A weight concern intervention for smokers. One of the single greatest challenges in tobacco cessation treatment is that the majority of patients/participants relapse after successfully quitting. This presents a study of a solution to a common reason for relapse; Weight Concerns

1. Consumer-Centric Health
Models for Change ‘11

2. A Weight Concern Intervention for Smokers
Susan M Zbikowski, PhD
Alere Wellbeing (formerly Free & Clear)

3. One of the single greatest challenges in tobacco
cessation treatment is that the
majority of patients/participants relapse after
successfully quitting.

4. A solution to a common reason for relapse
Weight Concerns

5. Need for Specialized Counseling for Weight Concerns of Smokers
 Average smoker gains 8-15 pounds after quitting
 Concerns about weight gain after quitting is common
1) 50% of women
2) 26% of men
3) Even higher among quitlines callers
 Fear of weight gain can:
1) lead to smokers not attempting to quit
2) hinder adherence to cessation programs
3) lead to early relapse
 Weight loss while quitting is a controversial topic

6. Weight 2Quit Study
Randomized Control Trial with the Oklahoma Helpline

7. ‘Weigh2Quit’ Study Methods
Assess
weight/height, w Transfer to Coach
Smokers calling
eight to obtain consent
the Oklahoma
concerns, eligibili and administer
Helpine (OKHL)
ty and interest in baseline survey
the study
Randomization to
groups and
deliver
intervention call
#1

8. Study Hypotheses
1. cessation
2. satisfaction with the helpline
3. post quit weight gain
4. weight concerns

9. Standard Treatment

10. ‘Weigh2Quit’ Intervention

11. Intervention Content
Body Image &
Maladaptive
beliefs about
weight
Increase Motivation and
Confidence in
physical Quitting
activity smoking
Coaches
focus on
Acceptance of
Encourage
post quit
healthy snacks
weight gain
Discourage
dietary
restriction
while quitting

12. Weight-Related Characteristics of Randomized Participants
100% Weight Concerns
76% believe they are overweight
76% reported weight gain in prior quit
attempts (avg. 17lbs)
40% reported dieting while quitting
tobacco
Expect to gain 19 lbs
57% only willing to gain 10 lbs

13. RESULTS: Hypothesis 1 & 2 - Increase satisfaction and cessation
*6-month results; responder quit rates

14. RESULTS: Post-quit weight change
*Among those quit 30+ days at follow-up (N=350)
P= 0.0004

15. RESULTS: Post-quit weight change
Among those quit 30+ days at follow-up (N=350)
*P= 0.011
**P=.09

16. RESULTS: Change in weight concerns
*Among those quit 30+ days at follow-up (N=350)
P= 0.0004

17. Other Results
 Significant reduction in weight concerns and negative attitudes
about weight gain.
 Intervention effects did not vary as a function of age, gender or
tobacco status at baseline
 Intervention stronger for
Whites/ Caucasians
smokers with higher baseline self-efficacy
smokers with diabetes

18. Emerging Practice Validated
Tailored Intervention Quit &Weight Concerns
Product Development and Scaling
Adaptation by Client
QL Excellent Infrastructure for Testing Emerging
Practices and improving our outcomes

19. The complexity of helping people achieve health behavior change
Target
Multiple Populations
Tools &
Techniques
Multiple
Behaviors
Health Behavior Change

20. Innovation and Future Directions
• Measure outcomes across BMI spectrum
Obesity • Determine if there is a need for tailored treatments
Weight • Weight Concerns RCT with smokers with diabetes
Concerns
• Enhanced intervention for smokers with diabetes vs STD and UC
Diabetes • Cessation counseling plus M&B concepts
• Tobacco cessation and weight loss
Multiple
Behaviors
• Simultaneous vs sequential

21. Collaborating Organizations
 Alere Wellbeing (formerly Free & Clear)
 The Oklahoma Tobacco Settlement Endowment Trust (TSET)*
 Tobacco Use Prevention Service - Oklahoma State Department of
Health*
 Chronic Disease Program
 The University of Oklahoma
* Funders of the Oklahoma Helpline and this study.

22. Weight2Quit Collaborators
 Terry Bush PhD, Lead Investigator1
 Susan Zbikowski PhD1,Co Investigator
 Mona Deprey MS1, Research Staff
 Barbara Cerutti MS1, Research Staff
 Michele D. Levine PhD, University of Pittsburgh, Co Investigator
 Laura Beebe PhD, University of Oklahoma, Co Investigator
 Tim McAfee MD1, now at CDC, Co Investigator
1: Alere Wellbeing, (formerly Free & Clear), Seattle, WA

23. Thank you.
www.alerewellbeing.com

24. Alere Wellbeing
“Bringing together science, technology, and human
interaction to help people identify health risks and modify
behaviors so they may avoid chronic illness and live
longer, more vital lives.”