Finding disproves clinical guidelines about dieting while quitting smoking

Many women don't quit smoking because they are afraid of gaining weight. That's because nicotine suppresses the appetite and boosts a smoker's metabolism.

But a new meta-analysis (results of several studies) shows that women who quit smoking while receiving treatment for weight control are better able to control their weight gain and are more successful at quitting cigarettes.

The finding disproves current clinical guidelines that say trying to diet and quit smoking at the same time will sabotage efforts to ditch cigarettes.

"Women who smoke often feel caught between a rock and hard place, because they're concerned about their health but also concerned about their appearance," said Bonnie Spring, lead author of the study and a professor of preventive medicine at the Northwestern University Feinberg School of Medicine. "Now they don't have to choose between the two."

Previously, it was assumed that a person could only change one health risk behavior at a time. "But these findings show that, at least in the case of smoking and eating, you actually get an added benefit when you try to change a couple of behaviors at once," Spring said.

Recently published in the journal Addiction, Spring's paper examined the results from 2,233 smokers in 10 studies from 1991 to 2007.

The study showed that women whose treatment addressed both smoking and weight control were 29 percent more likely to quit smoking in the short term (at three months) and 23 percent in the long term (from six to 14 months) than those whose treatment addressed only smoking. Women whose treatment included smoking and weight control also gained less weight than those whose treatment included only smoking. They gained an average of 2.1 pounds less in the short term and 2.5 pounds less in the long term.

Spring hopes the study results will change doctors' attitudes and current clinical guidelines about combining weight control and smoking cessation. "Perhaps this news also will encourage more women to quit," she added, noting that cigarette smoking kills an estimated 178,000 women in the U.S. each year. About 17.4 percent of women in the U.S. smoke.

Her meta-analysis looked at different kinds of approaches to weight control.

"Some worked better than others, " she said. "Now we need different investigators to test out those most promising treatments to see if they get the same good results."

More studies also are needed that offer longer-term intervention for weight and smoking cessation. The literature on weight control shows patients lose the benefit when they stop treatment, Spring pointed out.

"We're in the right ball park, we just need refine our pitch," she said.