cognitive behavior therapy

Patients who received cognitive behavior therapy (CBT) were less likely to gain weight while abstaining from smoking. These findings suggest that CBT can be provided effectively over the internet and at a low cost.


One-fifth of obese people currently smoke. While the risks of smoking alone are substantial, the compounded effect for obese people who smoke is even greater. For example, the cardiovascular risks to obese individuals who smoke are 3.5-5 times greater than for non-obese smokers.

Smoking cessation is associated with modest weight gain, a concern among many smokers. The prospect of gaining weight deters weight-concerned smokers from attempting to quit, and for many, the weight gain leads to a return to smoking.

Marney A White, Valentina Ivezaj and Carlos M Grilo worked together to test the effectiveness of an Internet-based smoking cessation treatment specifically for overweight smokers. Treatment included 12 weeks of nicotine replacement therapy and Internet-administered cognitive behavioral therapy (CBT) or health education. Their results are published in the Journal of Health Psychology.

Study participants included 54 overweight and obese smokers, with a minimum BMI of greater than or equal to 25, between the ages of 18 and 65. Participants smoked 10 or more cigarettes a day with no more than three consecutive months of non-smoking in the past year. In-person evaluations occurred with the subjects at the beginning of the study, after the initial 12 weeks and then again 12 weeks later. During assessments, each participant’s height and weight were measured, along with their carbon monoxide levels to verify their smoking status.

Participants were divided into two groups. One group received Internet-based CBT aimed at preventing weight gain, and the other received general health education. Both groups received a nicotine patch daily for 10 weeks, beginning the second week of the study.

While there was no difference in the percentage of people in each group who were able to quit smoking successfully, the CBT group gained less weight than those who received health education. These results support the use of CBT to address quitting-related weight gain concerns in overweight/obese smokers, and indicate that this therapy can be provided effectively over the Internet at a low cost.



Written By: Sean Manning, BA, DC, MC

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