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Smith CE, O'Neil PM. Prevalence of Obesity Among Electronic Cigarette and Tobacco Users in the United States: Results from the 2018 Wave of the Behavioral Risk Factor Surveillance System. Subst Use Misuse 2024; 59:1481-1487. [PMID: 38803011 DOI: 10.1080/10826084.2024.2354787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/29/2024]
Abstract
Objective: Tobacco use and obesity are leading causes of preventable death in the U.S. E-cigarette use is on the rise; however, obesity prevalence among e-cigarette users is unknown. The present study characterized obesity prevalence among e-cigarette and tobacco users in a national sample of U.S. adults. Method: Data were obtained from the 2018 Behavioral Risk Factor Surveillance System. Approximately 249,726 participants provided data on e-cigarette and tobacco use, height, weight, and demographics, and were categorized as follows: Ever vaped, ever smoked; Ever vaped, never smoked; Never vaped, ever smoked; Never vaped, never smoked. Results: Obesity prevalence (BMI ≥30 kg/m2) differed significantly across groups: 33.0% (ever vaped, ever smoked); 27.7% (ever vaped, never smoked); 33.1% (never vaped, ever smoked); 32.1% (never vaped, never smoked), p < .001. Groups also differed demographically. Logistic regressions adjusted for demographics revealed subjects in the never vaped, ever smoked group were significantly more likely to have obesity relative to those in the never vaped, never smoked group (p < 0.001) with vaping status having no main effect. Secondary analyses using never smokers as the reference found current smokers were less likely to have obesity and former smokers were more likely to have obesity, p < .001. Discussion: The present study is the first to characterize U.S. obesity prevalence among e-cigarette and tobacco users. Obesity prevalence was lower in the ever vaped, never smoked group; however, this finding appears to be attributable to demographic variables. As e-cigarette use becomes more common, future research should examine the development and maintenance of obesity among users.
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Affiliation(s)
- Caitlin E Smith
- Department of Psychiatry and Behavioral Sciences, Weight Management Center, Medical University of South Carolina, Charleston, South Carolina, USA
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA
| | - Patrick M O'Neil
- Department of Psychiatry and Behavioral Sciences, Weight Management Center, Medical University of South Carolina, Charleston, South Carolina, USA
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Krotter A, García-Fernández G, García-Pérez Á, Aonso-Diego G, Weidberg S. Contingency management for smoking cessation for individuals with overweight or obesity: A randomized controlled trial. Drug Alcohol Depend 2024; 258:111269. [PMID: 38547787 DOI: 10.1016/j.drugalcdep.2024.111269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 03/09/2024] [Accepted: 03/10/2024] [Indexed: 05/13/2024]
Abstract
BACKGROUND Interventions for quitting smoking and weight control among individuals with excess weight are scarce. Our study evaluated the effectiveness of cognitive behavioral therapy (CBT) plus contingency management (CM) in this population, and examined whether CM for smoking cessation improved CBT treatment outcomes at end of treatment (EOT) and at 1-, 3-, 6-, and 12-month follow-ups (FU). METHODS In an 8-week randomized clinical trial, 120 adults who smoke with overweight or obesity (54.16% females; MBMI = 31.75 ± 4.31) were randomly assigned to CBT for both quitting smoking and weight control (n = 60) or the same treatment plus CM for smoking cessation (n = 60). Outcome variables were compared (i.e., treatment completion, smoking abstinence, weight change and secondary outcomes). RESULTS At EOT, the CBT + CM group achieved 78.33% 7-day point-prevalence abstinence rates compared to 61.67% in the CBT group (p = .073), and rates declined over time (12-month FU: 18% vs 12%). Participants who attained abstinence weighed more compared to baseline at EOT (Mkg = 1.07; SD = 1.88) and over time (12-month FU: Mkg = 4.19; SD = 4.31). No differences were found between the two groups in outcome variables. CONCLUSIONS Both interventions were effective in promoting abstinence and reducing tobacco use over time. Combining CBT with CM for smoking cessation did not improve treatment outcomes in individuals with overweight or obesity compared to CBT only. Future studies should evaluate whether implementing CM for weight maintenance helps control post-cessation weight gain in this population.
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Affiliation(s)
| | | | - Ángel García-Pérez
- Department of Psychology, Sociology and Philosophy, University of Leon, Spain
| | | | - Sara Weidberg
- Department of Psychology, University of Oviedo, Spain
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Krotter A, García-Pérez Á, Aonso-Diego G, García-Fernández G. Body weight change during a smoking cessation intervention for individuals with overweight or obesity. Eat Behav 2024; 53:101882. [PMID: 38723487 DOI: 10.1016/j.eatbeh.2024.101882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 04/27/2024] [Accepted: 05/01/2024] [Indexed: 06/03/2024]
Abstract
INTRODUCTION A more comprehensive understanding of the factors regarding weight control in individuals with overweight or obesity after quitting smoking is needed. The study aimed to analyze the changes of in-treatment variables during a smoking cessation intervention and examine their impact on weight. METHODS A total of 120 individuals who smoke with overweight or obesity (MBMI = 31.75 ± 4.31; 54.16 % female) participated in a cognitive-behavioral therapy for smoking cessation and weight control or the same treatment plus contingency management. Weight, smoking variables (cotinine and continuous abstinence), eating behaviors (appetite, grazing), exercise, and sleep were assessed weekly throughout the treatment. RESULTS More participants gained weight over time with reduced nicotine use or abstinence. There was a tendency during treatment to increase appetite and exercise time, while grazing episodes and sleeping hours remained stable. Higher baseline weight (p < .001), greater cotinine reduction (p = .021) and time (p = .009) were associated with greater weight gain, while more hours of exercise (p = .003), no appetite changes (p = .003) and diminished appetite (p < .001) were associated with less gain over the treatment. Both treatment conditions showed similar results in all in-treatment variables. DISCUSSION Individuals with overweight and obesity with higher baseline weight and higher baseline cotinine levels during smoking cessation interventions may require special attention to improve weight outcomes. Exercise and appetite regulation may be useful for mitigating weight gain in smoking cessation interventions for individuals with overweight or obesity.
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Affiliation(s)
- Andrea Krotter
- Department of Psychology, University of Oviedo, Plaza Feijoo s/n, 33003 Oviedo, Spain.
| | - Ángel García-Pérez
- Department of Psychology, University of Oviedo, Plaza Feijoo s/n, 33003 Oviedo, Spain; Department of Psychology, Sociology and Philosophy, University of Leon, Education Faculty, Vegazana Campus s/n, 24071 Leon, Spain.
| | - Gema Aonso-Diego
- Department of Psychology, University of Oviedo, Plaza Feijoo s/n, 33003 Oviedo, Spain.
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Wolters I, Kastaun S, Kotz D. Associations between body mass index and smoking behaviour: A cross-sectional study of the German adult population. Physiol Behav 2024; 275:114436. [PMID: 38103627 DOI: 10.1016/j.physbeh.2023.114436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 12/08/2023] [Accepted: 12/13/2023] [Indexed: 12/19/2023]
Abstract
BACKGROUND 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). METHODS 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. RESULTS 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). CONCLUSION 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.
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Affiliation(s)
- Isabel Wolters
- Institute of General Practice (ifam), Centre for Health and Society (chs), Addiction Research and Clinical Epidemiology Unit, Medical Faculty of the Heinrich-Heine-University, Düsseldorf, Germany
| | - Sabrina Kastaun
- Institute of General Practice (ifam), Centre for Health and Society (chs), Addiction Research and Clinical Epidemiology Unit, Medical Faculty of the Heinrich-Heine-University, Düsseldorf, Germany; Institute of General Practice (ifam), Centre for Health and Society (chs), Patient-Physician Communication Research Unit, Medical Faculty of the Heinrich-Heine-University, Düsseldorf, Germany
| | - Daniel Kotz
- Institute of General Practice (ifam), Centre for Health and Society (chs), Addiction Research and Clinical Epidemiology Unit, Medical Faculty of the Heinrich-Heine-University, Düsseldorf, Germany; Department of Behavioural Science and Health, University College London, London, United Kingdom.
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Toyon A, Bursac Z, Werner N, Krukowski RA. Impact of Weight Concern on Post-Cessation Weight Management, Smoking Cessation, and Program Engagement. Am J Health Promot 2024:8901171241234136. [PMID: 38356272 DOI: 10.1177/08901171241234136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2024]
Abstract
PURPOSE Weight concern is a barrier to smoking cessation. We examined the impact of weight concern on post-cessation weight gain, abstinence and program engagement. DESIGN Randomized-controlled trial. SETTING Telephone-based and group-based intervention sessions. SUBJECTS 305 participants were randomized and analyzed. INTERVENTION Participants were randomized to receive a self-guided intervention, a weight loss intervention, or a weight stability intervention prior to all receiving the same smoking cessation intervention. MEASURES Level of weight concern on three measures, point-prevalence abstinence, weight change, and session attendance at 12 months. ANALYSIS Continuous and discrete outcomes were compared between weight-concerned and non-weight-concerned participants using two-sample t-tests and chi-square tests respectively. RESULTS There were no significant differences in weight change (range: +1.77, -1.91 kg) when comparing weight-concerned and non-weight-concerned participants. Point-prevalence abstinence ranged from 36% to 64%, with no differences by condition based on level of weight concern. There were no significant differences in session attendance by weight concern (Weight sessions: 50-70%, Smoking cessation sessions: 41-56%, Booster sessions: 28-45%). Weight concern, on all measures, significantly decreased between screening and 2 months (after the weight management intervention), for most of the comparisons made overall and by condition. CONCLUSION It may not be necessary to screen for weight concerns in smoking cessation and/or post-cessation weight management programs, as the trial interventions were beneficial regardless of weight concern.
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Affiliation(s)
- Anjola Toyon
- School of Medicine, University of Virginia, Charlottesville, VA, USA
| | - Zoran Bursac
- Department of Biostatistics, Florida International University, Miami, FL, USA
| | - Nicole Werner
- Department of Health & Wellness Design, Indiana University, Bloomington, IN, USA
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Kilmurray C, Vander Weg M, Wilson N, Relyea G, McClanahan B, Stockton MB, Ward KD. Determinants of smoking related weight-concern in smokers participating in a community-based cessation program. Eat Behav 2023; 51:101809. [PMID: 37699309 PMCID: PMC10840988 DOI: 10.1016/j.eatbeh.2023.101809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Revised: 07/18/2023] [Accepted: 08/30/2023] [Indexed: 09/14/2023]
Abstract
BACKGROUND 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. METHODS 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. RESULTS 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). CONCLUSIONS 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.
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Affiliation(s)
- Cheri Kilmurray
- School of Health Studies, The University of Memphis, Memphis, TN 38152, USA; School of Public Health, The University of Memphis, Memphis, TN 38152, USA.
| | - Mark Vander Weg
- University of Iowa, Iowa City VA Health Care System, Iowa City, IA 52242, USA.
| | - Nancy Wilson
- School of Public Health, The University of Memphis, Memphis, TN 38152, USA.
| | - George Relyea
- School of Public Health, The University of Memphis, Memphis, TN 38152, USA
| | - Barbara McClanahan
- School of Health Studies, The University of Memphis, Memphis, TN 38152, USA.
| | - Michelle B Stockton
- School of Health Studies, The University of Memphis, Memphis, TN 38152, USA.
| | - Kenneth D Ward
- School of Public Health, The University of Memphis, Memphis, TN 38152, USA.
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Shang J, Nie X, Qi Y, Zhou J, Qi Y. Short-term smoking cessation leads to a universal decrease in whole blood genomic DNA methylation in patients with a smoking history. World J Surg Oncol 2023; 21:227. [PMID: 37496025 PMCID: PMC10369823 DOI: 10.1186/s12957-023-03099-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 07/12/2023] [Indexed: 07/28/2023] Open
Abstract
BACKGROUND Epigenetics is involved in various human diseases. Smoking is one of the most common environmental factors causing epigenetic changes. The DNA methylation changes and mechanisms after quitting smoking have yet to be defined. The present study examined the changes in DNA methylation levels before and after short-term smoking cessation and explored the potential mechanism. METHODS Whole blood and clinical data were collected from 8 patients before and after short-term smoking cessation, DNA methylation was assessed, and differentially methylated sites were analyzed, followed by a comprehensive analysis of the differentially methylated sites with clinical data. GO/KEGG enrichment and protein-protein interaction (PPI) network analyses identified the hub genes. The differentially methylated sites between former and current smokers in GSE50660 from the GEO database were detected by GEO2R. Then, a Venn analysis was carried out using the differentially methylated sites. GO/KEGG enrichment analysis was performed on the genes corresponding to the common DNA methylation sites, the PPI network was constructed, and hub genes were predicted. The enriched genes associated with the cell cycle were selected, and the pan-cancer gene expression and clinical significance in lung cancer were analyzed based on the TCGA database. RESULTS Most genes showed decreased DNA methylation levels after short-term smoking cessation; 694 upregulated methylation CpG sites and 3184 downregulated methylation CpG sites were identified. The DNA methylation levels were altered according to the clinical data (body weight, expiratory, and tobacco dependence score). Enrichment analysis, construction of the PPI network, and pan-cancer analysis suggested that smoking cessation may affect various biological processes. CONCLUSIONS Smoking cessation leads to epigenetic changes, mainly decreased in the decline of most DNA methylation levels. Bioinformatics further identified the biologically relevant changes after short-term smoking cessation.
