% increase (P<0.001) in self-efficacy for weight control (Weight Efficacy Life-Style Questionnaire), which was associated with improved diet quality (Healthy Eating Index) (r=0.292, P<0.01), weight loss (r=0.582, P<0.001), increased self-efficacy for quitting smoking (Smoking Self-Efficacy Questionnaire) (r=0.291, P<0.014), a decrease in number of cigarettes smoked (r=0.331, P<0.005), and positive movement in stage of change toward smoking cessation (r=0.435, P<0.001). These findings suggest that for this group of weight-concerned smokers' success in changing eating behavior may trigger a positive change in smoking behavior.
Psychosocial factors associated with weight control expectancies in treatment-seeking African American smokers
2009, Journal of the National Medical Association
African Americans are disproportionately affected by tobacco smoking and obesity. As weight control expectancies can reinforce smoking maintenance, the purpose of this study was to explore psychosocial factors related to expectancies for weight control among African Americans seeking cessation treatment. African American smokers (N = 117) provided information on demographics, family medical history, personal risk factors, smoking, weight control expectancies and concerns, perceived stress, and acculturation. Multivariate analyses examined hypotheses regarding determinants of weight control expectancies. Fifty-one percent of participants were concerned about gaining weight upon cessation. Positive expectations for weight control through smoking were associated with older age, a family history of heart disease, greater perceived stress, and a lower level of acculturation.
In conclusion, many African American smokers are concerned about postcessation weight gain; expectations for weight control through smoking are most evident those with elevated perceived stress, traditional African American cultural values, and a family history of chronic illness. Needed are culturally specific smoking cessation interventions that include weight management strategies as an adjunct to smoking cessation treatments.
Eating and weight concerns during smoking cessation: Literature review and implications for psychological interventions
2009, Journal de Therapie Comportementale et Cognitive
Des travaux récents ont porté sur les difficultés à initier et maintenir les patients dans des démarches structurées d’accompagnement de l’arrêt du tabac. Les préoccupations concernant la prise de poids au cours de cette démarche ont été particulièrement étudiées. L’arrêt est accompagné par une prise de poids et ces préoccupations sont plus fréquentes chez les femmes. Parmi ces patients, beaucoup ne sont pas prêts à faire des efforts pour cesser de fumer. Ils ont également tendance à abandonner les traitements en cours et ont moins de succès dans leur démarche. De nombreuses femmes semblent utiliser la consommation de tabac comme un comportement compensatoire, en plus de conduites alimentaires péjoratives et d’autres comportements compensatoires variés comme les régimes, les jeûnes, les vomissements et les exercices physiques. Afin de les accompagner dans les programmes d’arrêt, il est important d’aborder les difficultés liées à l’image du corps en lien avec l’estime de soi, les comportements alimentaires et la dépendance au tabac. Plusieurs domaines doivent être explorés : les caractéristiques anthropométriques, le niveau de dépendance, les comportements compensatoires, les préoccupations pondérales, le niveau de confiance dans sa capacité à contrôler son poids, les restrictions cognitives et les troubles alimentaires, le niveau de satisfaction vis-à-vis de l’image du corps, l’existence d’autres troubles psychiatriques et la motivation à l’arrêt. Différentes stratégies d’accompagnement sont intégrées à partir de programmes éprouvés dans l’obésité et les troubles alimentaires, et à partir des thérapies cognitives, de l’approche transthéorique et des entretiens motivationnels.
Recent attention has been paid to the difficulty in recruiting and retaining patients in smoking cessation programs. Worry about cessation-related weight gain has received substantial attention. Smoking cessation is accompanied by weight gain, and weight gain worries are more frequent among women than men. Many of these patients are unlikely to try to quit smoking. They are also likely to drop out of treatment, less likely to quit successfully or abandon their quit attempts early. Many women seem to use smoking as a “compensatory behaviour” This concerns essentially women, who are engaged in a pattern of unhealthy nutritional practices and compensatory behaviours, including dieting, fasting, purging, and physical exercise. In order to help women in smoking cessation programs, we discuss the need to address body image disturbance itself, in association with self-esteem, eating patterns and smoking dependence. Several domains have to be measured and explored during functional analysis: anthropometrics data, level of dependence, “compensatory” behaviours, weight preoccupations, confidence in the capacity to control weight, cognitive restrictions and eating disorders, level of body-image satisfaction, psychiatric disorders, and motivation for quitting. Different strategies are incorporated from many disorder treatment programs, including the leading evidence-based for obesity and eating disorders, the cognitive therapy, the transtheoretical approach and the motivational interviewing.
Smoking-related weight control expectancies among African American light smokers enrolled in a smoking cessation trial
2008, Addictive Behaviors
Citation Excerpt :
Post cessation weight gain has frequently been described as a deterrent to cessation, especially among women (French & Jeffery, 1995; Perkins, Epstein, Grobe, & Fonte, 1994). Smoking for weight control has been associated with several variables including younger age, greater nicotine dependence, restrained eating (i.e., restricting eating in order to lose weight or prevent weight gain), and lower levels of self-efficacy to manage weight (Pinto et al., 1999). Although weight concern has been found to be a disincentive to cessation in several cross-sectional studies (Fletcher & Doll, 1969; Klesges, Somes et al., 1988; Loken, 1982; Ogden & Fox, 1994; Streater, Sargent, & Ward, 1989; Weekly, Klesges, & Reylea, 1992), prospective studies have yielded mixed results (French, Jeffery, Klesges, & Forster, 1995; Klesges, Brown et al., 1988; Meyers et al., 1997; French et al., 1995; French, Jeffery, Pirie, & McBride, 1992; Jeffery, Boles, Strycker, & Glasgow, 1997; Jeffery, Hennrikus, Lando, Murray, & Liu, 2000).
Concern about weight gain following smoking cessation has been frequently described in the literature. However, little is known about smoking-related weight expectancies among African American, light smokers (defined as ≤ 10 cigarettes per day [CPD] for > 25 of last 30 days). Given the high rate of obesity among African Americans, concern about weight gain may be a significant barrier to cessation. The association of demographic, psychosocial and tobacco-related variables and smoking-related weight control expectancies were examined in 755 African American regular, light smokers enrolled in a smoking cessation trial (number of years smoked = 23.9+ 11.9; CPD = 7.6 ± 3.2; age = 45.1 ± 10.7; BMI = 31 ± 8.1; 67% female). Overall, participants had minimal smoking-related weight control expectancies (M = 3.7/10, SD ± 3.4); however, higher weight control expectancies were related to female gender, lower dietary fat intake and lower internal self-efficacy to refrain from smoking. Further, smoking-related weight control expectancies were not associated with cessation outcome at week-26. Findings suggest that weight control expectancies exist among some African American light smokers and are related to decreased self-efficacy to refrain from smoking. However, the relationship between smoking-related weight expectancies and health behaviors are complex and modest in magnitude.

