Weight concerns among male smokers

doi:10.1016/j.addbeh.2004.02.034

Addictive Behaviors

Volume 29, Issue 8, November 2004, Pages 1637-1641

https://doi.org/10.1016/j.addbeh.2004.02.034 Get rights and content

Abstract

Many smokers perceive that smoking controls their body weight and that stopping smoking leads to weight gain. This study examined characteristics associated with weight concerns in 72 male smokers enrolled in a controlled trial for smoking cessation. Motivation to quit smoking was found to be significantly lower in those with weight concerns (P<.001). Further investigation is needed to enable the tailoring of interventions for weight-concerned male smokers.

Introduction

Concern about weight gain subsequent to stopping smoking is a frequently identified barrier, and smokers with weight concerns are more likely to relapse (Meyers et al., 1997). Smoking for weight control reasons has been associated with being female (Klesges & Klesges, 1988), smoking more cigarettes per day (Sorensen et al., 1992), lower motivation to quit smoking (Chapman, Wong, & Smith, 1993), body image dissatisfaction (King, Matacin, Marcus, Bock, & Tripolone, 2000), and higher Fagerström scores (Pinto et al., 1999). Tailored interventions designed specifically for weight-concerned female smokers have shown that assignment to an on-site exercise program improved smoking abstinence rates and delayed weight gain (Marcus et al., 1999), and cognitive–behavioral therapy to reduce weight concerns (Perkins et al., 2001) both improved smoking cessation outcome and reduced weight gain. In contrast, the factors associated with weight concerns in men have received limited empirical attention. Thus, the purpose of this study was to examine the association of weight concerns in male smokers to motivational level to stop smoking, weight, level of nicotine dependence, and smoking history variables.

Section snippets

Participants and measurements

A total of 600 participants enrolled in a randomized, pharmacological, and behavioral clinical trial. The basis of this report is the 286 male participants, of whom 72 were classified as “weight concerned.” Participants were current cigarette smokers with a mean age of 45.0 years. The ethnic composition was 86% Caucasian, 6% African-American, 3% Asian, and 5% of other ethnicity. Participants smoked an average of 26.2 cigarettes per day. Their average body mass index (BMI) was 27.2. Participants

Results

Of the 286 males, 25% (72) were weight concerned. Univariately, BMI, FTND scores, or average number of cigarettes smoked per day were not significantly associated with weight concerns. Motivation to quit smoking was found to be significantly associated with weight concerns. As motivation increased, the participants were less likely to be weight concerned (odds ratio 0.54; 95% confidence internal [0.40–0.73]; P<.001). The percentage of participants who were weight concerned for motivational

Discussion

In this study, we found that 25% of men enrolled in a clinical trial were weight concerned. This frequency is very similar with the frequency (22.1%) reported by previous investigators (Meyers et al., 1997). We also found that motivational level for quitting decreased as weight concerns increased. This finding is striking, given that the study inclusion criteria of a rating of 7 or higher on a motivational level scale of 1–10 restricted the range of responses. Motivation level has been shown to

Acknowledgements

This study was supported by Sanofi-Synthelabo Researche.

