Contingency management for smoking cessation for individuals with overweight or obesity: A randomized controlled trial

• Published in: Drug and alcohol dependence 2024-05, Vol.258, p.111269-111269, Article 111269
• Main Authors: Krotter, Andrea, García-Fernández, Gloria, García-Pérez, Ángel, Aonso-Diego, Gema, Weidberg, Sara
• Format: Article
• Language: English
• Subjects: Adult; Cognitive behavioral therapy; Cognitive Behavioral Therapy - methods; Contingency management; Female; Follow-Up Studies; Humans; Male; Middle Aged; Obesity; Obesity - therapy; Overweight; Overweight - psychology; Overweight - therapy; Smoking cessation; Smoking Cessation - methods; Treatment Outcome; Weight gain
• ISSN: 0376-8716; 1879-0046
• DOI: 10.1016/j.drugalcdep.2024.111269

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). 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). 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. 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. •Quitting smoking and weight control is crucial for individuals with excess weight.•Evaluated cognitive-behavioral therapy (CBT) and CBT plus contingency management.•Smoking abstinence rates were high at the end of treatment but declined over time.•Abstinent participants experienced greater weight gain over time.•Adding contingency management for abstinence did not benefit treatment outcomes.