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Affiliation(s)
- Junyi Shang
- Department of Respiratory and Critical Care Medicine, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University; People's Hospital of Henan University, No. 7 Weiwu Road, Jinshui District, Zhengzhou, 450003, Henan, China
| | - Xinran Nie
- Academy of Medical Science, Zhengzhou University, Zhengzhou, China
- Department of Respiratory and Critical Care Medicine, People's Hospital of Zhengzhou University, Zhengzhou, 450003, Henan, China
| | - Yanan Qi
- Department of Respiratory and Critical Care Medicine, Central China Fuwai Hospital; Central China Fuwai Hospital of Zhengzhou University; People's Hospital of Zhengzhou University; Henan Provincial People's Hospital, Zhengzhou, 450003, Henan, China
| | - Jing Zhou
- Department of Health Management, Henan Provincial People's Hospital, Henan University People's Hospital, Zhengzhou, 450003, China
| | - Yong Qi
- Department of Respiratory and Critical Care Medicine, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University; People's Hospital of Henan University, No. 7 Weiwu Road, Jinshui District, Zhengzhou, 450003, Henan, China.
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Audrain-McGovern J, Wileyto EP, Ashare R, Albelda B, Manikandan D, Perkins KA. Behavioral activation for smoking cessation and the prevention of smoking cessation-related weight gain: A randomized trial. Drug Alcohol Depend 2023; 244:109792. [PMID: 36739753 PMCID: PMC10024937 DOI: 10.1016/j.drugalcdep.2023.109792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 01/24/2023] [Accepted: 01/26/2023] [Indexed: 02/04/2023]
Abstract
BACKGROUND Post-cessation weight gain (PCWG) is an obstacle to smoking cessation. This trial evaluated a behavioral intervention targeting alternative rewards to smoking and high calorie snacking to promote smoking cessation while mitigating PCWG. METHODS Adult smokers (n = 288; 119 females, 169 males) received eight weeks of transdermal nicotine and were randomized to eight sessions of behavioral activation for smoking cessation and the mitigation of PCWG (BAS+) or standard smoking cessation counseling (SC). Primary outcomes were 7-day point prevalence abstinence and PCWG 26 weeks after the target quit date. Change in caloric intake from pre-treatment through the 26-week follow-up was a secondary outcome. Data were collected from September 2016 to February 2021, and analyses were completed in July 2022. RESULTS BAS+ and SC did not differ in smoking abstinence rates at the 26-week follow-up (OR=0.80, 95%CI 0.50-1.27, p = 0.34; 18% versus 23%). There were no significant differences in PCWG between BAS+ and SC who were 7-day point prevalence abstinent (β = -0.29, 95%CI -2.13 to 1.65, p = 0.77; 2.60 versus 2.20 pounds, respectively) or among those continuously abstinent (5.78 versus 5.34 pounds, respectively). There were no significant differences in caloric intake between BAS+ and SC from baseline to the 26-week follow-up (β = 110.65, 95%CI -96.72 to 318.02, p = 0.30; -19.1 versus -116.9 kcals/day, respectively). CONCLUSIONS The results do not support the efficacy of BAS+ for smoking cessation and the prevention of PCWG. These findings join a growing body of research highlighting the challenge of minimizing PCWG and promoting smoking abstinence.
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Affiliation(s)
- Janet Audrain-McGovern
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
| | - E Paul Wileyto
- Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, PA, USA
| | - Rebecca Ashare
- Department of Psychology, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Benjamin Albelda
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Divya Manikandan
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Kenneth A Perkins
- University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, PA, USA
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Ely AV, Wetherill RR. Reward and inhibition in obesity and cigarette smoking: Neurobiological overlaps and clinical implications. Physiol Behav 2023; 260:114049. [PMID: 36470508 PMCID: PMC10694810 DOI: 10.1016/j.physbeh.2022.114049] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 11/29/2022] [Accepted: 12/01/2022] [Indexed: 12/12/2022]
Abstract
Cigarette smoking and obesity are the leading causes of premature morbidity and mortality and increase the risk of all-cause mortality four-fold when comorbid. Individuals with these conditions demonstrate neurobiological and behavioral differences regarding how they respond to rewarding stimuli or engage in inhibitory control. This narrative review examines the role of reward and inhibition in cigarette smoking and obesity independently, as well as recent research demonstrating an effect of increased body mass index (BMI) on neurocognitive function in individuals who smoke. It is possible that chronic smoking and overeating of highly palatable food, contributing to obesity, dysregulates reward neurocircuitry, subsequently leading to hypofunction of brain networks associated with inhibitory control. These brain changes do not appear to be specific to food or nicotine and, as a result, can potentiate continued cross-use. Changes to reward and inhibitory function due to increased BMI may also make cessation more difficult for those comorbid for obesity and smoking.
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Affiliation(s)
- Alice V Ely
- Cooper University Health Care, Center for Healing, Division of Addiction Medicine, Camden, NJ 08103, USA.
| | - Reagan R Wetherill
- University of Pennsylvania, Department of Psychiatry, Philadelphia, PA 19104, USA
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Therapeutics in Metabolic Diseases. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2023; 1396:255-273. [DOI: 10.1007/978-981-19-5642-3_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
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BMI as a moderator of the relationship between stigmatizing attitudes and smoking: An exploratory study. JOURNAL OF SUBSTANCE USE 2022. [DOI: 10.1080/14659891.2022.2082333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Ely AV, Keyser H, Spilka N, Franklin TR, Wetherill RR, Audrain-McGovern J. An exploration of associations between smoking motives and behavior as a function of body mass index. DRUG AND ALCOHOL DEPENDENCE REPORTS 2021; 1:100008. [PMID: 36843906 PMCID: PMC9948816 DOI: 10.1016/j.dadr.2021.100008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 11/05/2021] [Accepted: 11/18/2021] [Indexed: 11/19/2022]
Abstract
Objective Cigarette smoking and obesity are the leading causes of premature morbidity and mortality and increase the risk of all-cause mortality four-fold when comorbid. Although research suggests that smoking motives may differ based on body mass index (BMI), it is unclear how these differences translate to smoking behavior. Method Three groups of adults who smoke cigarettes (N = 79; obese n = 25, overweight n = 30, and lean n = 24) completed measures of smoking and the Smoking Motivations Questionnaire. Groups did not differ on age, education, cigarettes per day (CPD), pack-years, or nicotine dependence, as measured by the Fagerström Test for Cigarette Dependence (FTCD). Results Analyses revealed different associations between reasons for smoking and smoking behavior depending on lean, overweight, or obesity status. Participants (N = 37 female, average age 39.8 years) self-reported smoking was positively associated with Addictive, and Automatic subscale scores among lean participants, with only the Addictive subscale score among those with overweight, and only the Automatic subscale score among those with obesity. Post hoc MANCOVA analysis revealed a significant interaction effect of Group x Automatic Smoking on Pack-years (F(2, 79)=3.34, p = 0.04). Conclusion Findings suggest smoking motives are differentially associated with smoking behavior in adults who smoke depending on weight status. The daily smoking rate of participants with obesity may be less related to the addictive quality of smoking, and automaticity may be less associated with smoking history in those with overweight. Additional research on the influence of BMI on cigarette smoking is necessary to fully elucidate how obesity may impact treatment outcomes to optimize smoking cessation treatment among those with excess body weight.
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Affiliation(s)
- Alice V. Ely
- University of Pennsylvania, Department of Psychiatry, 3535 Market St Suite 500, Philadelphia, PA 19104, United States
| | - Heather Keyser
- University of Pennsylvania, Department of Psychiatry, 3535 Market St Suite 500, Philadelphia, PA 19104, United States
| | - Nathaniel Spilka
- University of Pennsylvania, Department of Psychiatry, 3535 Market St Suite 500, Philadelphia, PA 19104, United States
| | - Teresa R. Franklin
- University of Pennsylvania, Department of Psychiatry, 3535 Market St Suite 500, Philadelphia, PA 19104, United States
| | - Reagan R. Wetherill
- University of Pennsylvania, Department of Psychiatry, 3535 Market St Suite 500, Philadelphia, PA 19104, United States
| | - Janet Audrain-McGovern
- University of Pennsylvania, Department of Psychiatry, 3535 Market St Suite 500, Philadelphia, PA 19104, United States
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13
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Ely AV, Jagannathan K, Spilka N, Keyser H, Rao H, Franklin TR, Wetherill RR. Exploration of the influence of body mass index on intra-network resting-state connectivity in chronic cigarette smokers. Drug Alcohol Depend 2021; 227:108911. [PMID: 34364193 PMCID: PMC8464487 DOI: 10.1016/j.drugalcdep.2021.108911] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 06/07/2021] [Accepted: 06/08/2021] [Indexed: 01/11/2023]
Abstract
BACKGROUND Obesity and cigarette smoking are two leading preventable causes of death. Previous research suggests that comorbid smoking and obesity likely share neurobehavioral underpinnings; however, the influence of body mass index (BMI) on resting-state functional connectivity (rsFC) in smokers remains unknown. In this study, we explore how BMI affects rsFC and associations between rsFC and smoking-related behavior. METHODS Treatment-seeking cigarette smokers (N = 87; 54 % men) completed a BOLD resting-state fMRI scan session. We grouped smokers into BMI groups (N = 23 with obesity, N = 33 with overweight, N = 31 lean) and used independent components analysis (ICA) to identify the resting state networks commonly associated with cigarette smoking: salience network (SN), right and left executive control networks (ECN) and default mode network (DMN). Average rsFC values were extracted (p < 0.001, k = 100) to determine group differences in rsFC and relationship to self-reported smoking and dependence. RESULTS Analyses revealed a significant relationship between BMI and connectivity in the SN and a significant quadratic effect of BMI on DMN connectivity. Heavier smoking was related to greater rsFC in the SN among lean and obese groups but reduced rsFC in the overweight group. CONCLUSIONS Findings build on research suggesting an influence of BMI on the neurobiology of smokers. In particular, dysfunction of SN-DMN-ECN circuitry in smokers with overweight may lead to a failure to modulate attention and behavior and subsequent difficulty quitting smoking. Future research is needed to elucidate the mechanism underlying the interaction of BMI and smoking and its impact on treatment.
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Affiliation(s)
- Alice V. Ely
- Corresponding authors: University of Pennsylvania, Department of Psychiatry, 3535 Market St Suite 500, Philadelphia PA 19104, ,
| | | | | | | | | | | | - Reagan R. Wetherill
- Corresponding authors: University of Pennsylvania, Department of Psychiatry, 3535 Market St Suite 500, Philadelphia PA 19104, ,
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14
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Gangadi M, Kalpourtzi N, Gavana M, Vantarakis A, Chlouverakis G, Hadjichristodoulou C, Trypsianis G, Voulgari PV, Alamanos Y, Karakosta A, Touloumi G, Karakatsani A. Prevalence of tobacco smoking and association with other unhealthy lifestyle risk factors in the general population of Greece: Results from the EMENO study. Tob Prev Cessat 2021; 7:61. [PMID: 34585029 PMCID: PMC8432411 DOI: 10.18332/tpc/140242] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 06/23/2021] [Accepted: 07/15/2021] [Indexed: 11/24/2022]
Abstract
INTRODUCTION The EMENO (National Morbidity and Risk Factors) survey is one of the first and most representative population-based surveys in Greece due to its study design and sampling procedure. We aimed to estimate the prevalence of smoking, secondhand smoking (SHS) and their potential associations with other socioeconomic and unhealthy lifestyle risk factors. METHODS EMENO is a cross-sectional health status survey conducted in Greece from May 2013 to June 2016. The survey was performed using face-to-face interviews and enrolled 6006 adults. Data were collected through questionnaires administered by trained interviewers. Current smoking (CS) and SHS were based on self-reporting. Analysis accounted for study design. RESULTS Information on smoking was available for 5862 individuals (97.6%). Overall, 37.8% were current and 16.1% former smokers. More males (44.3%) than females (31.6%) were current smokers. CS increased during adulthood and declined sharply in the elderly (p<0.001). Smoking initiation by the age of 17 years was reported by 48.7% of males and 36.2% of females. Multivariable analysis showed that higher alcohol consumption (>7 glasses/ week, OR=2.52; 95% CI: 1.97–3.23) and lower education level in men were positively associated with ever smoking. Moreover, women aged >35 years and respondents with low adherence to the Mediterranean diet (MD) (high/ low, OR= 0.35; 95% CI: 0.21–0.58) had higher odds to be current smokers than former smokers. Finally, the overall prevalence of exposure to SHS at work, home and public places was 38.8%, 30% and 44.6 %, respectively. CONCLUSIONS Unhealthy lifestyles of smokers, increased rates of CS in vulnerable groups, such as females and young adults, and early age of smoking initiation constitute alarming public health issues in Greece.
