Smoking-Related Weight Concerns Among Underserved, Black Maternal Smokers

Abstract

Objective-To expand understanding of a smoking cessation barrier for women, weight concerns, in a medically underserved population.Methods-Baseline weight concerns were examined among 235 low-income, black maternal smokers enrolled in a smoking trial. Logistic regression evaluated factors related to weight concerns.Results-Higher BMI (OR 3.35, P<.001), intention to quit (OR 2.12, P=.02), more previous quit attempts (OR 1.14, P=.03), and less support for quitting (OR 0.81, P=.05) predicted weight concerns.Conclusions-This is the first study to delineate factors predicting weight concerns in this population, thus expanding our understanding of a key cessation barrier and informing future cessation strategies in a population known to bear increased risk of tobacco-related disease.Keywords weight concerns; smoking cessation; maternal; underserved; black Studying factors associated with smoking in groups with high risk for tobacco-related disease remains a public health priority. Weight concerns are an important factor contributing to smoking among women, but little is known about variability in weight concerns among high-risk groups, such as those living in medically underserved homes. Most smokers learn that nicotine suppresses appetite and weight; however, women are more likely than men to smoke to control weight and to express concern about postcessation weight gain. [1][2][3] Weight-concerned smokers are more likely to smoke to control weight, 4 refrain from quitting for fear of postcessation weight gain, 5 have poorer abstinence outcomes, 1 and have high attrition rates in smoking treatment. 6 Improving our understanding of variability in weight concerns among medically underserved maternal smokers could inform future cessation strategies designed to reduce women and children's tobacco morbidity and mortality risk. This paper examines weight concerns among mostly NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript low-income, undereducated, black maternal smokers, a group known to experience unique and elevated tobacco use consequences compared to other subgroups of smokers.A number of factors may predict weight concerns. Greater weight concern is often associated with higher levels of education and income, 7 and women under 30 years are more likely to smoke to control weight 8 and to cite weight gain as a reason for relapse. 9 Social support and depressive symptoms, known factors associated with smoking in women, 10,11 may also relate to weight concerns. Because of potential weight concern-depressive symptoms associations, 12 together with the high prevalence of lifetime major depression among weight-concerned women, 13 depressive symptoms may contribute to weightconcerned women's challenges with quitting smoking and relapse. Depressive symptoms, social support, and weight concerns may be particularly important factors for maternal smokers with infants and toddlers. During the first couple of years postpartum, there is potential for depressive mood presentation, increased parenti...

Post-Cessation Weight Concerns Among Women Calling a State Tobacco Quitline

“…The results of this study support previous findings that obese and overweight women are more likely to be concerned about weight gain as a result of cessation, 6,7,16 but is the first to report an interaction with race/ethnicity. Unlike prior research, this study comprised a relatively large sample of American Indian women (n=441); thus, it includes novel findings related to the association between BMI and weight concerns in this population subgroup, which experiences significant disparity in smoking prevalence.…”

“…[1][2][3] Research 4,5 also suggests that this relationship does not hold for all racial groups and may differ by gender. Numerous studies [6][7][8][9][10][11][12][13][14][15][16][17][18] have established weight management and body image as influential reasons for smoking among women. Women are more likely than men to gain weight after quitting smoking.…”

Proactive recruitment predicts participant retention to end of treatment in a secondhand smoke reduction trial with low-income maternal smokers

“…Researchers have explored factors that influence underserved smokers' enrollment in clinical trials [9,10,15] including studies evaluating effects of different recruitment strategies [16][17][18][19][20]. However, little is known about how different recruitment methods influence participant retention [21,32]. Across populations, factors such as education [7,22,23], income [22,[24][25][26], older age [27,28], and male gender [29][30][31] have been predictive of retention.…”

“…Across populations, factors such as education [7,22,23], income [22,[24][25][26], older age [27,28], and male gender [29][30][31] have been predictive of retention. Among women in particular, psychosocial factors that relate to smoking (e.g., depressive symptoms, weight concerns) [32][33][34] may influence retention during smoking intervention trials [35][36][37].…”

Differential effects of a body image exposure session on smoking urge between physically active and sedentary female smokers.

“…This evidence warrants ongoing research to better understand behavioral mechanisms underlying smoking among women. Body and weight concerns are primary factors related to smoking and difficulty quitting among women (Collins, Nair, Hovell, & Audrain-McGovern, 2009;Perkins, 2001). In general, women smokers have greater body image dissatisfaction and weight concerns than men (King, Matacin, Marcus, Bock, & Tripolone, 2000), refrain from quitting to avoid weight gain (Pomerleau, Zucker, & Stewart, 2001), and have greater attrition from smoking cessation programs (Copeland, Martin, Geiselman, Rash, & Kendzor, 2006).…”