Department of Psychology, University of Oviedo, Spain.
Department of Psychology, University of Oviedo, Spain.
Drug Alcohol Depend. 2024 May 1;258:111269. doi: 10.1016/j.drugalcdep.2024.111269. Epub 2024 Mar 19.
Interventions for quitting smoking and weight control among individuals with excess weight are scarce. Our study evaluated the effectiveness of cognitive behavioral therapy (CBT) plus contingency management (CM) in this population, and examined whether CM for smoking cessation improved CBT treatment outcomes at end of treatment (EOT) and at 1-, 3-, 6-, and 12-month follow-ups (FU).
In an 8-week randomized clinical trial, 120 adults who smoke with overweight or obesity (54.16% females; M = 31.75 ± 4.31) were randomly assigned to CBT for both quitting smoking and weight control (n = 60) or the same treatment plus CM for smoking cessation (n = 60). Outcome variables were compared (i.e., treatment completion, smoking abstinence, weight change and secondary outcomes).
At EOT, the CBT + CM group achieved 78.33% 7-day point-prevalence abstinence rates compared to 61.67% in the CBT group (p = .073), and rates declined over time (12-month FU: 18% vs 12%). Participants who attained abstinence weighed more compared to baseline at EOT (M = 1.07; SD = 1.88) and over time (12-month FU: M = 4.19; SD = 4.31). No differences were found between the two groups in outcome variables.
Both interventions were effective in promoting abstinence and reducing tobacco use over time. Combining CBT with CM for smoking cessation did not improve treatment outcomes in individuals with overweight or obesity compared to CBT only. Future studies should evaluate whether implementing CM for weight maintenance helps control post-cessation weight gain in this population.
针对超重人群的戒烟和体重控制干预措施非常有限。本研究评估了认知行为疗法（CBT）加应急管理（CM）在该人群中的有效性，并探讨了戒烟的 CM 是否能改善治疗结束时（EOT）和 1、3、6 和 12 个月随访时（FU）的 CBT 治疗结果。
在一项为期 8 周的随机临床试验中，120 名超重或肥胖的成年吸烟者（女性占 54.16%；M = 31.75 ± 4.31）被随机分配到 CBT 戒烟和体重控制组（n = 60）或相同的治疗加戒烟的 CM 组（n = 60）。比较了结局变量（即治疗完成率、戒烟成功率、体重变化和次要结局）。
在 EOT 时，CBT + CM 组的 7 天点前戒烟率达到 78.33%，而 CBT 组为 61.67%（p =.073），且随时间下降（12 个月 FU：18%比 12%）。在 EOT 时，达到戒烟的参与者体重比基线时增加（M = 1.07；SD = 1.88），且随时间（12 个月 FU：M = 4.19；SD = 4.31）增加。两组在结局变量上无差异。
两种干预措施都能有效地促进戒烟并随时间减少烟草使用。与仅 CBT 相比，将 CBT 与 CM 结合用于戒烟并没有改善超重或肥胖人群的治疗结果。未来的研究应评估在该人群中实施 CM 以维持体重是否有助于控制戒烟后的体重增加。