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Affiliation(s)
- Maria Gangadi
- 2nd Pulmonary Department, 'Attikon' University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Natasa Kalpourtzi
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Magda Gavana
- Department of Primary Care, General Practice and Health Services Research, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Apostolos Vantarakis
- Environmental Microbiology Unit, Department of Public Health, Medical School, University of Patras, Patra, Greece
| | - Gregory Chlouverakis
- Division of Biostatistics, School of Medicine, University of Heraklion, Heraklion, Greece
| | | | - Gregory Trypsianis
- Department of Medical Statistics, Medical Faculty, Democritus University of Thrace, Alexandroupolis, Greece
| | - Paraskevi V Voulgari
- Rheumatology Clinic, Department of Internal Medicine, Medical School, University of Ioannina, Ioannina, Greece
| | - Yannis Alamanos
- Institute of Epidemiology Preventive Medicine and Public Health, Corfu, Greece
| | - Argiro Karakosta
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Giota Touloumi
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.,Contributed equally
| | - Anna Karakatsani
- 2nd Pulmonary Department, 'Attikon' University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece.,Contributed equally
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15
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Kim S. Using Intervention Mapping to Develop a Media Literacy-Based Smoking Prevention Program for Female Adolescents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18126305. [PMID: 34200803 PMCID: PMC8296112 DOI: 10.3390/ijerph18126305] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 05/27/2021] [Accepted: 06/08/2021] [Indexed: 11/16/2022]
Abstract
Smoking prevalence among female adolescents in South Korea has increased gradually, despite a decreasing trend seen for male adolescents. Smoking scenes or cigarette advertisements in the media have influenced female adolescents' initiation into smoking. It is therefore crucial to develop a smoking prevention program to enhance female adolescents' smoking media literacy by implementing gender-specific approach. The purpose of this study is to describe how intervention mapping protocol (IMP) was used to develop a media literacy-based smoking prevention program (MLSP) for female adolescents. The IMP was used in six steps: needs assessment (literature review and focus groups comprising 24 female adolescents and 12 teachers), program goal setting, selection of intervention methods, production of program components and materials, program implementation planning, and program evaluation by ten experts and three adolescents. Six performance objectives and 14 change objectives were generated. Each module consisted of theory-based methods such as raising consciousness. Half of the modules covered topics regarding smoking media literacy, while half covered topics related to gender-specific intervention. The major advantages of utilizing IMP are that MLSP has been developed to reflect multiple perspectives, including of adolescents, teachers, and professors through a systematic process, and identified to be acceptable and valid.
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Affiliation(s)
- Sookyung Kim
- College of Nursing, Yonsei University, Seoul 03722, Korea
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16
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Body weight variability and cancer incidence in men aged 40 years and older-Korean National Insurance Service Cohort. Sci Rep 2021; 11:12122. [PMID: 34108574 PMCID: PMC8190310 DOI: 10.1038/s41598-021-91601-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Accepted: 05/20/2021] [Indexed: 12/11/2022] Open
Abstract
Repeated weight fluctuation has been proposed as a potential risk factor for increasing morbidity and mortality including cancer. We aimed to investigate the association between body weight variability (BWV) and all cancer and site-specific cancer incidence and the impact of smoking on these associations. A total of 1,759,848 cancer-free male subjects who had their weight measured at least 5 times from the National Health Insurance Service-Health Screening Cohort from 2002 to 2011 were included and followed up until 2015. BWV was defined as the average absolute difference between successive values (ASV). The risk of cancer and site-specific cancer from BWV was identified using Cox proportional hazards regression analysis using hazard ratios (HRs) and 95% confidence intervals (CIs) adjusted for potential confounders including weight, and stratified analysis was also conducted according to smoking status. During the 7,015,413 person-years of follow-up, 11,494 patients (0.65%) developed new-onset cancers. BWV was associated with a higher risk of all cancers after adjustment for confounders. The highest BWV quintile group compared to the lowest had greater risks of all cancers and site-specific cancers including lung, liver, and prostate cancer (HR 1.22, 95% CI 1.15–1.30; HR 1.22, 95% CI 1.07–1.39; HR 1.46, 95% CI 1.19–1.81; HR 1.36, 95% CI 1.15–1.62, in all cancers, lung, liver and prostate cancer, respectively). Due to small number of cancer occurrence, the risk of kidney cancer was increased, but statistically insignificant (HR 1.38, 95% CI 0.91–2.10). Similar results were observed in noncurrent smokers. However, in current smokers, the risks of all cancers and only prostate cancer were significantly increased in the highest BWV quintile group (HR 1.19, 95% CI 1.09–1.31; HR 1.51, 95% CI 1.08–2.11). The risk of kidney cancer also increased in this group, although the finding was not statistically significant (HR 1.77, 95% CI 0.87–3.63) This study suggested BWV is an independent risk factor for cancer in men, especially in lung, liver, and prostate cancer, but evidence was weaker in kidney cancer. This association remained significant only in prostate cancer in current smokers.
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The Utilization of National Tobacco Cessation Services among Female Smokers and the Need for a Gender-Responsive Approach. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18105313. [PMID: 34067704 PMCID: PMC8156447 DOI: 10.3390/ijerph18105313] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 05/03/2021] [Accepted: 05/15/2021] [Indexed: 12/23/2022]
Abstract
Despite the steadily increasing prevalence of female smoking, gender-responsive tobacco cessation services have not been widely provided worldwide. The purpose of this study is to identify factors associated with the use of tobacco cessation services among female tobacco product users in Korea from a national perspective. We performed a logistic regression analysis using data from 663 female smokers; 11.0% of female smokers had used government-supported smoking cessation services. A logistic regression model showed a statistically significant association between the utilization of smoking cessation services and a history of pregnancy and childbirth, depression, current use of heated tobacco products and multiple tobacco products, parental smoking status and receiving advice to quit. With regard to the motivation ruler, those in their 50s reported a higher importance than those in their 20s. Weight gain concerns when quitting smoking were the lowest among the participants aged 19-29. The need to develop gender-specific smoking cessation programs is the highest among the participants aged 39-49 and the lowest among those aged 19-29. This study suggests several factors related to the utilization of national health services among female smokers. Further studies considering gender-specific needs for the development of gender-responsive tobacco cessation support are needed.
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18
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Liao Y, Wang Y, Liu Y, McNeill A, Tang J. Effectiveness of the WeChat-based smoking cessation intervention ('WeChat WeQuit' program) in China: study protocol for a randomized controlled trial. Addiction 2021; 116:1279-1290. [PMID: 32567065 DOI: 10.1111/add.15166] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 04/23/2020] [Accepted: 06/16/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND AIMS Since its first release in 2011, WeChat (Chinese pinyin: Wei Xin) has been widely used to promote health. As the most popular all-in-one social media application providing free instant messaging, voice, text, pictures, videos and location information exchange via smartphone, WeChat holds promise for delivering smoking cessation services to a large number of people at low unit cost in China, a country with more than 300 million smokers. This protocol is for a study that aims to assess the efficacy of a WeChat-based smoking cessation intervention ('WeChat WeQuit') for treatment-seeking smokers in China. DESIGN In this two-arm randomized controlled trial (RCT), the control group will receive only a digital version of a booklet of 'Happy Quit'. The intervention group will also receive the 2 weeks pre- and 12 weeks post-quit 'WeChat WeQuit' intervention. Both groups will be followed-up to 26 weeks (6 months) after quit day. SETTING This on-line trial has no restrictions on setting or location. PARTICIPANTS Chinese-speaking current smokers (have smoked ≥100 cigarettes in their life-time and currently smoke cigarettes) aged 18+ years willing to make a quit attempt within 1 month (n = 2000) will be recruited by on- and off-line advertising. Potential participants will register their interest by sending WeChat messages or text messages, or making a voice call. MEASUREMENTS The primary outcome measure is self-reported 26-week continuous smoking abstinence with biological verification [test by clinic visit: expired carbon monoxide concentration <10 parts per million (p.p.m.) or by mailing cotinine urine dipsticks: urine cotinine <200 ng/ml]. Secondary outcome measures include: 7-day point prevalence abstinence at weeks 1, 4, 8, 12, 16, 20 and 26 after-quit day; self-reported 12-week continuous smoking abstinence and 26-week continuous smoking abstinence; reductions in number of cigarettes smoked per day; and rates of participation in and completion of the smoking-cessation program. CONCLUSIONS If the 'WeChat WeQuit' program is found to be effective, it will be an accessible, affordable and widely implementable intervention to help cigarette smokers to quit. The potential public health impact of its expansion into underserved regions or communities is considerable.
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Affiliation(s)
- Yanhui Liao
- Department of Psychiatry, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Zhejiang, Hangzhou, China.,Key Laboratory of Medical Neurobiology of Zhejiang Province, Zhejiang, Hangzhou, China.,Department of Psychiatry, the Second Xiangya Hospital, Central South University, Changsha, Hunan, China.,National Clinical Research Center on Mental Disorders, Changsha, Hunan, China.,Addictions Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Yunfei Wang
- Department of Psychiatry, the Second Xiangya Hospital, Central South University, Changsha, Hunan, China.,National Clinical Research Center on Mental Disorders, Changsha, Hunan, China
| | - Yueheng Liu
- Department of Psychiatry, the Second Xiangya Hospital, Central South University, Changsha, Hunan, China.,National Clinical Research Center on Mental Disorders, Changsha, Hunan, China
| | - Ann McNeill
- Addictions Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Jinsong Tang
- Department of Psychiatry, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Zhejiang, Hangzhou, China.,Key Laboratory of Medical Neurobiology of Zhejiang Province, Zhejiang, Hangzhou, China.,Department of Psychiatry, the Second Xiangya Hospital, Central South University, Changsha, Hunan, China.,National Clinical Research Center on Mental Disorders, Changsha, Hunan, China
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Kos K. Cardiometabolic Morbidity and Mortality with Smoking Cessation, Review of Recommendations for People with Diabetes and Obesity. Curr Diab Rep 2020; 20:82. [PMID: 33289870 PMCID: PMC7722253 DOI: 10.1007/s11892-020-01352-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/26/2020] [Indexed: 12/16/2022]
Abstract
PURPOSE OF REVIEW Obesity is closely linked with the pathogenesis of type 2 diabetes (T2DM) and cardiovascular disease (CVD), and whilst smoking cessation is associated with weight gain, there are concerns that this weight gain may offset the benefit of CVD risk reduction especially in those with considerable post-cessation weight gain. The aim of this narrative review is to evaluate recent evidence on smoking cessation and cardiometabolic outcomes and discuss limitations of current knowledge and studies. RECENT FINDINGS Nicotine is a key player in modulating energy balance by influencing lipid storage in adipose tissue by affecting lipolysis, energy input by modulating appetite and energy output by increasing sympathetic drive and thermogenesis. It also increases insulin resistance and promotes abdominal obesity. The CVD risk and mortality associated with cigarette smoking potentiate the CVD risks in patients with diabetes. Evidence supports the benefit of quitting cigarette smoking regardless of any subsequent weight gain. Data suggests that the cardiometabolic risk is limited to the first few years and that cardiovascular health and mortality benefit of smoking cessation outweighs the harm related to weight gain. This weight gain can be limited by nicotine replacement of which e-cigarettes (vaping) are increasingly popular if it is not an alternative to cigarette smoking. However, long-term health data on e-cigarettes is needed prior to formal recommendation for its use in smoking cessation. The recommendation for cessation of cigarette smoking is justified for those at high risk of weight gain and diabetes. However, for most benefit, consideration should be given for personalized weight management to limit weight gain. Awareness of a 'lean paradox' by which lower weight is associated with increased CVD risk may help to improve motivation and insight into the bias of smoking, health and body composition otherwise known to epidemiologists as the 'obesity paradox'.
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Affiliation(s)
- Katarina Kos
- Institute of Biomedical and Clinical Sciences, University of Exeter Medical School, University of Exeter, Exeter, Devon, UK.
