Characterizing concerns about post-cessation weight gain: results from a national survey of women smokers

Abstract

Differences among adult women smokers with differing levels of concern about post-cessation weight gain were investigated in a national random-digit-dialing survey. To avoid defining weight concerns in terms of possible etiologies or contributory factors, respondents were stratified using a single item querying concern about postcessation weight gain; 39% described themselves as very concerned (VC), 28% as somewhat concerned (SC), and 33% as not concerned (NC). Significant between-groups differences were detected for measures of weight and body image, eating patterns and weight control practices, and nicotine dependence, but not for depression. Differences, primarily between VC and NC, were also detected for several weight-related smoking variables, including importance of weight as a factor in initiation, smoking as a weight control strategy, increased appetite and weight gain as withdrawal symptoms, willingness to gain weight upon quitting, self-efficacy about relapse in the face of weight gain, and readiness to quit smoking. Most differences persisted even after adjusting for body mass index and nicotine dependence. Although the importance of thinness was rated higher by weightconcerned women, the difference did not reach significance. Rather, what differentiated groups was the importance of overall body image, suggesting a larger pattern of preoccupation with body image that may not be captured by queries about weight concerns alone. We conclude that weight-concerned women smokers will be especially unlikely to seek treatment or attempt self-quitting; and that redirecting attention to other aspects of body image is likely to be more helpful than attempting to divert attention away from body image.

Gender, Ethnicity, and Their Intersectionality in the Prediction of Smoking Outcome Expectancies in Regular Cigarette Smokers

“…Domains of smoking outcome expectancies can be parsed into: (1) negative consequences (i.e., expectations of smoking’s negative effects on health and social impressions); (2) positive reinforcement (i.e., expectations that smoking produces positive sensory effects and social facilitation); (3 ) negative reinforcement (i.e., expectations that smoking produces negative affect reduction); and (4) weight control (i.e., expectation that smoking aids in weight and hunger management; Brandon & Baker, 1991). Individuals who endorse stronger pro-smoking outcome expectancies tend to be at greater risk for greater cigarette dependence and smoking relapse following a quit attempt (Gwaltney, Shiffman, Balabanis, & Paty, 2005; Herd, Borland, & Hyland, 2009; Jeffries et al, 2004; Pang, Khoddam, Guillot, & Leventhal, 2014; Pomerleau, Zucker, & Stewart, 2001), putatively because they are motivated to continue smoking in order to obtain the anticipated positive emotional, social, sensory, and weight-related outcomes they believe that smoking provides.…”