Behavioral intervention to promote smoking cessation and prevent weight gain: a systematic review and meta-analysis
Article first published online: 22 JUN 2009
© 2009 The Authors. Journal compilation © 2009 Society for the Study of Addiction
Volume 104, Issue 9, pages 1472–1486, September 2009
How to Cite
Spring, B., Howe, D., Berendsen, M., McFadden, H. G., Hitchcock, K., Rademaker, A. W. and Hitsman, B. (2009), Behavioral intervention to promote smoking cessation and prevent weight gain: a systematic review and meta-analysis. Addiction, 104: 1472–1486. doi: 10.1111/j.1360-0443.2009.02610.x
- Issue published online: 3 AUG 2009
- Article first published online: 22 JUN 2009
- Submitted 30 July 2008; initial review completed 29 October 2008; final version accepted 11 March 2009
- smoking cessation;
- systematic review;
- weight gain
Aims The prospect of weight gain discourages many cigarette smokers from quitting. Practice guidelines offer varied advice about managing weight gain after quitting smoking, but no systematic review and meta-analysis have been available. We reviewed evidence to determine whether behavioral weight control intervention compromises smoking cessation attempts, and if it offers an effective way to reduce post-cessation weight gain.
Methods We identified randomized controlled trials (RCTs) that compared combined smoking treatment and behavioral weight control to smoking treatment alone for adult smokers. English-language studies were identified through searches of PubMed, Ovid MEDLINE, CINAHL, EMBASE, PsycINFO and Cochrane Central Register of Controlled Trials. Of 779 articles identified and 35 potentially relevant RCTs screened, 10 met the criteria and were included in the meta-analysis.
Results Patients who received both smoking treatment and weight treatment showed increased abstinence [odds ratio (OR) = 1.29, 95% confidence interval (CI) = 1.01, 1.64] and reduced weight gain (g = −0.30, 95% CI = −0.57, −0.02) in the short term (<3 months) compared with patients who received smoking treatment alone. Differences in abstinence (OR = 1.23, 95% CI = 0.85, 1.79) and weight control (g = −0.17, 95% CI = −0.42, 0.07) were no longer significant in the long term (>6 months).
Conclusions Findings provide no evidence that combining smoking treatment and behavioral weight control produces any harm and significant evidence of short-term benefit for both abstinence and weight control. However, the absence of long-term enhancement of either smoking cessation or weight control by the time-limited interventions studied to date provides insufficient basis to recommend societal expenditures on weight gain prevention treatment for patients who are quitting smoking.