View all citing articles on Scopus

^☆: The work was carried out at The Miriam Hospital, 164 Summit Ave., Providence, RI 02906.

View full text

Weight control smoking among sedentary women☆

Abstract

Section snippets

Method

Demographic factors

Discussion

Acknowledgements

Addictive Behaviors

Addictive behaviors

Preventive Medicine

Journal of Substance Abuse

Addictive Behaviors

Addictive Behaviors

Journal of Affective Disorders

Journal of the American Dietetic Association

Psychosocial stress and coping in smokers who relapse or quit

Health Psychology

The development of a short form of the manifest anxiety scale

Journal of Consulting & Clinical Psychology

Assessment of habitual physical activity by seven-day recall in a community survey and controlled experiments

American Journal of Epidemiology

A data-based approach to diet questionnaire design and testing

American Journal of Epidemiology

The relationship between body weight concerns and adolescent smoking

Health Psychology

Self-efficacy in weight management

Journal of Consulting & Clinical Psychology

The process of smoking cessationAn analysis of precontemplation, contemplation and preparation stages of change

Journal of Consulting & Clinical Psychology

Self-efficacy and the stages of self-change of smoking

Cognitive Therapy & Research

Smoking abstinence, eating style, and food intake

Journal of Consulting & Clinical Psychology

Trends in cigarette smoking in the United StatesThe changing influence of gender and race

Journal of the American Medical Association

Weight concerns and smokingA literature review

Annals of Behavioral Medicine

Weight concerns and change in smoking behavior over two years in a working population

American Journal of Public Health

Weight concerns, dieting behavior, and smoking initiation among adolescentsA prospective study

American Journal of Public Health

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

American Journal of Health Promotion

Smoking cessation and weight gain

Journal of Consulting and Clinical Psychology

Weight gain prevention and smoking cessationCautionary findings

American Journal of Public Health