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20
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Allen S, Petersen A, Harrison K, Tosun N, Cameron J. Response to nicotine following overnight smoking abstinence during short-term progesterone treatment in women. Exp Clin Psychopharmacol 2020; 28:306-316. [PMID: 31464476 PMCID: PMC7048655 DOI: 10.1037/pha0000312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Preclinical and clinical literature suggest that sex hormones impact tobacco use behaviors in women. The goal of this double-blind crossover laboratory study was to examine the effect of oral exogenous progesterone (200 mg twice per day) versus placebo on nicotine response using measures of motor speed and cognitive function in women following overnight smoking abstinence. We hypothesized that increased progesterone would blunt the nicotine response whereby producing less change in motor speed and cognition in response to nicotine exposure. Female smokers, age 18-35, were randomized to participate in two 9-day crossover testing weeks. Participants completed a lab session following overnight abstinence where they were administered nicotine nasal spray and asked to complete measures of immediate memory (IMT), delayed memory (DMT), word recall (WR), and finger tapping speed (FT). After the first 9-day testing week, participants resumed smoking and returned the following month to complete the identical lab session in the crossover condition. Forty-seven women were included in this analysis (n = 47). We found no differences in the magnitude of response for IMT, DMT, and WR between conditions. For FT, women had a blunted response to nicotine during the placebo condition. When examining the association between hormone levels and relative performance, we found increases in DMT, WR, and FT but decreases in IMT during the progesterone condition. We observed differences between progesterone versus placebo in relative change in some measures of nicotine response following overnight abstinence. Future studies are needed to further characterize this response. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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Affiliation(s)
- Sharon Allen
- Department of Family Medicine & Community Health, University of Minnesota 516 Delaware Street SE, Minneapolis, MN 55455
| | - Ashley Petersen
- Division of Biostatistics, School of Public Health, University of Minnesota 420 Delaware Street SE, Minneapolis, MN 55455
| | - Katherine Harrison
- Department of Family Medicine & Community Health, University of Minnesota 717 Delaware Street SE, Minneapolis, MN 55414
| | - Nicole Tosun
- Department of Family Medicine & Community Health, University of Minnesota 717 Delaware Street SE, Minneapolis, MN 55414
| | - Jacquelyn Cameron
- William Beaumont School of Medicine, Oakland University 586 Pioneer Dr, Rochester, MI 48309
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21
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Stinson J, Wolfson L, Poole N. Technology-Based Substance Use Interventions: Opportunities for Gender-Transformative Health Promotion. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17030992. [PMID: 32033304 PMCID: PMC7037203 DOI: 10.3390/ijerph17030992] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 02/01/2020] [Accepted: 02/04/2020] [Indexed: 11/16/2022]
Abstract
Drawing on data from a scoping review on sex, gender and substance use, this narrative review explores the use of gender-informed and technology-based approaches in substance use prevention and health promotion interventions. With an ever-changing landscape of new technological developments, an understanding of how technology-based interventions can address sex, gender, and intersecting equity considerations related to substance use is warranted. Current technology-based approaches to substance use prevention and health promotion are described and assessed for gender-specific and gender transformative outcomes, and limitations are discussed related to inclusivity, access, confidentiality, and a dearth of research on technological approaches that integrate gender-based analysis. A call for action designed to advance technology-based health promotion, prevention and brief interventions that address gender equity simultaneously with substance use is proposed.
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Affiliation(s)
- Julie Stinson
- Centre of Excellence for Women’s Health, D404-4500 Oak St, Vancouver, BC V6H 3N1, Canada; (L.W.); (N.P.)
- Correspondence:
| | - Lindsay Wolfson
- Centre of Excellence for Women’s Health, D404-4500 Oak St, Vancouver, BC V6H 3N1, Canada; (L.W.); (N.P.)
- Canada FASD Research Network, PO Box 11364, Vancouver, BC V5R 0A4, Canada
| | - Nancy Poole
- Centre of Excellence for Women’s Health, D404-4500 Oak St, Vancouver, BC V6H 3N1, Canada; (L.W.); (N.P.)
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22
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Lycett D, Aveyard P, Farmer A, Lewis A, Munafò M. Referral to Slimming World in UK Stop Smoking Services (SWISSS) versus stop smoking support alone on body weight in quitters: results of a randomised controlled trial. BMJ Open 2020; 10:e032271. [PMID: 31988226 PMCID: PMC7045045 DOI: 10.1136/bmjopen-2019-032271] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
INTRODUCTION Most people who stop smoking gain weight. Dietary modification may seem an obvious solution, but food restriction may increase cigarette craving and smoking relapse. TRIAL DESIGN An unblinded parallel randomised controlled trial. METHODS Participants were adult smokers with a body mass index greater or equal to 23 kg/m2. Setting was National Health Service commissioned Stop Smoking Services, interventions were referral to a commercial weight management programme, plus stop smoking support (treatment group), compared with stop smoking support alone (control group). Objective was to compare weight change between interventions in smoking abstainers and not abstinent rates in all. Primary outcome was change in weight (kg) at 12 weeks. Randomisation sequence was computer generated and concealed until allocation. RESULTS Seventy-six participants were recruited, 37 were randomised to the treatment group and 39 to the control group. Change in weight was analysed in long-term abstainers (13 treatment, 14 control) only because the aim was to prevent weight gain associated with smoking cessation. Abstinence was analysed on an intention-to-treat basis (37 treatment, 39 control). At 12 weeks weight gain was less in the treatment than the control group with an adjusted mean difference of -2.3 kg 95% CI (-4.4 to -0.1). Craving scores were lower (Mood and Physical Symptoms Scale craving domain -1.6 (-2.7 to -0.5)) and quit rates were higher in the treatment than the control group (32% vs 21%), although the trial was not powered to superiority in cravings and quit rates. No adverse events or side effects were reported. CONCLUSION In people who are obese and want to quit smoking, these data provide modest encouragement that providing weight management at the time of quitting may be helpful. Those who are not obese, but who are informed about potential weight gain during their quit attempt, were uninterested in a weight management programme. TRIAL REGISTRATION NUMBER ISRCTN65705512.
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Affiliation(s)
- Deborah Lycett
- Faculty of Health and Life Sciences, Coventry University, Coventry, West Midlands, UK
| | - Paul Aveyard
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, Oxfordshire, UK
| | - Andrew Farmer
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, Oxfordshire, UK
| | - Amanda Lewis
- Population Health Sciences Bristol Medical School, University of Bristol, Bristol, UK
| | - Marcus Munafò
- School of Experimental Psychology, University of Bristol, Bristol, UK
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23
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Faro JM, Orvek EA, Blok AC, Nagawa CS, McDonald AJ, Seward G, Houston TK, Kamberi A, Allison JJ, Person SD, Smith BM, Brady K, Grosowsky T, Jacobsen LL, Paine J, Welch JM, Sadasivam RS. Dissemination and Effectiveness of the Peer Marketing and Messaging of a Web-Assisted Tobacco Intervention: Protocol for a Hybrid Effectiveness Trial. JMIR Res Protoc 2019; 8:e14814. [PMID: 31339104 PMCID: PMC6683651 DOI: 10.2196/14814] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 06/27/2019] [Accepted: 06/27/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Smoking continues to be the leading preventable cause of death. Digital Interventions for Smoking Cessation (DISCs) are health communication programs accessible via the internet and smartphones and allow for greater reach and effectiveness of tobacco cessation programs. DISCs have led to increased 6-month cessation rates while also reaching vulnerable populations. Despite this, the impact of DISCs has been limited and new ways to increase access and effectiveness are needed. OBJECTIVE We are conducting a hybrid effectiveness-dissemination study. We aim to evaluate the effectiveness of a machine learning-based approach (recommender system) for computer-tailored health communication (CTHC) over a standard CTHC system based on quit rates and risk reduction. In addition, this study will assess the dissemination of providing access to a peer recruitment toolset on recruitment rate and variability of the sample. METHODS The Smoker-to-Smoker (S2S) study is a 6-month hybrid effectiveness dissemination trial conducted nationally among English-speaking, current smokers aged ≥18 years. All eligible participants will register for the DISC (Decide2quit) and be randomized to the recommender system CTHC or the standard CTHC, followed by allocation to a peer recruitment toolset group or control group. Primary outcomes will be 7-day point prevalence and risk reduction at the 6-month follow-up. Secondary outcomes include recruitment rate, website engagement, and patient-reported outcomes collected via the 6-month follow-up questionnaire. All primary analyses will be conducted on an intent-to-treat basis. RESULTS The project is funded from 2017 to 2020 by the Patient Centered Outcomes Research Institute. Enrollment was completed in early 2019, and 6-month follow-ups will be completed by late 2019. Preliminary data analysis is currently underway. CONCLUSIONS Conducting a hybrid study with both effectiveness and dissemination hypotheses raises some unique challenges in the study design and analysis. Our study addresses these challenges to test new innovations and increase the effectiveness and reach of DISCs. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/14814.
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Affiliation(s)
- Jamie M Faro
- Division of Health Informatics and Implementation Science, Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, United States
| | - Elizabeth A Orvek
- Division of Health Informatics and Implementation Science, Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, United States
| | - Amanda C Blok
- Division of Health Informatics and Implementation Science, Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, United States
- Center for Healthcare Organization and Implementation Research, Bedford Veterans Affairs Medical Center, Bedford, MA, United States
| | - Catherine S Nagawa
- Division of Health Informatics and Implementation Science, Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, United States
| | - Annalise J McDonald
- Division of Health Informatics and Implementation Science, Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, United States
| | - Gregory Seward
- Division of Health Informatics and Implementation Science, Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, United States
| | - Thomas K Houston
- Division of Health Informatics and Implementation Science, Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, United States
| | - Ariana Kamberi
- Division of Health Informatics and Implementation Science, Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, United States
| | - Jeroan J Allison
- Division of Health Informatics and Implementation Science, Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, United States
| | - Sharina D Person
- Division of Biostatistics And Health Services Research, Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, United States
| | - Bridget M Smith
- Center of Innovation for Complex Chronic Healthcare, Spinal Cord Injury Quality Enhancement Research Initiative, Hines VA Medical Center, Chicago, IL, United States
- Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Evanston, IL, United States
| | | | - Tina Grosowsky
- S2S Patient Panel, Worcester, MA, United States
- Department of Psychiatry, University of Massachusetts Medical School, Worcester, MA, United States
| | | | | | | | - Rajani S Sadasivam
- Division of Health Informatics and Implementation Science, Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, United States
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Salk RH, Germeroth LJ, Emery RL, Conlon RPK, Wang Z, Cheng Y, Marcus MD, Perkins KA, Levine MD. Predictive utility of subtyping women smokers on depression, eating, and weight-related symptoms. Health Psychol 2019; 38:248-258. [PMID: 30762404 DOI: 10.1037/hea0000702] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
OBJECTIVE Smoking and overweight or obesity are preventable causes of disease and death. Women are reluctant to quit smoking because of concerns about postcessation weight gain, underscoring the need to elucidate patterns of weight concerns and associated psychosocial factors that may affect smoking cessation outcomes. The present study aimed to subtype women smokers based on psychosocial and behavioral factors associated with smoking and weight, and examine the utility of these subtypes to predict abstinence and postcessation weight gain. METHOD Weight-concerned women (N = 343) were randomized to 1 of 2 smoking cessation counseling adjuncts and 1 of 2 cessation medication conditions. At baseline, women were weighed and completed measures of depression, weight or appearance concerns, and eating behaviors. At 3-, 6-, and 12-months after the target quit date, women were weighed and completed self-report and biochemical smoking assessments. RESULTS Latent profile (LP) analyses supported a 3-profile model. The groups had typical (53%, LP1), minimal (33%, LP2), and high (14%, LP3) levels of depressive symptoms and weight concerns. At 12-months posttarget quit date, women in LP3 were more likely to relapse than women in LP1 (odds ratio, OR = 2.93). Among abstinent women, those in LP2 and LP3 gained more postcessation weight than those in LP1. CONCLUSIONS Heterogeneity in symptoms of depression, weight or appearance concerns, and eating behaviors was captured by three groups of women smokers, with unique risks for relapse and postcessation weight gain. The distinct profiles identified may help personalize the delivery of care for smoking cessation and, ultimately, reduce disease risk. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Murphy CM, Rohsenow DJ, Johnson KC, Wing RR. Smoking and weight loss among smokers with overweight and obesity in Look AHEAD. Health Psychol 2018; 37:399-406. [PMID: 29698015 DOI: 10.1037/hea0000607] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Smoking cessation is associated with increases in body weight, but little is known about the relationship between participation in a weight loss intervention and smoking. OBJECTIVE To determine whether (a) weight losses at 1 year differ as a function of baseline smoking status (never smoker, current smoker, ex-smoker) and (b) participation in a weight loss intervention affects smoking behavior. METHOD This analysis addressed these questions using the publicly available database from Look AHEAD, a randomized trial comparing intensive lifestyle intervention (ILI) and diabetes support and education (DSE; control condition) among individuals with overweight/obesity and Type 2 diabetes, and included 4,387 participants who had self-reported smoking and objective weight measures available at baseline and at 1 year. RESULTS Although participants in ILI lost a significantly greater percentage of weight than those in DSE at 1 year (ILI, M = -8.8%, SD = 6.8; DSE, M = -0.7%, SD = 4.7), there were no differences in weight loss outcomes between never smokers (n = 2,297), ex-smokers (n = 2,115), and current smokers (n = 188) within either condition. Participation in ILI was not associated with compensatory smoking or likelihood of quitting smoking or relapsing. CONCLUSIONS Smokers in a weight loss intervention had reductions in weight that were comparable to individuals who did not smoke without any evidence of compensatory smoking to manage eating and appetite. Smokers with obesity should be encouraged to pursue weight loss without concerns regarding the impact on smoking behavior. (PsycINFO Database Record
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Affiliation(s)
- Cara M Murphy
- Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, Brown University School of Public Health
| | - Damaris J Rohsenow
- Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, Brown University School of Public Health
| | - Karen C Johnson
- Department of Preventive Medicine, University of Tennessee Health Science Center
| | - Rena R Wing
- Weight Control & Diabetes Research Center, The Miriam Hospital
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Walker JF, Loprinzi PD. Association of BMI Changes Between Adolescence and Young Adulthood With Smoking Cessation. Am J Health Promot 2018; 33:358-362. [PMID: 30105914 DOI: 10.1177/0890117118772492] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
PURPOSE Weight gain frequently accompanies smoking cessation. This study examined if increasing body mass index (BMI) during the early years of smoking influences quitting by young adulthood. DESIGN Longitudinal, observational study using in-home interview data. SETTING National Longitudinal Study of Adolescent and Adult Health (Add Health) 1994 to 2008. SUBJECTS Nine hundred forty-nine adolescent smokers (12-19 years) followed into young adulthood (20-32 years) through 4 waves of in-home interviews. MEASURES Outcome variable: Young adult smoking status (yes or no) reported at in-home interviews. Factors: Gender and 4 longitudinal adolescent/young adult BMI trajectories-normal/normal, normal/overweight, normal/obese, and overweight/obese. Covariates: Race-ethnicity, education, household income, and recent quit attempt in adolescence. ANALYSIS Binary logistic regression analysis. RESULTS Overall, the rate at which young adults quit smoking was not significantly different based on gender. However, longitudinal changes in BMI trajectory and gender interact to influence young adult smoking status. Women having normal/overweight and normal/obese BMI trajectories were less likely to quit smoking than men. Odds that young adults having some college or post-high school education quit smoking were greater than those with high school education or less. CONCLUSION At a minimum, providing direct information regarding anticipated weight changes after quitting is indicated in smoking cessation intervention, in addition to strategies to mitigate postcessation weight gain. Faced with weight gain, younger smokers, particularly women, may be more resistant to quitting smoking.
