Pilot randomized trial of cognitive-behavioral treatment plus contingency management for quitting smoking and weight gain prevention among smokers with overweight or obesity

• Published in: Drug and alcohol dependence 2022-07, Vol.236, p.109477-109477, Article 109477
• Main Authors: García-Fernández, Gloria, Krotter, Andrea, García-Pérez, Ángel, Aonso-Diego, Gema, Secades-Villa, Roberto
• Format: Article
• Language: English
• Subjects: Abstinence; Acceptability; Behavior modification; Body mass index; Body weight; Body weight gain; Cigarette smoking; Clinical research; Clinical trial; Clinical trials; Cognitive ability; Cognitive behavioral therapy; Cognitive-behavioral factors; Cognitive-behavioral treatment; Contingency; Contingency learning; Contingency management; Drug addiction; Efficacy; Feasibility; Incentives; Obesity; Overweight; Prevention; Recruitment; Relapse; Risk analysis; Risk factors; Smoking; Smoking cessation; Tobacco; Weight control; Weight gain
• ISSN: 0376-8716; 1879-0046
• DOI: 10.1016/j.drugalcdep.2022.109477

Post-cessation weight gain is a risk factor for relapse among quitters. The primary study aim was to evaluate, among smokers with overweight or obesity, the feasibility and acceptability of a cognitive-behavioral treatment (CBT) plus contingency management (CM) for quitting smoking and weight control. The secondary aim was to examine preliminary tobacco abstinence and weight change outcomes. In an 8-week pilot randomized clinical trial, 41 participants (Mage = 52.73, SD = 10.91, 56.1% females) with overweight or obesity (MBMI = 31.86, SD = 4.7) received a CBT for both quitting smoking and weight gain prevention (n = 24) or the same treatment plus CM (n = 17), consisting of providing incentives contingent upon smoking abstinence biochemically verified. Recruitment success rate was 80.39% (41/51), completion rate was 90.24% (37/41), and mean number of sessions attended (out of 15 possible) was 13.20 (SD = 3.1). Mean satisfaction rating for the treatment (1–10 likert-type scale with 10 being most satisfactory) was 9.73 (SD =.61). Preliminary efficacy data indicated that the CM group achieved higher abstinence rates compared with the CBT condition (100% vs. 58.33%, p = .007). Abstinent participants increased 1.25 kg (SD = 1.79) their baseline body weight at the end of treatment (p = .001). Providing weight gain prevention strategies and CM within a smoking cessation treatment seems feasible and acceptable. Preliminary data indicated that including CM facilitates tobacco abstinence rates, nevertheless no advantage for CM was found for weight control. •Program targeting smoking cessation and post-cessation weight control simultaneously.•Evaluated cognitive-behavioral therapy (CBT) and contingency management (CM).•CBT and CM were found to be feasible and acceptable among smokers with obesity.•Preliminary support of CBT plus CM in reducing smoking and weight gain.