Randomized controlled trial for behavioral smoking and weight control treatment: effect of concurrent versus sequential intervention

Abstract

The authors compared simultaneous versus sequential approaches to multiple health behavior change in diet, exercise, and cigarette smoking. Female regular smokers (N = 315) randomized to 3 conditions received 16 weeks of behavioral smoking treatment, quit smoking at Week 5, and were followed for 9 months after quit date. Weight management was omitted for control and was added to the 1st 8 weeks for early diet (ED) and the final 8 weeks for late diet (LD). ED lacked lasting effect on weight gain, whereas LD initially lacked but gradually acquired a weight-suppression effect that stabilized (p = .004). Behavioral weight control did not undermine smoking cessation and, when initiated after the smoking quit date, slowed the rate of weight gain, supporting a sequential approach.

Figure 1

Flow chart showing progression of participants through the study. Hatch marks between end of treatment and follow-up indicate that participants in the first cohort were not asked to attend follow-up.

Figure 2

Estimated probability of smoking by each group over time.

Figure 3

Mean weight change by group across treatment and follow-up periods showing all available data.

Figure 4

Estimated weight change by groups across time