University of Miami, Sylvester Comprehensive Cancer Center, 1475 NW 12th Ave, Miami, FL 33136, United States.
University of Minnesota, 420 Delaware St. SE, Minneapolis, MN 55455, United States.
Addict Behav. 2018 Jun;81:84-90. doi: 10.1016/j.addbeh.2018.02.002. Epub 2018 Feb 3.
Research has shown that African Americans gain more than average weight after smoking cessation. However, African Americans have been underrepresented in post-cessation weight gain research. The current study examined 1) the pattern of weight gain and 2) the association between smoking status and weight gain in a sample of African Americans seeking smoking cessation treatment.
Data were drawn from a randomized controlled trial testing the efficacy of a 4-week culturally specific smoking cessation cognitive behavioral therapy (CBT) intervention among African American smokers (N = 342). Weight was measured and self-reported smoking status was biochemically verified at baseline, end of counseling, 3-, 6-, and 12-month follow-ups. Random effects multilevel modeling was used to examine weight gain over twelve months post CBT, and a fully unconditional model tested the pattern of weight gain over time. Smoking status was included as a time-varying factor to examine its effect on weight gain, controlling for potential confounding variables.
Weight significantly increased among those who remained abstinent over 12 months post CBT [average gain of seven lbs. (three kg)]. Controlling for covariates, abstinence was predictive of the rate of weight gain for those with high weight concern.
Weight gain among African American abstainers was comparable to the average post-cessation weight gain observed among the general population. It is possible that exposure to CBT (culturally specific or standard) may have mitigated excessive weight gain. Future research should assess predictors of weight gain in African American smokers to inform future smoking cessation interventions and help elucidate factors that contribute to tobacco- and obesity-related health disparities.
研究表明,非裔美国人在戒烟后体重会增加超过平均水平。然而,非裔美国人在戒烟后体重增加的研究中代表性不足。本研究考察了 1)体重增加的模式,2)在寻求戒烟治疗的非裔美国人群体中,吸烟状况与体重增加之间的关联。
数据来自一项随机对照试验,该试验测试了一种为期 4 周的具有文化针对性的戒烟认知行为疗法(CBT)干预措施对非裔美国吸烟者的疗效(N=342)。在基线、咨询结束时、3、6 和 12 个月的随访时测量体重,并通过生物化学方法验证自我报告的吸烟状况。使用随机效应多层模型来检查 CBT 后 12 个月内的体重增加情况,完全无条件模型测试了随时间的体重增加模式。吸烟状况被视为一个时变因素,以控制潜在的混杂变量,来检验其对体重增加的影响。
在 CBT 后 12 个月仍保持戒烟状态的人群中,体重显著增加[平均增重 7 磅(3.2 公斤)]。在控制了协变量后,对于那些对体重高度关注的人来说,戒烟状态预测了体重增加的速度。
非裔美国戒烟者的体重增加与一般人群中观察到的平均戒烟后体重增加相当。接触 CBT(具有文化针对性或标准)可能减轻了过度的体重增加。未来的研究应该评估非裔美国吸烟者体重增加的预测因素,为未来的戒烟干预措施提供信息,并帮助阐明导致烟草和肥胖相关健康差异的因素。