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Study seeks solution for women ready to quit smoking

Weight gain is tough problem to overcome

Stopping smoking and never using nicotine again is a challenge for all smokers.

Recently, investigators have identified subgroups of smokers, in particular those fearing weight gain as a consequence of quitting, who may benefit from tailored nicotine dependence treatment.

On the surface, the decision to quit smoking seems straightforward. But it can be a decision mired in psychological gridlock. The fear of weight gain can have a huge impact on a person's decision to quit, and to quit forever. This concern is found in both genders but is more frequently reported by female smokers. For women, smoking often wins.

According to Dr. Matthew Clark, a Mayo Clinic psychologist specializing in clinical health psychology, about 25 percent of men and at least 50 percent of women cite weight gain as a primary reason to continue smoking.

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"Weight gain is an enormous barrier for both quitting smoking and remaining quit from smoking," he said. "This is especially true for the female smoking population."

To better understand and treat this subgroup of smokers, Clark is conducting a research study at the Mayo Clinic Nicotine Research Center. Overall, the study seeks to compare the effectiveness of body image treatment to weight management treatment in female smokers who are concerned about weight gain as they attempt to quit smoking.

According to Clark, several studies have been aimed at this group of smokers. When researchers combined smoking cessation and weight management techniques, they found this combination ineffective for either the smoking or the weight-gain issues. A review of the results proposed that attempting two major, competing lifestyle changes at the same time might be overwhelming for the participant.

Thus, the quandary remained: If an individual is using smoking as a means for weight management, how can they be helped to quit smoking and cope with the potential weight gain?

Two strategies have been shown to be helpful. One strategy is exercise. For example, in a study at Brown University, researchers demonstrated that incorporating an exercise program into a smoking cessation program for women was helpful for both quitting smoking and preventing weight gain. Another strategy is the use of medication, which has been the subject of study at Mayo Clinic.

"Previous research has shown that exercise and some medications are beneficial for preventing weight gain and improving the participants' ability to quit smoking. The main purpose of our study is to determine which behavioral intervention will provide the highest level of success for this particular subgroup of weight-concerned female smokers," Clark said.

In addition, the timing of the interventions has been found to be crucial. Once enrolled, subjects will be randomly assigned to one of two groups for a 12-week period. The first group will receive weight-management guidance and an exercise program for four weeks. After four weeks, smoking cessation counseling will be incorporated into the group treatment. The second group will receive the same treatment, except body-image guidance will replace weight-management counseling.

Each participant will receive weight-management or body-image guidance four weeks before their smoking quit date to offset the expectation of quitting. The smoking cessation aid Zyban will be started in the fifth week of the study. Zyban helps not only to reduce potential weight gain but is effective in helping smokers quit.

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For more information and the possibility of enrolling, call 1-800-848-7853 or (507) 266-1944

Ann Walker is a personal trainer and kinesiologist and has a master's degree in exercise physiology. You can reach her at lifestyle@postbulletin.com

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