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Dissertation

Smoking cessation and weight change

20 July 1988

Abstract

Accurate information is needed concerning weight change consequences of smoking cessation, and concerning differences in weight change consequences for men versus women. Weight change following smoking cessation was investigated relative to independent variables such as gender, pre-cessation dependence level (cigarettes per day), activity level, and age. Of 656 subjects, 60% were women and 40% were men. They participated in a behavioral smoking intervention sponsored by a large health maintenance organization, and responded to e three-year follow-up questionnaire. Accuracy of self -reported weigh twas verified by on-site medical record verification procedures on a sub-sample of participants. For 211 abstainers versus 216 smokers, t-test comparisons were made for differences in post -cessetion weight change over three years and for differences between men and women. The effects of age, activity level, pre-cessation dependence level, and the rate of post-cessation weight change were determined by ANOVA end MANOVA methods. Results ere reported in pounds (lbs), in kilograms (kg), and are corrected for height by the use of body mass index (BMI) units. Subjects under-stated their weights from 1.4 to 3.4 lbs (.63 to 1.55 kg) over the three year period of recall, end formulas for the regression of self-reported weights upon medical chart weights are presented. It was found that abstainers gain more weight than smokers, but that 34% of those who quit smoking either do not gain weight or gein five pounds or less in a three year period. Remaining abstainers gained an average of 16.3 pounds (7.4 kg) or 2.46 BM I units, with women gain more weight than smokers, but that 34% of those who quit smoking either do not gain weight or gain five pounds or less in a three year period. Remaining abstainers gained an average of 16.3 pounds (7.4 kg) or 2.46 BMI units, with women gaining significantly more, and at a faster rate, than men. Pre-cessation dependence level is not related to the magnitude of of weight change at three years, but those with high initial levels are less likely to quit smoking permanently. High-activity men and women abstainers gain approximately one-half the amount of the weight gained by low-activity men and women, with the low-activity women gaining 24.7 lbs (11.2 kg) by year two. Abstainers' ages and sex are also found to be significant in influencing post-cessation weight change: younger and older men lose weight while middle-aged men gain. Women of all ages, except those over 69, gain weight upon cessation of smoking. In general, lower statistical probability levels are noted with BMI measures than those reported in pounds. In some cases changes not significant in pounds are significant when body mass is considered. Theoretical implications for building interdisciplinary models of post-cessation weight change are discussed, and clinical implications for more comprehensive smoking-cessation programs are presented.


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