Association between smoking cessation and weight gain in treatment-seeking African Americans

• Published in: Addictive behaviors 2018-06, Vol.81, p.84-90
• Main Authors: Tan, Marcia M., Okuyemi, Kolawole S., Resnicow, Ken, Dietz, Noella A., Antoni, Michael H., Webb Hooper, Monica
• Format: Article
• Language: English
• Subjects: Adult; African American smokers; African Americans; Cigarette Smoking - therapy; Cognitive Behavioral Therapy; Culturally Competent Care; Drug addiction; Ethnic minority health; Female; Health disparities; Humans; Male; Middle Aged; Minority & ethnic groups; Model testing; Multilevel Analysis; Obesity; Post-cessation weight gain; Randomized Controlled Trials as Topic; Smoking; Smoking Cessation; Tobacco; Weight; Weight concern; Weight Gain
• ISSN: 0306-4603; 1873-6327
• DOI: 10.1016/j.addbeh.2018.02.002

Research has shown that African Americans gain more than average weight after smoking cessation. However, African Americans have been underrepresented in post-cessation weight gain research. The current study examined 1) the pattern of weight gain and 2) the association between smoking status and weight gain in a sample of African Americans seeking smoking cessation treatment. Data were drawn from a randomized controlled trial testing the efficacy of a 4-week culturally specific smoking cessation cognitive behavioral therapy (CBT) intervention among African American smokers (N = 342). Weight was measured and self-reported smoking status was biochemically verified at baseline, end of counseling, 3-, 6-, and 12-month follow-ups. Random effects multilevel modeling was used to examine weight gain over twelve months post CBT, and a fully unconditional model tested the pattern of weight gain over time. Smoking status was included as a time-varying factor to examine its effect on weight gain, controlling for potential confounding variables. Weight significantly increased among those who remained abstinent over 12 months post CBT [average gain of seven lbs. (three kg)]. Controlling for covariates, abstinence was predictive of the rate of weight gain for those with high weight concern. Weight gain among African American abstainers was comparable to the average post-cessation weight gain observed among the general population. It is possible that exposure to CBT (culturally specific or standard) may have mitigated excessive weight gain. Future research should assess predictors of weight gain in African American smokers to inform future smoking cessation interventions and help elucidate factors that contribute to tobacco- and obesity-related health disparities. •Previous research showed that African Americans gain excessive weight after smoking cessation.•We found that African American smokers gained the average 4–10 lbs (1.8–4.5 kg) reported in literature.•Abstainers gained weight particularly if they had high pre-treatment weight concern.•Exposure to cognitive-behavioral therapy may mitigate excessive weight gain.