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Affiliation(s)
- Jerome F Walker
- 1 Department of Respiratory Therapy, Bellarmine University, Louisville, KY, USA
| | - Paul D Loprinzi
- 2 Department of Health, Exercise Science, and Recreation Management, University of Mississippi, Oxford, MS, USA
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Pánková A, Králíková E, Štepánková L, Zvolska K, Bortlícek Z, Bláha M, Clark MM, Schroeder DR, Croghan IT. Weight Concerns Associated With Delay in Quit Date But Not Treatment Outcomes: A Czech Republic Experience. Nicotine Tob Res 2018; 20:89-94. [PMID: 27729514 DOI: 10.1093/ntr/ntw276] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Accepted: 10/10/2016] [Indexed: 12/13/2022]
Abstract
Background Weight concerns are prevalent in smokers and may reduce the success rate of quitting. This concept has been primarily studied on US populations and it is unknown how weight concerns may differ cross-culturally. This study examined the role of weight concern in European smokers wishing to stop smoking. Methods A sample of 593 smokers (299 men and 294 women, mean age 38 years) utilizing the Centre for Tobacco-Dependent in Prague, Czech Republic, between 2010 and 2013 were studied. Weight concerns were assessed at baseline prior to treatment by evidence-based stop smoking methods. Abstinence was evaluated at 12 months post baseline. Results Approximately 34% of all patients (204/593) were classified as weight concerned (by indicating on the Weight Concern Scale that they would return to smoking after any weight gain) at the time they sought treatment. Among all men, 19.4% (58/299) were weight concerned and among all women, 49.7% (146/294) were weight concerned. Among females, weight-concerned smokers were of similar weight, but younger (p < .001), and had been smoking cigarettes for fewer years (p = .002) compared with those without weight concerns, whereas the male weight-concerned smokers were significantly (p = .030) heavier than those without weight concerns. Although the presence of weight concern was associated with a delay in setting a quit date (log-rank test p = .019), it was not associated with abstinence at one year. Conclusion The quit success rate of weight-concerned smokers in Czech Republic did not differ from those without weight concern when utilizing an individualized smoking cessation treatment program. Individually tailored tobacco dependence treatment could help to prevent weight concern from affecting successful quitting. Implications This study adds the new cross-cultural aspect of post-cessation weight concern. Weight concern has been studied primarily on US populations and our sample consists of European sample of smokers. Additionally, we have found that the presence of weight concern lead to delay in setting a quit date, but the success rate of those weight concerned did not differ from those without weight concern. Thus, it is possible, that this individualized evidence-based tobacco treatment program was able to prevent weight concern impact towards successful quitting.
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Affiliation(s)
- Alexandra Pánková
- Centre for Tobacco-Dependent, 3rd Internal Department - Department of Endocrinology and Metabolism, First Faculty of Medicine and the General University Hospital, Charles University, Prague, Czech Republic.,Institute of Hygiene and Epidemiology, First Faculty of Medicine and the General University Hospital, Charles University, Prague, Czech Republic
| | - Eva Králíková
- Centre for Tobacco-Dependent, 3rd Internal Department - Department of Endocrinology and Metabolism, First Faculty of Medicine and the General University Hospital, Charles University, Prague, Czech Republic.,Institute of Hygiene and Epidemiology, First Faculty of Medicine and the General University Hospital, Charles University, Prague, Czech Republic
| | - Lenka Štepánková
- Centre for Tobacco-Dependent, 3rd Internal Department - Department of Endocrinology and Metabolism, First Faculty of Medicine and the General University Hospital, Charles University, Prague, Czech Republic
| | - Kamila Zvolska
- Centre for Tobacco-Dependent, 3rd Internal Department - Department of Endocrinology and Metabolism, First Faculty of Medicine and the General University Hospital, Charles University, Prague, Czech Republic
| | - Zbynek Bortlícek
- Institute of Biostatistics and Analyses, Medical Faculty, Masaryk University, Brno, Czech Republic
| | - Milan Bláha
- Institute of Biostatistics and Analyses, Medical Faculty, Masaryk University, Brno, Czech Republic
| | - Matthew M Clark
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN
| | - Darrell R Schroeder
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, MN
| | - Ivana T Croghan
- Nicotine Dependence Center, Clinical Research Office and Clinical Trial Unit, Department of Medicine, Mayo Clinic, Rochester, MN
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Chung JWY, Wong BYM, Yan VCM, Chung LMY, So HCF, Chan A. Cardiovascular Health of Construction Workers in Hong Kong: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15061251. [PMID: 29895813 PMCID: PMC6025116 DOI: 10.3390/ijerph15061251] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Revised: 06/08/2018] [Accepted: 06/10/2018] [Indexed: 01/10/2023]
Abstract
Background: Given a shortage of construction workers, it is important to develop strategies to avoid early retirement caused by cardiovascular diseases in Hong Kong. Objectives: (1) to describe the cardiovascular health of construction workers in Hong Kong, (2) to examine the demographic differences in cardiovascular health, and (3) to examine the association between health behaviors and cardiovascular health factors. Methods: 626 registered construction workers were included in the analysis. Blood chemistry, blood pressure, weight, and height were measured. Face-to-face questionnaire interviews for health behaviors were conducted. Results: Approximately two-thirds of the construction workers achieved only three out of the seven “ideal” cardiovascular health metrics. The younger, more educated, and female subjects had better cardiovascular health scores than the older, less educated, and male counterparts. Fish and seafood consumption was associated with (1) ideal weight status and (2) ideal cholesterol level, whereas less soft drink consumption was associated with ideal cholesterol level. Conclusions: The findings highlighted the importance of promoting cardiovascular health in the construction industry. This study provided some insights for future interventions, which should include increasing fish and seafood intake, decreasing soft drink consumption, and enhancing the health literacy amongst older, less educated, and male construction workers.
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Affiliation(s)
- Joanne Wai-Yee Chung
- Department of Health and Physical Education, The Education University of Hong Kong, 10 Lo Ping Road, Tai Po, New Territories, Hon Kong, China.
| | - Bonny Yee-Man Wong
- Department of Health and Physical Education, The Education University of Hong Kong, 10 Lo Ping Road, Tai Po, New Territories, Hon Kong, China.
| | - Vincent Chun-Man Yan
- Department of Health and Physical Education, The Education University of Hong Kong, 10 Lo Ping Road, Tai Po, New Territories, Hon Kong, China.
| | - Louisa Ming-Yan Chung
- Department of Health and Physical Education, The Education University of Hong Kong, 10 Lo Ping Road, Tai Po, New Territories, Hon Kong, China.
| | - Henry Chi-Fuk So
- Department of Mathematics and Information Technology, The Education University of Hong Kong, 10 Lo Ping Road, Tai Po, New Territories, Hong Kong, China.
| | - Albert Chan
- Department of Building and Real Estate, Polytechnic University, 11 Yuk Choi Rd, Hung Hom, Hong Kong, China.
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Bush T, Lovejoy J, Javitz H, Torres AJ, Wassum K, Tan MM, Spring B. Simultaneous vs. sequential treatment for smoking and weight management in tobacco quitlines: 6 and 12 month outcomes from a randomized trial. BMC Public Health 2018; 18:678. [PMID: 29855294 PMCID: PMC5984316 DOI: 10.1186/s12889-018-5574-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Accepted: 05/17/2018] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Smoking cessation often results in weight gain which discourages many smokers from quitting and can increase health risks. Treatments to reduce cessation-related weight gain have been tested in highly controlled trials of in-person treatment, but have never been tested in a real-world setting, which has inhibited dissemination. METHODS The Best Quit Study (BQS) is a replication and "real world" translation using telephone delivery of a prior in-person efficacy trial. DESIGN randomized control trial in a quitline setting. Eligible smokers (n = 2540) were randomized to the standard 5-call quitline intervention or quitline plus simultaneous or sequential weight management. Regression analyses tested effectiveness of treatments on self-reported smoking abstinence and weight change at 6 and 12 months. RESULTS Study enrollees were from 10 commercial employer groups and three state quitlines. Participants were between ages 18-72, 65.8% female, 68.2% white; 23.0% Medicaid-insured, and 76.3% overweight/obese. The follow-up response rate was lower in the simultaneous group than the control group at 6 months (p = 0.01). While a completers analysis of 30-day point prevalence abstinence detected no differences among groups at 6 or 12 months, multiply imputed abstinence showed quit rate differences at 6 months for:simultaneous (40.3%) vs. sequential (48.3%), p = 0.034 and simultaneous vs. control (44.9%), p = 0.043. At 12 months, multiply imputed abstinence, was significantly lower for the simultaneous group (40.7%) vs. control (46.0%), p < 0.05 and vs. sequential (46.3%), p < 0.05. Weight gain at 6 and 12 months was minimal and not different among treatment groups. The sequential group completed fewer total calls (3.75) vs. control (4.16) and vs. simultaneous group (3.83), p = 0.01, and fewer weight calls (0.94) than simultaneous (2.33), p < 0.0001. The number of calls completed predicted 30-day abstinence, p < 0.001, but not weight outcomes. DISCUSSION This study offers a model for evaluating population-level public health interventions conducted in partnership with tobacco quitlines. CONCLUSIONS Simultaneous (vs. sequential) delivery of phone/web weight management with cessation treatment in the quitline setting may adversely affect quit rate. Neither a simultaneous nor sequential approach to addressing weight produced any benefit on suppressing weight gain. This study highlights the need and the challenges of testing intensive interventions in real-world settings. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT01867983 . Registered: May 30, 2013.
