Departments of Psychiatry and Human Behavior and Medicine, Alpert Medical School of Brown University, Providence, RI.
Rhode Island Hospital, Providence, RI.
Nicotine Tob Res. 2020 Aug 24;22(9):1578-1586. doi: 10.1093/ntr/ntaa026.
The majority of women who smoke cigarettes report that concern about weight gain is a barrier to quitting. We developed an intervention incorporating distress tolerance, appetite awareness, and mindful eating skills to target concerns about post-cessation weight gain and emotional eating (DT-W). In the current study, we conducted a pilot randomized controlled trial of DT-W versus a smoking health education (HE) intervention.
Participants (N = 69 adult female, weight-concerned smokers) were recruited in cohorts of 4-11. Cohorts were randomized to DT-W or HE. DT-W and HE were matched on format (single individual session followed by eight group sessions), inclusion of cognitive behavioral therapy for smoking cessation (CBT) content, and pharmacotherapy (nicotine patches). Follow-up assessments occurred at 1-, 3-, and 6-months post-treatment.
The recruitment goal was met; 61 of the 69 participants attended at least one group session. There were no significant differences between DT-W and HE in the number of group sessions attended (DT-W adjusted M = 5.09, HE adjusted M = 5.03, p = .92), ratings of treatment effectiveness or usefulness of skills, or retention at 6-month follow-up (79% in DT-W vs. 78% in HE) (ps > .05), but comprehension ratings were lower in DT-W than in HE (p = .02).
Overall, these results suggest that the study procedures and interventions were feasible and acceptable, but changes to the DT-W intervention content to improve comprehension should be considered prior to conducting a fully powered trial.
A distress tolerance-based treatment targeting fear of weight gain after smoking cessation and post-cessation emotional eating was feasible and acceptable relative to a smoking HE comparison condition, but changes should be considered before conducting a larger trial. Continued innovation in treatment development for weight-concerned smokers is needed.
大多数吸烟的女性报告称，担心体重增加是戒烟的障碍。我们开发了一种干预措施，结合了痛苦耐受、食欲意识和正念饮食技巧，以针对戒烟后体重增加和情绪性进食的担忧（DT-W）。在当前的研究中，我们对 DT-W 与吸烟健康教育（HE）干预进行了一项试点随机对照试验。
参与者（N = 69 名成年女性，关注体重的吸烟者）以 4-11 人为一组进行招募。组被随机分配到 DT-W 或 HE。DT-W 和 HE 在格式（单次个体会议后进行八次小组会议）、包含戒烟认知行为疗法（CBT）内容和药物治疗（尼古丁贴片）方面相匹配。随访评估在治疗后 1、3 和 6 个月进行。
达到了招募目标；69 名参与者中有 61 名至少参加了一次小组会议。DT-W 和 HE 组在参加小组会议的次数（DT-W 调整后的 M = 5.09，HE 调整后的 M = 5.03，p =.92）、治疗效果或技能实用性的评分，或 6 个月随访时的保留率（DT-W 为 79%，HE 为 78%）（p >.05）方面均无显著差异，但 DT-W 的理解评分低于 HE（p =.02）。
总体而言，这些结果表明，研究程序和干预措施是可行和可接受的，但为了提高理解，应考虑对 DT-W 干预内容进行更改，然后再进行全面的试验。
与吸烟健康教育比较条件相比，针对戒烟后对体重增加的恐惧和戒烟后情绪性进食的基于痛苦耐受的治疗是可行和可接受的，但在进行更大规模的试验之前，应考虑进行更改。需要继续创新针对关注体重的吸烟者的治疗方法。