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Both smoking and high body weight are risk factors for disease, hence, the association between smoking and body weight is an important health issue. Furthermore, concern about weight gain after quitting smoking is for many smokers a barrier to smoking cessation. The present study aims to explore the association between body mass index (BMI) and current tobacco smoking status in the population of Germany, and smoking and quitting behaviour amongst smokers (and recent ex-smokers =<12 months since quitting).
Cross-sectional analysis of two waves of data collected from March through June 2021 through a representative face-to-face household survey in Germany (N = 3 997 respondents aged ≥18). The associations between smoking and quitting behaviours and BMI were analysed through four regression models adjusted for socio-demographic, socio-economic, and smoking characteristics of respondents.
Long-term ex-smokers (>= 12 months since quitting smoking) were more likely to have a higher BMI compared to never smokers (β = 0.64, 95% confidence interval (CI) = 0.10–1.19). There was no statistically significant association between current smoking status or recent ex-smoking status and BMI (β = -0.29,95 %CI = -0.75–0.17 and β = -0.53, 95 %CI = -2.45–1.40). Among current smokers, no statistically significant association was found between BMI and the motivation to stop smoking (OR = 1.01, 95 %CI = 0.99–1.03). Neither number of cigarettes smoked a day nor outcome of most recent quit attempt were related to BMI (β = 0.01, 95 %CI = -0.04–0.05 and OR = 0.41, 95 %CI = 0.05–3.05).
In the German population long-term ex-smoking but not current and recent ex-smoking was associated with increased BMI. Future research should further explore the association between smoking behaviour and abdominal obesity, preferably using a more accurate measure for abdominal obesity than BMI.
Network analysis reveals the associations of past quit experiences on current smoking behavior and motivation to quit
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This is supported by previous work suggesting previous quit attempts are predictors of future attempts (Baker et al., 2011; Vangeli et al., 2011). Contrary to previous research findings (Baker et al., 2011; Clark et al., 2004), problems with weight gain and higher cravings were associated with increased motivation to quit smoking. It is possible be that individuals who experienced aversive consequences in previous quit attempts (e.g., weight gain, craving) are more motivated to quit with the aid of a treatment program (Garey et al., 2016).
Smoking is a leading cause of morbidity and mortality in the United States. While most smokers endorse a desire to quit, achieving abstinence is notoriously difficult. Network analysis is a method for understanding the complex relationships of factors that maintain smoking behavior and impact motivation to quit.
This study examined self-report prescreen data from treatment-seeking smokers (N = 3913). The number of prior quit attempts and withdrawal symptoms experienced, as well as current smoking behavior and motivation to quit were modeled as interconnected nodes in a network. Two key network metrics were examined: 1) edge weights, which quantify the strength and direction of the associations of interest, and 2) the sum of each node’s edge weights, which quantifies the expected influence of a node on the overall network.
The withdrawal symptom of craving, r = 0.10, 95% CI [0.07, 0.13] and digestive problems, r = −0.06, 95% CI [−0.09, −0.03], had the strongest positive and negative association with daily cigarettes, respectively. The number of prior quit attempts, r = 0.17, 95% CI [0.14, 0.20], concentration problems, r = −0.04, 95% CI [−0.027, −0.01], showed the strongest positive and negative associations, respectively, with current motivation to quit. Nodes with significant links to current smoking and motivation to quit were also among the most influential in the overall network.
Findings suggest prior quit experiences and consequences associated with withdrawal symptoms may differentially relate to maintenance of smoking behavior and motivation to quit in treatment-seeking smokers. Interventions targeting key withdrawal symptoms may enhance motivation to quit.
Postcessation weight gain concern as a barrier to smoking cessation: Assessment considerations and future directions
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Concern about postcessation weight gain may be one potential barrier to quitting smoking. In this ‘mini-review’ of recent literature, we summarize findings on the relationship between postcessation weight gain concern and smoking cessation, and evaluate varied use of postcessation weight gain concern assessments and potential moderators of the postcessation weight gain concern-cessation association.
We conducted a search using the terms “smoking” OR “smoking cessation” AND “weight concern” for articles published between January 1, 2011 and December 31, 2016. We identified 17 studies assessing postcessation weight gain concern, seven of which evaluated the postcessation weight gain concern-cessation association.