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Affiliation(s)
- Terry Bush
- Alere Wellbeing (a solely owned subsidiary of Optum), 999 Third Avenue Suite 2000, Seattle, WA 98104-1139 USA
| | | | | | - Alula Jimenez Torres
- Alere Wellbeing (a solely owned subsidiary of Optum), 999 Third Avenue Suite 2000, Seattle, WA 98104-1139 USA
| | - Ken Wassum
- Alere Wellbeing (a solely owned subsidiary of Optum), 999 Third Avenue Suite 2000, Seattle, WA 98104-1139 USA
| | - Marcia M. Tan
- Feinberg School of Medicine, Northwestern University, Chicago, IL USA
| | - Bonnie Spring
- Center for Behavior and Health, Institute for Public Health and Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL USA
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Coa KI, Augustson E, Kaufman A. The Impact of Weight and Weight-Related Perceptions on Smoking Status Among Young Adults in a Text-Messaging Cessation Program. Nicotine Tob Res 2018; 20:614-619. [PMID: 28340132 DOI: 10.1093/ntr/ntx053] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Accepted: 03/01/2017] [Indexed: 12/30/2022]
Abstract
Introduction Weight gain and concerns about weight can influence a smoker's ability to successfully quit, and young adults are a subgroup of smokers who are particularly concerned about the impact of quitting on their body weight. This study explored the associations between body mass index, weight perceptions, and smoking status among young adults. Methods The sample consisted of 4027 young adults between the ages of 18 and 29 who participated in a randomized control trial of the National Cancer Institute's SmokefreeTXT program. Multivariable logistic regression models were used to examine the associations between weight related variables and smoking status. Results Obese participants had a 0.72 lower odds (95% CI: 0.62, 0.85) of reporting smoking at the end of the program than participants of normal weight, and this difference persisted over time. Weight perceptions were also associated with smoking status. Those who perceived themselves to be slightly underweight/underweight were more likely to report smoking than those who reported being just about the right weight (OR: 1.53, 95% CI: 1.20, 1.95), and those who strongly disagreed that smoking cigarettes helps people keep their weight down were less likely to report smoking at the end of treatment than those who neither agreed nor disagreed with this statement (OR: 0.69, 95% CI: 0.54, 0.87). Conclusions Weight related factors assessed at baseline predicted smoking status at the end of treatment and through long term follow-up. Smoking cessation programs that tailor content to addresses the specific needs of weight concerned smokers may enhance effectiveness. Implications This study explores the association between weight related factors and smoking status among young adults, a priority population for smoking cessation efforts. This study demonstrates that both actual weight and weight perceptions (eg, perception of body weight, perception of associations between smoking and weight) are associated with smoking outcomes, and thus need to be a considered in the development of smoking cessation programs.
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Affiliation(s)
| | - Erik Augustson
- Tobacco Control Research Branch, National Cancer Institute, Rockville, MD
| | - Annette Kaufman
- Tobacco Control Research Branch, National Cancer Institute, Rockville, MD
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Postcessation weight gain concern as a barrier to smoking cessation: Assessment considerations and future directions. Addict Behav 2018; 76:250-257. [PMID: 28865363 DOI: 10.1016/j.addbeh.2017.08.022] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Revised: 08/01/2017] [Accepted: 08/21/2017] [Indexed: 12/19/2022]
Abstract
PURPOSE 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. METHODS 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. RESULTS 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. CONCLUSIONS 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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Lee JY, Kim SM, Choi YS, Park YG, Kim EY, Yoon SJ, Kim JW, Yoon JH, Kim M, Jeon HR. The Relationship between Body Mass Index and Smoking Cessation Plans in Korean Adults. J Obes Metab Syndr 2017; 26:281-286. [PMID: 31089531 PMCID: PMC6489477 DOI: 10.7570/jomes.2017.26.4.281] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Revised: 07/11/2017] [Accepted: 09/21/2017] [Indexed: 11/26/2022] Open
Abstract
Background Concerns regarding weight gain after smoking cessation may interfere with quitting smoking. This study investigated the association between smoking cessation plans and body mass index (BMI, kg/m2) in Korean adult smokers. Methods Using data from the sixth Korea National Health and Nutrition Examination Survey (2013–2015), 3,000 current smokers aged 19 years or older were selected and divided into four weight groups. The cohorts included an underweight group (BMI, <18.5 kg/m2), normal weight group (BMI, ≥18.5 to <23 kg/m2), overweight group (BMI, ≥23 to <25 kg/m2), and obese group (BMI, ≥25 kg/m2). The relationship between BMI and smoking cessation plans in Korean adults was analyzed using multiple logistic regression analysis. Results Multiple logistic regression analysis showed sex (odds ratio [OR], 0.723; 95% confidence interval [CI], 0.556–0.939), high-risk drinking (OR, 0.796; 95% CI, 0.634–0.998), aerobic physical activity (OR, 1.326; 95% CI, 1.092–1.612), and hypertension (OR, 1.387; 95% CI, 1.034–1.860) were the significant factors related to smoking cessation plans. According to the BMI categories, the ORs of smoking cessation plans were numerically higher in the normal weight group than the other three groups. However, the difference was not statistically significant. Conclusion Normal weight subjects tended to have a greater number of smoking cessation plans than the other three weight groups, but the difference was not statistically significant. In the clinic, it is necessary to consider not only BMI but also other factors associated with a smoking cessation plans.
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Affiliation(s)
- Ji Young Lee
- Department of Family Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Seon Mee Kim
- Department of Family Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Yoon Seon Choi
- Department of Family Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Yong Gyu Park
- Department of Biostatistics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - E Yeon Kim
- Department of Family Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - So Jung Yoon
- Department of Family Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Jin Wook Kim
- Department of Family Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Jung Hwan Yoon
- Department of Family Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Man Kim
- Department of Family Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Hye Ran Jeon
- Department of Family Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
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Tian J, Gall SL, Smith KJ, Dwyer T, Venn AJ. Worsening Dietary and Physical Activity Behaviors Do Not Readily Explain Why Smokers Gain Weight After Cessation: A Cohort Study in Young Adults. Nicotine Tob Res 2017; 19:357-366. [PMID: 27613937 DOI: 10.1093/ntr/ntw196] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Accepted: 07/20/2016] [Indexed: 12/17/2022]
Abstract
Introduction The relationship between smoking cessation and weight gain is well established but the underlying mechanisms remain poorly understood. We aimed to determine whether postcessation weight gain was mediated by changing health behaviors. Methods A total of 281 smokers self-reported their demographic, smoking, and lifestyle characteristics in 2004-2006 (aged 26-36) and 2009-2011 (aged 31-41). Behaviors considered as potential mediators of weight gain were changes in consumption of breakfast, discretionary foods (servings/d), fruit and vegetables (servings/d), alcohol (g/d), takeaway food (times/wk), Diet Guideline Index score, leisure time physical activity (PA, min/wk), total PA (min/wk), time spent sitting (min/d), and TV viewing (h/d). Results In total, 124 smokers quit smoking during 5 years follow-up. After adjustment for age, sex, baseline body mass index, education, and follow-up length, smoking cessation was associated with average excess weight gain of 2.09kg (95% CI = 0.35-3.83). Compared with continuing smokers, quitters reported a higher Diet Guideline Index score and less consumption of alcohol at baseline and follow-up (all p < .05). In addition, there was a tendency towards healthier dietary and PA behaviors over 5 years among quitters than continuing smokers except for time spent sitting, although these differences did not reach statistical significance. Adjustment for changes in these behaviors made little difference to the magnitude of postcessation weight gain (β: 2.32kg, 95% CI = 0.54-4.10). Conclusions The weight gain associated with smoking cessation was not explained by worsening dietary and PA behaviors. Future research is needed to elucidate the complex mechanisms and particularly ways it may be prevented. Implications Fear of weight gain often discourages smokers from trying to quit but guidance on ways to most effectively avoid weight gain is lacking. It is important to identify what causes postcessation weight gain and the ways it may be prevented. The current study explored the effects of several changing dietary and PA behaviors on the relationship between smoking cessation and weight gain in 281 young Australian smokers. We found that quitters tended to adopt healthier dietary and PA behaviors than continuing smokers, so these behaviors did not readily explain the postcessation weight gain. Further investigations of other potential mechanisms are needed.
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Affiliation(s)
- Jing Tian
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Seana L Gall
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Kylie J Smith
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Terry Dwyer
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia.,The George Institute for Global Health, University of Oxford, Oxford, UK
| | - Alison J Venn
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
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Shoemaker ML, White MC, Hawkins NA, Hayes NS. Prevalence of Smoking and Obesity Among U.S. Cancer Survivors: Estimates From the National Health Interview Survey, 2008-2012. Oncol Nurs Forum 2017; 43:436-41. [PMID: 27314186 DOI: 10.1188/16.onf.43-04ap] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE/OBJECTIVES To describe smoking and obesity prevalence among male and female cancer survivors in the United States.
. DESIGN Cross-sectional survey.
. SETTING Household interviews.
. SAMPLE 9,753 survey respondents who reported ever having a malignancy, excluding nonmelanoma skin cancers.
. METHODS Data from the National Health Interview Survey (2008-2012) were used to calculate weighted smoking status prevalence estimates. Cross-tabulations of smoking and weight status were produced, along with Wald chi-square tests and linear contrasts.
. MAIN RESEARCH VARIABLES Cancer history, smoking status, obesity status, gender, age, and age at diagnosis.
. FINDINGS Seventeen percent of cancer survivors reported current smoking. Female survivors had higher rates of current smoking than males, particularly in the youngest age category. Male survivors who currently smoked had lower obesity prevalence rates than males who previously smoked or never smoked. Among female survivors, 31% were obese and no significant differences were seen in obesity prevalence by smoking status for all ages combined.
. CONCLUSIONS The findings highlight the variation in smoking status and weight by age and gender. Smoking interventions may need to be targeted to address barriers specific to subgroups of cancer survivors.
. IMPLICATIONS FOR NURSING Nurses can be instrumental in ensuring that survivors receive comprehensive approaches to address both weight and tobacco use to avoid trading one risk for another.
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Bush T, Lovejoy J, Javitz H, Mahuna S, Torres AJ, Wassum K, Magnusson B, Benedict C, Spring B. IMPLEMENTATION, RECRUITMENT AND BASELINE CHARACTERISTICS: A RANDOMIZED TRIAL OF COMBINED TREATMENTS FOR SMOKING CESSATION AND WEIGHT CONTROL. Contemp Clin Trials Commun 2017; 7:95-102. [PMID: 29124236 PMCID: PMC5673122 DOI: 10.1016/j.conctc.2017.06.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Background Two-thirds of treatment-seeking smokers are obese or overweight. Most smokers are concerned about gaining weight after quitting. The average smoker experiences modest post-quit weight gain which discourages many smokers from quitting. Although evidence suggests that combined interventions to help smokers quit smoking and prevent weight gain can be helpful, studies have not been replicated in real world settings. Methods This paper describes recruitment and participant characteristics of the Best Quit Study, a 3-arm randomized controlled trial testing tobacco cessation treatment alone or combined with simultaneous or sequential weight management. Study participants were recruited via tobacco quitlines from August 5, 2013 to December 15, 2014. Results Statistical analysis on baseline data was conducted in 2015/2016. Among 5082 potentially eligible callers to a tobacco quitline, 2540 were randomized (50% of eligible). Compared with individuals eligible but not randomized, those randomized were significantly more likely to be female (65.7% vs 54.5%, p < 0.01), overweight or obese (76.3% vs 62.5%, p < 0.01), more confident in quitting (p < 0.01), more addicted (first cigarette within 5 min: 50.0% vs 44.4%, p < 0.01), and have a chronic disease (28.6% vs. 24.4%, p < 0.01). Randomized groups were not statistically significantly different on demographics, tobacco or weight variables. Two-thirds of participants were female and white with a mean age of 43. Conclusions Adding weight management interventions to tobacco cessation quitlines was feasible and acceptable to smokers. If successful for cessation and weight outcomes, a combined intervention may provide a treatment approach for addressing weight gain with smoking cessation through tobacco quitlines. Trial registration Clinicaltrials.gov NCT01867983.
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Affiliation(s)
- Terry Bush
- Alere Wellbeing, solely owned subsidiary of Optum, 999 Third Avenue Suite 1800, Seattle, Washington 98104-1139, USA
| | - Jennifer Lovejoy
- Arivale, Inc and University of Washington School of Public Health, Seattle, WA
| | | | | | - Alula Jimenez Torres
- Alere Wellbeing, solely owned subsidiary of Optum, 999 Third Avenue Suite 1800, Seattle, Washington 98104-1139, USA
| | | | | | - Cody Benedict
- Gates Foundation (previously at Alere Wellbeing), Seattle, WA
| | - Bonnie Spring
- Center for Behavior and Health, Feinberg School of Medicine, Northwestern University, Chicago, IL
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Pinsker EA, Hennrikus DJ, Erickson DJ, Call KT, Forster JL, Okuyemi KS. Cessation-related weight concern among homeless male and female smokers. Prev Med Rep 2017; 7:77-85. [PMID: 28593127 PMCID: PMC5458131 DOI: 10.1016/j.pmedr.2017.05.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Revised: 03/14/2017] [Accepted: 05/15/2017] [Indexed: 11/05/2022] Open
Abstract
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. Although several types of characteristics predicted cessation-related weight concern among males, only smoking characteristics predicted cessation-related weight concern among females. Given the small proportion of quitters in this study (8% of males and 5% of females), further research on the impact of cessation-related weight concern on smoking cessation among the homeless is warranted. Concern about post-quitting weight gain is higher among homeless females than males. In multivariate analyses, weight concern decreased over time among homeless females. Several types of variables predicted weight concern among homeless males. Only smoking characteristics predicted weight concern among homeless females. Weight concern was not associated with smoking cessation among the homeless.
