Efficacy of two novel behavioral post-cessation weight gain interventions

虽然戒烟导致死亡率和发病率的显着改善，体重增加后， 停止部分削弱了这种益处。此外，对戒烟后体重增加的担忧也很常见 并且经常被引用作为推迟戒烟尝试的理由。此外，戒烟后体重增加是 与吸烟复发有关。因此，尽管戒烟对健康的好处超过了 体重增加的负面影响，理想情况下会有干预“包”，不需要 人们在戒烟和体重增加之间做出选择。因此，在拟议的研究中，我们将 确定是否有两个非常有前途的方法减少戒烟后体重增加，即体重 稳定性干预（基于循证稳定性技能第一次干预）与体重减轻 干预（基于循证的Look AHEAD强化生活方式干预），然后吸烟 戒烟干预对于减少戒烟后体重增加是有效的。我们将随机抽取400名吸烟者 三组之一：a）戒烟前体重稳定性干预（稳定）; B）体重减轻干预 停止前（LOSS），或c）停止前（BIBLIO）的阅读疗法比较条件， 在12个月随访时确定干预措施对预防体重增加的有效性。所有三种条件 接受高效的面对面戒烟行为干预和6个月的伐尼克兰治疗 （ChantixTM）药物治疗。随机分配至稳定和丢失条件的受试者将 在完成行为戒烟后，接受每月一次的助推体重管理会议 干预主要结果将是12个月随访时的体重变化和戒烟。在 此外，我们将通过治疗措施收集有关治疗结果介质的过程数据 接合（例如，会话出席率、伐尼克兰利用率）。我们将能够确定一个重量 稳定性干预或体重减轻干预在减少戒烟后体重增加方面是有效的。的 如果干预措施取得成功，可以传播这些成果， 肥胖症在这个脆弱的人群中。

While smoking cessation leads to significant improvements in mortality and morbidity, weight gain post- cessation partially attenuates this benefit. Furthermore, concerns about postcessation weight gain are common and are often cited as a reason to delay cessation attempts. In addition, postcessation weight gain is associated with smoking relapse. Thus, although the health benefits of smoking cessation outweigh the negative impact of weight gain, ideally there would be intervention “packages” that would not require that people choose between smoking cessation and nontrivial weight gain. Thus, in the proposed study, we will determine whether two very promising methods of reducing postcessation weight gain, namely a weight stability intervention (based on the evidence-based Stability Skills First intervention) versus a weight loss intervention (based on the evidence-based Look AHEAD intensive lifestyle intervention) followed by a smoking cessation intervention are efficacious for reducing postcessation weight gain. We will randomize 400 smokers to one of three arms: a) a weight stability intervention prior to cessation (STABLE); b) a weight loss intervention prior to cessation (LOSS), or c) a bibliotherapy comparison condition prior to cessation (BIBLIO) and to determine the efficacy of the interventions on preventing weight gain at 12 month follow-up. All three conditions receive a highly efficacious in-person smoking cessation behavioral intervention and six months of Varenicline (ChantixTM) pharmacotherapy. Those participants randomized to the STABLE and LOSS conditions will receive monthly booster weight management sessions, after completing the behavioral smoking cessation intervention. The primary outcomes will be weight change and smoking cessation at 12 month follow-up. In addition, we will gather process data on mediators of treatment outcome via measures of treatment engagement (e.g., session attendance, varenicline utilization). We will be able to determine whether a weight stability intervention or a weight loss intervention is efficacious in reducing post-cessation weight gain. The intervention results, if successful, could be disseminated and make a significant contribution towards curtailing obesity in this vulnerable population.