The relationship between postcessation weight gain concern and smoking cessation was mixed. Recent studies varied in their assessments of postcessation weight gain concern, many of which were not validated and assessed correlates of this construct. Studies varied in their adjustment of demographic (e.g., sex), smoking-specific (e.g., smoking level), and weight-specific (e.g., body mass index) variables.
The use of non-validated assessments and variability in testing covariates/moderators may contribute to conflicting results regarding the postcessation weight gain concern-cessation relationship. We recommend validating an assessment of postcessation weight gain concern, maintaining vigilance in testing and reporting covariates/moderators, and investigating trajectories of this construct over time and by smoking status to inform future assessment and intervention efforts.
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Concern about post-cessation weight gain, that is cessation-related weight concern, is a barrier to making attempts to quit smoking (Rosenthal et al., 2013; Pomerleau et al., 2001; Tuovinen et al., 2015), and a reason for relapse (Donny et al., 2011). Approximately one quarter of daily smoking males and half of daily smoking females experience cessation-related weight concern (Meyers et al., 1997; Clark et al., 2006, 2004). However, the effect cessation-related weight concern has on smoking cessation during a quit attempt is unclear with some studies finding smokers with these concerns are less likely to quit (Meyers et al., 1997; Levine et al., 2010; Klesges et al., 1988; Schauer et al., 2013; Aubin et al., 2009), and other studies not finding an association between cessation-related weight concern and cessation (Pisinger and Jorgensen, 2007; Borrelli and Mermelstein, 1998; Jeffery et al., 2000; French et al., 1995; Landrau-Cribbs et al., 2015).
Concern about post-cessation weight gain is a barrier to making attempts to quit smoking; however, its effect on smoking cessation is unclear. In this study we examine cessation-related weight concern among the homeless, which hasn't been studied.
Homeless males (n = 320) and females (n = 110) participating in a smoking cessation RCT in the Twin Cities, Minnesota from 2009 to 2011 completed surveys on cessation-related weight concern, smoking status, and components from the Behavioral Model for Vulnerable Populations. Generalized estimating equations were used to examine baseline predictors of cessation-related weight concern at baseline, the end of treatment, and 26-weeks follow-up. Logistic regression models were used to examine the relationship between cessation-related weight concern and smoking status at the end of treatment and follow-up.
Females had higher cessation-related weight concern than males. Among males, older age, Black race, higher BMI, depression, and having health insurance were associated with higher cessation-related weight concern. Among females, nicotine dependence, greater cigarette consumption, indicating quitting is more important, older age of smoking initiation, and less support to quit from family were associated with higher cessation-related weight concern. In multivariate analyses, cessation-related weight concern decreased over time among females. Cessation-related weight concern wasn't associated with smoking cessation.
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The remaining additional barriers included two items involving changes in eating and appetite, one item involving the presence of other people smoking, and one item regarding the difficulty of giving up the first cigarette of the day. Eating/Appetite items were added as research has suggested that increased caloric intake is common during smoking cessation (Klesges, Meyers, Klesges, & LaVasque, 1989) and concerns regarding post-cessation weight gain are associated with lower readiness and motivation to quit (Clark et al., 2004; Pomerleau, Zucker, & Stewart, 2001). The item involving the presence of other smokers was included as social networks appear important in smoking behavior and smoking cessation (Christakis & Fowler, 2008).
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A major barrier to quitting smoking (Chiolero et al., 2008) involves cessation-related weight gain (Filozof et al., 2004) and smoking-related leanness (Albanes et al., 1987; Chiolero et al., 2008). Concerns of weight gain may undermine smoking-cessation efforts and promote relapse (Meyers et al., 1997; Clark et al., 2004). Foods and drugs of abuse, including nicotine, activate brain circuits involved in motivation, learning, and behavioral reinforcement (Di Chiara, 2002; Volkow et al., 2008).
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Short communicationWeight concerns among male smokers

Abstract

Introduction

Section snippets

Participants and measurements

Results

Discussion

Acknowledgements

Addictive Behaviors

Addictive Behaviors

Self-exempting beliefs about smoking and health: Differences between smokers and ex-smokers

American Journal of Preventive Medicine

Brief motivational interviewing in a hospital setting for adolescent smoking: A preliminary study

Journal of Consulting and Clinical Psychology

The Fagerström test for nicotine dependence: A revision of the Fagerström tolerance questionnaire

British Journal of Addiction

Short communication
Weight concerns among male smokers