Once bitten, twice shy: concern about gaining weight after smoking cessation and its association with seeking treatment


  • Disclosure None of the authors have any financial disclosures. JF has worked as a paid consultant for companies involved in the production of pharmaceutical products as aids to smoking cessation (e.g. Cypress Bioscience, GSK, Novartis, Pfizer). This research was supported by funds from the Penn State Cancer Institute to JF.



Concern about weight gain after quitting smoking is often cited as a barrier to smokers making a quit attempt or seeking treatment.


To identify whether smokers who are non-treatment seekers (NTS) are more concerned about weight gain and have lower confidence to maintain weight after quitting smoking as compared with treatment-seeking smokers (TS).


Participants were smokers recruited from Penn State Hershey Medical Center and family practice outpatient clinics. A total of 102 NTS and 186 TS, who participated in a smoking cessation trial, completed a survey regarding tobacco use, weight concern and diet. Stepwise logistic regression was used to identify variables associated with treatment seeking, overall and stratified by those who gained and did not gain weight on a previous quit attempt.


Fifty three per cent of the overall sample (47.1% NTS vs. 56.5% TS, p = 0.127) had gained weight on a prior quit attempt. Among smokers who had gained weight, higher weight gain concern (WGC) and lower confidence in ability to maintain weight were significantly associated with being a NTS after adjusting for other factors.


Among smokers who gained weight on a previous quit attempt, NTS had greater concern about gaining weight and less confidence in their ability to maintain their weight after quitting than treatment seekers. Clinicians can identify smokers for whom WGC may be a barrier to seeking treatment by asking if they gained weight on a previous quit attempt. These smokers should be assured that this issue will be addressed in treatment.