Extended duration therapy with transdermal nicotine may attenuate weight gain following smoking cessation

Abstract

Aim: People who quit smoking often gain 11-12 lb, on average, which can frequently lead to a relapse to smoking. This study evaluated whether extended vs. standard duration treatment with nicotine patch helps those able to quit smoking to reduce cessation-induced weight gain and explored nicotine patch adherence as a mediator of treatment effects.

Design and setting: We examined data from a completed randomized placebo-controlled clinical trial of extended (24 weeks) vs. standard (8 weeks plus 16 weeks of placebo) transdermal nicotine patch therapy. Changes in measured weight over 24 weeks were compared across the two treatment arms, controlling for gender, baseline smoking rate, and previous weight. Adherence to patch use was assessed using self-report of daily use over 24 weeks.

Participants: 139 clinical trial participants who were confirmed to be abstinent at weeks 8 and 24.

Findings: Compared to participants who received 8 weeks of nicotine patch therapy, participants who received 24 weeks of treatment showed significantly less weight gain from pre-treatment to week 24 (β=-4.76, 95% CI: -7.68 to -1.84, p=.002) and significantly less weight gain from week 8 to week 24 (β=-2.31, 95% CI: -4.39 to -0.23, p=.03). Extended treatment increased patch adherence which, in turn, reduced weight gain; patch adherence accounted for 20% of the effect of treatment arm on weight gain.

Conclusion: Compared to 8 weeks of transdermal nicotine therapy, 24 weeks of patch treatment may help to reduce the weight gain that is typical among smokers who are able to achieve abstinence from tobacco use. Extended treatment increased nicotine patch adherence which, in turn, reduced weight gain.

Figure 1

Mediation model of treatment, adherence, and weight gain. Note. Treatment is coded 0 = standard, 1 = extended; * p < .05.