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Meta-Analysis
. 2009 Sep;104(9):1472-86.
doi: 10.1111/j.1360-0443.2009.02610.x. Epub 2009 Jun 22.

Behavioral intervention to promote smoking cessation and prevent weight gain: a systematic review and meta-analysis

Bonnie Spring  1 , Dorothea Howe, Mark Berendsen, H Gene McFadden, Kristin Hitchcock, Alfred W Rademaker, Brian Hitsman
Affiliations
Meta-Analysis

Behavioral intervention to promote smoking cessation and prevent weight gain: a systematic review and meta-analysis

Bonnie Spring et al. Addiction. 2009 Sep.

Abstract

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.

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Figures

Figure 1
Figure 1. Study Flow Diagram
Figure 2
Figure 2. Effect of Control Treatment (Smoking Cessation Only) versus Weight Treatment (Smoking Cessation + Weight Control) on Odds of Short Term Smoking Cessation
Diamond indicates overall short-term effect. The width of the diamond indicates the 95% confidence interval. The size of the square for each individual effect is proportional to the study's weight in the analysis.
Figure 3
Figure 3. Effect of Control Treatment (Smoking Cessation Only) versus Weight Treatment (Smoking Cessation + Weight Control) on Odds of Long Term Smoking Cessation
Diamond indicates overall long-term effect. The width of the diamond indicates the 95% confidence interval. The size of the square for each individual effect is proportional to the study's weight in the analysis.
Figure 4
Figure 4. Effect of Control Treatment (Smoking Cessation Only) versus Weight Treatment (Smoking Cessation + Weight Control) on Short-Term Post-Quit Weight Gain
Diamond indicates overall short-term effect. The width of the diamond indicates the 95% confidence interval. The size of the square for each individual effect is proportional to the study's weight in the analysis.
Figure 5
Figure 5. Effect of Control Treatment (Smoking Cessation Only) versus Weight Treatment (Smoking Cessation + Weight Control) on Long-Term Post-Quit Weight Gain
Diamond indicates overall long-term effect. The width of the diamond indicates the 95% confidence interval. The size of the square for each individual effect is proportional to the study's weight in the analysis.
See this image and copyright information in PMC

Comment in

References

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