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Affiliation(s)
- Erika Ashley Pinsker
- Minneapolis VA Health Care System, Center for Chronic Disease Outcomes Research, One Veterans Drive Minneapolis, MN 55417, USA.,University of Minnesota, Department of Medicine, 401 East River Parkway Suite 131, Minneapolis, MN 55455, USA
| | - Deborah Jane Hennrikus
- University of Minnesota, Division of Epidemiology and Community Health, 1300 S 2nd St., Minneapolis, MN 55455, USA
| | - Darin J Erickson
- University of Minnesota, Division of Epidemiology and Community Health, 1300 S 2nd St., Minneapolis, MN 55455, USA
| | - Kathleen Thiede Call
- University of Minnesota, Division of Health Policy & Management, 516 Delaware St. SE Suite 15-223, Minneapolis, MN 55455, USA
| | - Jean Lois Forster
- University of Minnesota, Division of Epidemiology and Community Health, 1300 S 2nd St., Minneapolis, MN 55455, USA
| | - Kolawole Stephen Okuyemi
- University of Minnesota, Program in Health Disparities Research, 717 Delaware St. SE Suite 166, Minneapolis, MN 55414, USA
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Gordon JS, Armin J, D Hingle M, Giacobbi P, Cunningham JK, Johnson T, Abbate K, Howe CL, Roe DJ. Development and evaluation of the See Me Smoke-Free multi-behavioral mHealth app for women smokers. Transl Behav Med 2017; 7:172-184. [PMID: 28155107 PMCID: PMC5526811 DOI: 10.1007/s13142-017-0463-7] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Women face particular challenges when quitting smoking, especially those with weight concerns. A multi-behavioral smoking cessation intervention addressing these concerns and incorporating guided imagery may assist women to engage in healthy lifestyle behaviors. An mHealth app can easily disseminate such an intervention. The goals of this pilot study were to develop and test the feasibility and potential of the See Me Smoke-Free™ mHealth app to address smoking, diet, and physical activity among women smokers. We used pragmatic, direct-to-consumer methods to develop and test program content, functionality, and the user interface and conduct a pre-/post-test, 90-day pilot study. We enrolled 151 participants. Attrition was 52%, leaving 73 participants. At 90 days, 47% of participants reported 7-day abstinence and significant increases in physical activity and fruit consumption. Recruitment methods worked well, but similar to other mHealth studies, we experienced high attrition. This study suggests that a guided imagery mHealth app has the potential to address multiple behaviors. Future research should consider different methods to improve retention and assess efficacy.
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Affiliation(s)
- Judith S Gordon
- Department of Family and Community Medicine, College of Medicine, University of Arizona, Tucson, AZ, USA.
| | - Julie Armin
- Department of Family and Community Medicine, College of Medicine, University of Arizona, Tucson, AZ, USA
| | - Melanie D Hingle
- Department of Nutritional Sciences, College of Agriculture and Life Sciences, University of Arizona, Tucson, AZ, USA
| | - Peter Giacobbi
- College of Physical Activity and Sports Sciences, University of West Virginia, Morgantown, WV, USA
| | - James K Cunningham
- Department of Family and Community Medicine, College of Medicine, University of Arizona, Tucson, AZ, USA
| | - Thienne Johnson
- Departments of Computer Science and Electrical and Computer Engineering, University of Arizona, Tucson, AZ, USA
| | | | - Carol L Howe
- Department of Family and Community Medicine, College of Medicine, University of Arizona, Tucson, AZ, USA
| | - Denise J Roe
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
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Association of Weight Perception, Race and Readiness to Quit Smoking amongst a Cohort of Workers. J Smok Cessat 2016. [DOI: 10.1017/jsc.2016.26] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Introduction: Weight concerns may inhibit smoking quit attempts and may be more influential amongst African-Americans who are more likely to be overweight.Aims: To assess if weight perception is associated with readiness to quit and whether this relationship is modified by race.Methods: We used data from a cohort of current smokers undergoing routine health examinations. Based on differences between ideal and measured BMI, participants’ weight perceptions were classified as within, somewhat above, or far above ideal weight. Logistic regression analysis was used to evaluate adjusted associations of weight perception and race with readiness to quit.Results: Of 2,831 current smokers, 23% were obese and 38% overweight. Amongst white smokers, those who perceived being far above ideal weight were more likely to be ready to quit (OR: 1.45, 95% CI: 1.03–2.03), but this association was not observed for African-American smokers who perceived themselves to be somewhat or far above their ideal weight (OR: 0.35, 95% CI: 0.10–1.24 and OR: 0.36, 95% CI: 0.11–1.19, respectively).Conclusions: Perception of being overweight is associated with increased readiness to quit amongst white but not African-American smokers. Smoking cessation programmes may need to culturally tailor interventions based on smokers’ weight perceptions.
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Murphy CM, Owens MM, Sweet LH, MacKillop J. The substitutability of cigarettes and food: A behavioral economic comparison in normal weight and overweight or obese smokers. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2016; 30:857-867. [PMID: 27736143 DOI: 10.1037/adb0000223] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Obesity and cigarette smoking contribute to a multitude of preventable deaths in the United States and eating and smoking behavior may influence each other. The field of behavioral economics integrates principles from psychology and economics and permits systematic examination of how commodities interrelate with one another. Using this framework, the current study evaluated the effects of rising food and cigarette prices on consumption to investigate their substitutability and their relationship to BMI and associated variables. Behavioral economics categorizes commodities as substitutable when the consumption of one increases as a function of a price increase in the other. Smokers (N = 86) completed a 2-part hypothetical task in which money was allocated to purchase cigarettes and fast-food-style reinforcers (e.g., hamburgers, ice cream) at various prices. Results indicated that food and cigarettes were not substitutes for one another (cross-price elasticity coefficients < .20). Food purchases were independent of cigarette price, whereas cigarette purchases decreased as food price rose. Cross-price elasticity coefficients were significantly associated with confidence in one's ability to control weight without smoking (rs = -.23 and .29), but not BMI (rs = .04 and .04) or postcessation weight concerns (rs = -.05 and .12). Perceived ability to manage weight without cigarettes may influence who substitutes food for cigarettes when quitting. In addition, given observed decreases in purchases of both commodities as food prices increased, these findings imply that greater taxation of fast-food-style reinforcers could potentially reduce consumption of these foods and also cigarettes among smokers. (PsycINFO Database Record
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Affiliation(s)
| | - Max M Owens
- Department of Psychology, University of Georgia
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40
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An individually-tailored smoking cessation intervention for rural Veterans: a pilot randomized trial. BMC Public Health 2016; 16:811. [PMID: 27535024 PMCID: PMC4989380 DOI: 10.1186/s12889-016-3493-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Accepted: 08/12/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Tobacco use remains prevalent among Veterans of military service and those residing in rural areas. Smokers frequently experience tobacco-related issues including risky alcohol use, post-cessation weight gain, and depressive symptoms that may adversely impact their likelihood of quitting and maintaining abstinence. Telephone-based interventions that simultaneously address these issues may help to increase treatment access and improve outcomes. METHODS This study was a two-group randomized controlled pilot trial. Participants were randomly assigned to an individually-tailored telephone tobacco intervention combining counseling for tobacco use and related issues including depressive symptoms, risky alcohol use, and weight concerns or to treatment provided through their state tobacco quitline. Selection of pharmacotherapy was based on medical history and a shared decision interview in both groups. Participants included 63 rural Veteran smokers (mean age = 56.8 years; 87 % male; mean number of cigarettes/day = 24.7). The primary outcome was self-reported 7-day point prevalence abstinence at 12 weeks and 6 months. RESULTS Twelve-week quit rates based on an intention-to-treat analysis did not differ significantly by group (Tailored = 39 %; Quitline Referral = 25 %; odds ratio [OR]; 95 % confidence interval [CI] = 1.90; 0.56, 5.57). Six-month quit rates for the Tailored and Quitline Referral conditions were 29 and 28 %, respectively (OR; 95 % CI = 1.05; 0.35, 3.12). Satisfaction with the Tailored tobacco intervention was high. CONCLUSIONS Telephone-based treatment that concomitantly addresses other health-related factors that may adversely affect quitting appears to be a promising strategy. Larger studies are needed to determine whether this approach improves cessation outcomes. TRIAL REGISTRATION ClinicalTrials.gov identifier number NCT01592695 registered 11 April 2012.
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Abstract
Smoking continues to be the leading cause of preventable death in the USA, despite the vast and widely publicized knowledge about the negative health effects of tobacco smoking. Data show that smoking cessation is often accompanied by weight gain and an improvement in insulin sensitivity over time. However, paradoxically, post-cessation-related obesity might contribute to insulin resistance. Furthermore, post-cessation weight gain is reportedly the number one reason why smokers, especially women, fail to initiate smoking cessation or relapse after initiating smoking cessation. In this Review, we discuss the metabolic effects of stopping smoking and highlight future considerations for smoking cessation programs and therapies to be designed with an emphasis on reducing post-cessation weight gain.
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Affiliation(s)
- Kindred K Harris
- Division of Endocrinology, Metabolism and Molecular Medicine, Charles R. Drew University of Medicine and Science, 1731 East 120th Street, Los Angeles, California 90059, USA
| | - Mohan Zopey
- Division of Endocrinology, Metabolism and Molecular Medicine, Charles R. Drew University of Medicine and Science, 1731 East 120th Street, Los Angeles, California 90059, USA
| | - Theodore C Friedman
- Division of Endocrinology, Metabolism and Molecular Medicine, Charles R. Drew University of Medicine and Science, 1731 East 120th Street, Los Angeles, California 90059, USA
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Sadasivam RS, Cutrona SL, Kinney RL, Marlin BM, Mazor KM, Lemon SC, Houston TK. Collective-Intelligence Recommender Systems: Advancing Computer Tailoring for Health Behavior Change Into the 21st Century. J Med Internet Res 2016; 18:e42. [PMID: 26952574 PMCID: PMC4802103 DOI: 10.2196/jmir.4448] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2015] [Revised: 10/15/2015] [Accepted: 01/23/2016] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND What is the next frontier for computer-tailored health communication (CTHC) research? In current CTHC systems, study designers who have expertise in behavioral theory and mapping theory into CTHC systems select the variables and develop the rules that specify how the content should be tailored, based on their knowledge of the targeted population, the literature, and health behavior theories. In collective-intelligence recommender systems (hereafter recommender systems) used by Web 2.0 companies (eg, Netflix and Amazon), machine learning algorithms combine user profiles and continuous feedback ratings of content (from themselves and other users) to empirically tailor content. Augmenting current theory-based CTHC with empirical recommender systems could be evaluated as the next frontier for CTHC. OBJECTIVE The objective of our study was to uncover barriers and challenges to using recommender systems in health promotion. METHODS We conducted a focused literature review, interviewed subject experts (n=8), and synthesized the results. RESULTS We describe (1) limitations of current CTHC systems, (2) advantages of incorporating recommender systems to move CTHC forward, and (3) challenges to incorporating recommender systems into CTHC. Based on the evidence presented, we propose a future research agenda for CTHC systems. CONCLUSIONS We promote discussion of ways to move CTHC into the 21st century by incorporation of recommender systems.
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Affiliation(s)
- Rajani Shankar Sadasivam
- Division of Health Informatics and Implementation Science, Department of Quantitative Health Science, University of Massachusetts Medical School, Worcester, MA, United States.
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Tian J, Venn A, Otahal P, Gall S. The association between quitting smoking and weight gain: a systematic review and meta-analysis of prospective cohort studies. Obes Rev 2015; 16:883-901. [PMID: 26114839 DOI: 10.1111/obr.12304] [Citation(s) in RCA: 119] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Revised: 05/05/2015] [Accepted: 05/14/2015] [Indexed: 12/28/2022]
Abstract
This systematic review and meta-analysis aimed to quantify weight gain after smoking cessation and the difference in weight gain between quitters and continuing smokers. Five electronic databases were searched before January 2015. Population-based prospective cohort studies were included if they recorded the weight change of adult smokers from baseline (before smoking cessation) to follow-up (at least 3 months after cessation). Thirty-five cohort studies were identified, including 63,403 quitters and 388,432 continuing smokers. The mean weight gain was 4.10 kg (95% confidence interval [CI]: 2.69, 5.51) and body mass index (BMI) gain was 1.14 kg m(-2) (95% CI: 0.50, 1.79) among quitters. Compared with continuing smoking, quitting smoking was significantly associated with absolute weight (adjusted mean difference [MD]: 2.61 kg; 95% CI: 1.61, 3.60) and BMI gain (adjusted MD: 0.63 kg m(-2) ; 95% CI: 0.46, 0.80). Subgroup analyses using geographic region found that the difference in weight gain was considerably greater in studies from North America than from Asia. Follow-up length was identified as a source of heterogeneity, such that studies with longer follow-up showed greater difference in weight gain. Effective strategies are needed to encourage smokers to quit irrespective of potential weight gain and to help quitters avoid excess weight gain.
