24 March 2010

Weight counselling + drug for smokers

For female smokers worried about gaining weight if they quit, a combination of specialised counseling and the anti-smoking drug Zyban may boost their chances of quitting.


For female smokers worried about gaining weight if they quit, a combination of specialised counselling and the anti-smoking drug Zyban may boost their chances of quitting -- at least for a while, researchers reported.

Many smokers gain weight when they quit and research suggests that women who are highly worried about that prospect have a particularly tough time giving up the habit.

How the study was done

For the new study, researchers looked at whether they could improve those odds with a combination of specialised counselling focused on women's weight concerns and the smoking-cessation drug bupropion SR, or Zyban.

They found that over six months of treatment, women who received the combo therapy were more successful at quitting than those who received weight counseling only, and also more successful than those who received standard smoking-cessation counselling plus Zyban.

Over six months, 34% of women in the weight counselling/Zyban group consistently abstained, the researchers report in the Archives of Internal Medicine. That compared with 21 % of women who received standard counselling and Zyban, 11% of those who received weight counselling plus a placebo (inactive pills) and 10% of those who had standard counselling plus placebo.

However, the advantage over standard counselling plus medication faded during the six months after treatment ended.

What the study found

At the one-year mark, 24% of women in the weight counselling/Zyban group had remained abstinent, as had 19% of those in the standard therapy/Zyban group. Still, the findings suggest that counselling focused on weight worries can give certain women an extra push to quit, the researchers say.

"Women concerned with weight might, for better results, need more- specialised counselling," lead researcher Dr Michele D. Levine, of the University of Pittsburgh Medical Centre, said in an interview.

Right now, however, women are not likely to find a targeted program like the one Levine's team developed -- cognitive behavioural therapy aimed at smokers' weight-gain issues.

Levine said she and her colleagues want to identify the "key elements" of the therapy program, and see whether they can be distilled into simpler formats -- a couple of sessions worked into standard smoking- cessation counselling, for example, or even a set of "talking points" that doctors can discuss with patients trying to quit smoking.

Because the team is still working on these issues, they can't yet put a price tag on the intervention.

Female smokers msot concerned about weight-gain

The current study included 349 female smokers who expressed strong concerns about quitting-related weight gain. They reported an average of three previous quit attempts.

The researchers randomly assigned the women to one of four groups: weight counselling plus Zyban; weight counselling plus placebo; standard smoking-cessation counselling plus Zyban; or standard counselling plus placebo.

In all groups, counselling involved 12 90-minute sessions given over three months. Drug or placebo treatment lasted six months.

Women in the weight-focused group received standard smoking-cessation counselling plus therapy to help them re-evaluate their body-image and weight-gain worries.

The idea of the weight counselling, according to Levine, is to change quitters' thinking toward weight gain, rather than trying to prevent it through dieting -- which research suggests is ineffective, and may even be counterproductive to smokers' quit attempts.

However, while Levine's team found that women in the weight-counselling group were more likely to abstain over six months, there was actually no clear effect on their reported weight concerns.

That finding is surprising, Levine said, and raises the question of why the program plus Zyban worked better in the shorter term. More studies are needed to answer that question, she and her colleagues say, and to see how weight-focused counselling can be most practically delivered. The study was funded by the National Institute on Drug Abuse; two co- researchers have served as consultants to Zyban maker GlaxoSmithKline. - (Reuters Health, March 2010)


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