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Affiliation(s)
- J Tian
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - A Venn
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - P Otahal
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - S Gall
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
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Veldheer S, Yingst J, Zhu J, Foulds J. Ten-year weight gain in smokers who quit, smokers who continued smoking and never smokers in the United States, NHANES 2003-2012. Int J Obes (Lond) 2015; 39:1727-32. [PMID: 26155918 DOI: 10.1038/ijo.2015.127] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Revised: 06/25/2015] [Accepted: 07/02/2015] [Indexed: 12/27/2022]
Abstract
BACKGROUND/OBJECTIVES Weight gain after quitting smoking is a common concern for smokers and can discourage quit attempts. The purpose of this analysis was to describe the long-term weight gain, smoking cessation attributable (SCA) weight gain and describe their relationship to cigarette consumption and body mass index (BMI) 10 years ago in a contemporary, nationally representative sample of smokers who continued to smoke and those who quit. SUBJECTS/METHODS In all, 12,204 adults ⩾36 years old were selected from the 2003-2012 National Health and Nutrition Examination Survey (NHANES). Ten-year weight gain for never, continuing and former smokers (who quit 1-10 years ago) was calculated by body mass index (BMI) 10 years ago and cigarettes per day (CPD). SCA weight gain was calculated by taking the difference between the adjusted mean 10-year weight gain of former smokers and that of continuing smokers. RESULTS Mean 10-year weight gain among continuing smokers was 3.5 versus 8.4 kg among former smokers; the SCA weight gain was 4.9 kg. After Bonferroni correction, there was no significant difference in overall weight gain between continuing and former smokers of 1-14 CPD, and SCA weight gain was lowest in this group (2.0 kg, confidence interval (CI): 0.3, 3.7). SCA weight gain was highest for former smokers of ⩾25 CPD (10.3 kg, CI: 7.4, 13.2) and for those who were obese (7.1 kg, CI: 2.9, 11.3) mostly because of lower than average weight gain or weight loss among continuing smokers in these groups. CONCLUSIONS In a current, nationally representative sample, baseline BMI and CPD were important factors that contributed to the magnitude of long-term weight gain following smoking cessation. Light to moderate smokers (<15 CPD) experienced little SCA weight gain, whereas heavy smokers (⩾25 CPD) and those who were obese before quitting experienced the most.
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Affiliation(s)
- S Veldheer
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA
| | - J Yingst
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA
| | - J Zhu
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA
| | - J Foulds
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA
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McHugh RK, Wigderson S, Greenfield SF. Epidemiology of substance use in reproductive-age women. Obstet Gynecol Clin North Am 2015; 41:177-89. [PMID: 24845483 DOI: 10.1016/j.ogc.2014.02.001] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
A significant number of women of reproductive age in the United States use addictive substances. In 2012 more than 50% reported current use of alcohol, 20% used tobacco products, and approximately 13% used other drugs. Among women, use of these substances is associated with several significant medical, psychiatric, and social consequences, and the course of illness may progress more rapidly in women than in men. The prevalence of substance use and evidence of accelerated illness progression in women highlight the importance of universal substance use screening in women in primary care settings.
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Affiliation(s)
- R Kathryn McHugh
- Division of Alcohol and Drug Abuse, McLean Hospital, 115 Mill Street, Belmont, MA 02478, USA; Department of Psychiatry, Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA
| | - Sara Wigderson
- Division of Alcohol and Drug Abuse, McLean Hospital, 115 Mill Street, Belmont, MA 02478, USA; Division of Women's Mental Health, McLean Hospital, 115 Mill Street, Belmont, MA 02478, USA
| | - Shelly F Greenfield
- Division of Alcohol and Drug Abuse, McLean Hospital, 115 Mill Street, Belmont, MA 02478, USA; Department of Psychiatry, Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA; Division of Women's Mental Health, McLean Hospital, 115 Mill Street, Belmont, MA 02478, USA.
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Beebe LA, Bush T. Post-cessation weight concerns among women calling a state tobacco quitline. Am J Prev Med 2015; 48:S61-4. [PMID: 25528710 DOI: 10.1016/j.amepre.2014.09.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2014] [Revised: 09/05/2014] [Accepted: 09/05/2014] [Indexed: 11/25/2022]
Abstract
BACKGROUND Obese and overweight women who smoke are more likely to be concerned about weight gain following cessation, impacting ability to quit and relapse. PURPOSE To determine differences in weight concerns for underweight, normal weight, overweight, and obese female smokers by race/ethnicity. METHODS From March to November 2008, female adult tobacco users calling the Oklahoma Tobacco Helpline were asked questions to determine the prevalence of obesity and concern for cessation-related weight gain. A score of 50 or greater, where 0=not at all concerned and 100=very concerned, on one of two weight concerns questions defined the outcome. BMI was calculated from self-reported height and weight. For the current analyses in 2013, race, ethnicity, age, education, marital status, and tobacco use history were examined as covariates. Multiple logistic regression was used to calculate ORs and 95% CIs. RESULTS A significant interaction between race and BMI was observed; thus, separate models were created for white (n=3,579); black (n=330); American Indian (n=441); and Hispanic (n=125) women. BMI was independently associated with weight concerns among all racial/ethnic groups, but the strength of the association varied. For black and Hispanic women, there was a particularly strong association between BMI and weight concerns among obese women (OR=9.55, 95% CI=5.05, 18.07, and OR=8.46, 95% CI=2.57, 27.83, respectively), although sample sizes were small. CONCLUSIONS State quitlines should consider tailoring promotional efforts and treatment protocols to include concerns about weight gain, especially for obese African American and Hispanic smokers.
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Affiliation(s)
- Laura A Beebe
- Department of Biostatistics and Epidemiology, College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma.
| | - Terry Bush
- Alere Wellbeing, Inc. Seattle, Washington
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Bush T, Hsu C, Levine MD, Magnusson B, Miles L. Weight gain and smoking: perceptions and experiences of obese quitline participants. BMC Public Health 2014; 14:1229. [PMID: 25428130 PMCID: PMC4295229 DOI: 10.1186/1471-2458-14-1229] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2014] [Accepted: 11/17/2014] [Indexed: 05/01/2023] Open
Abstract
Background Weight gain that commonly accompanies smoking cessation can undermine a person’s attempt to quit and increase the risk for metabolic disorders. Research indicates that obese smokers have more weight concerns and gain more weight after quitting than non-obese smokers, yet little is known about possible reasons for these outcomes. We sought to gain an understanding of obese smokers’ experiences of quitting and their attitudes and beliefs about the association between smoking and weight gain. Methods In-depth semi-structured interviews were conducted with obese smokers who called a state tobacco quitline. Interviewers elicited discussion of obese smokers’ thoughts about smoking, the effects of quitting on change in weight, challenges they faced with quitting, and how quitlines might better serve their needs. Results Participants (n = 29) discussed their fear of gaining weight after quitting, their beliefs about smoking and their weight and significant experiences related to quitting. Participants’ awareness of weight gain associated with quitting was based on prior experience or observation of others who quit. Most viewed cessation as their primary goal and discussed other challenges as being more important than their weight, such as managing stress or coping with a chronic health condition. Although weight gain was viewed as less important than quitting, many talked about changes they had made to mitigate the anticipated weight gain. Conclusions Weight gain is a concern for obese smokers interested in quitting. Understanding the relative importance of body weight and other challenges related to smoking cessation can help tailor interventions for the specific group of smokers who are obese and interested in smoking cessation.
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Affiliation(s)
- Terry Bush
- Alere Wellbeing, 999 3rd Ave, Suite 2000, Seattle, WA 98104-1139, USA.
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Choi SH, Waltje AH, Ronis DL, Noonan D, Hong O, Richardson CR, Meeker JD, Duffy SA. Web-enhanced tobacco tactics with telephone support versus 1-800-QUIT-NOW telephone line intervention for operating engineers: randomized controlled trial. J Med Internet Res 2014; 16:e255. [PMID: 25447467 PMCID: PMC4260077 DOI: 10.2196/jmir.3375] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2014] [Revised: 08/14/2014] [Accepted: 08/16/2014] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Novel interventions tailored to blue collar workers are needed to reduce the disparities in smoking rates among occupational groups. OBJECTIVE The main objective of this study was to evaluate the efficacy and usage of the Web-enhanced "Tobacco Tactics" intervention targeting operating engineers (heavy equipment operators) compared to the "1-800-QUIT-NOW" telephone line. METHODS Operating engineers (N=145) attending one of 25 safety training sessions from 2010 through 2012 were randomized to either the Tobacco Tactics website with nurse counseling by phone and access to nicotine replacement therapy (NRT) or to the 1-800-QUIT-NOW telephone line, which provided an equal number of phone calls and NRT. The primary outcome was self-reported 7-day abstinence at 30-day and 6-month follow-up. The outcomes were compared using chi-square tests, t tests, generalized mixed models, and logistic regression models. RESULTS The average age was 42 years and most were male (115/145, 79.3%) and white (125/145, 86.2%). Using an intent-to-treat analysis, the Tobacco Tactics website group showed significantly higher quit rates (18/67, 27%) than the 1-800-QUIT NOW group (6/78, 8%) at 30-day follow-up (P=.003), but this difference was no longer significant at 6-month follow-up. There were significantly more positive changes in harm reduction measures (quit attempts, number of cigarettes smoked per day, and nicotine dependence) at both 30-day and 6-month follow-up in the Tobacco Tactics group compared to the 1-800-QUIT-NOW group. Compared to participants in the 1-800-QUIT NOW group, significantly more of those in the Tobacco Tactics website group participated in the interventions, received phone calls and NRT, and found the intervention helpful. CONCLUSIONS The Web-enhanced Tobacco Tactics website with telephone support showed higher efficacy and reach than the 1-800-QUIT-NOW intervention. Longer counseling sessions may be needed to improve 6-month cessation rates. TRIAL REGISTRATION Clinicaltrials.gov NCT01124110; http://clinicaltrials.gov/ct2/show/NCT01124110 (Archived by WebCite at http://www.webcitation.org/6TfKN5iNL).
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Affiliation(s)
- Seung Hee Choi
- Michigan State University, College of Nursing, East Lansing, MI, United States
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Mieczkowski B, Ezzie ME. Update on obstructive sleep apnea and its relation to COPD. Int J Chron Obstruct Pulmon Dis 2014; 9:349-62. [PMID: 24748786 PMCID: PMC3986113 DOI: 10.2147/copd.s42394] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Chronic obstructive pulmonary disease (COPD) is a common and preventable lung disease that affects millions of people in the United States. Sleep disorders including obstructive sleep apnea (OSA) are also common. It is not surprising that many people with COPD also suffer from OSA. This relationship, however, puts people at risk for more nocturnal desaturations and potential complications related to this, including pulmonary hypertension and heart rhythm disturbances. This update focuses on the physiology of sleep disturbances in COPD as well as the clinical implications of OSA in COPD.
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Affiliation(s)
- Brian Mieczkowski
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Ohio State University, Wexner Medical Center, Columbus, OH, USA
| | - Michael E Ezzie
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Ohio State University, Wexner Medical Center, Columbus, OH, USA
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Bush TM, Levine MD, Magnusson B, Cheng Y, Chen X, Mahoney L, Miles L, Zbikowski SM. Impact of baseline weight on smoking cessation and weight gain in quitlines. Ann Behav Med 2014; 47:208-17. [PMID: 24048952 PMCID: PMC3960374 DOI: 10.1007/s12160-013-9537-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND The use and effectiveness of tobacco quitlines by weight is still unknown. PURPOSE This study aims to determine if baseline weight is associated with treatment engagement, cessation, or weight gain following quitline treatment. METHODS Quitline participants (n = 595) were surveyed at baseline, 3 and 6 months. RESULTS Baseline weight was not associated with treatment engagement. In unadjusted analyses, overweight smokers reported higher quit rates and were more likely to gain weight after quitting than obese or normal weight smokers. At 3 months, 40 % of overweight vs. 25 % of normal weight or obese smokers quit smoking (p = 0.01); 42 % of overweight, 32 % of normal weight, and 33 % of obese quitters gained weight (p = 0.05). After adjusting for covariates, weight was not significantly related to cessation (approaching significance at 6 months, p = 0.06) or weight gain. CONCLUSIONS In the first quitline study of this kind, we found no consistent patterns of association between baseline weight and treatment engagement, cessation, or weight gain.
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Affiliation(s)
- Terry M Bush
- Alere Wellbeing, 999 Third Avenue, Ste 2100, Seattle, WA, 98104, USA,
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