Referral to Slimming World in UK Stop Smoking Services (SWISSS) versus stop smoking support alone on body weight in quitters: results of a randomised controlled trial

Introduction Most people who stop smoking gain weight. Dietary modification may seem an obvious solution, but food restriction may increase cigarette craving and smoking relapse.Trial design An unblinded parallel randomised controlled trial.Methods Participants were adult smokers with a body mass in...

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Main Authors: Paul Aveyard, Marcus Munafò, Amanda Lewis, Andrew Farmer, Deborah Lycett
Format: Article
Language:English
Published: BMJ Publishing Group 2020-01-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/10/1/e032271.full
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author Paul Aveyard
Marcus Munafò
Amanda Lewis
Andrew Farmer
Deborah Lycett
author_facet Paul Aveyard
Marcus Munafò
Amanda Lewis
Andrew Farmer
Deborah Lycett
author_sort Paul Aveyard
collection DOAJ
description Introduction Most people who stop smoking gain weight. Dietary modification may seem an obvious solution, but food restriction may increase cigarette craving and smoking relapse.Trial design An unblinded parallel randomised controlled trial.Methods Participants were adult smokers with a body mass index greater or equal to 23 kg/m2. Setting was National Health Service commissioned Stop Smoking Services, interventions were referral to a commercial weight management programme, plus stop smoking support (treatment group), compared with stop smoking support alone (control group). Objective was to compare weight change between interventions in smoking abstainers and not abstinent rates in all. Primary outcome was change in weight (kg) at 12 weeks. Randomisation sequence was computer generated and concealed until allocation.Results Seventy-six participants were recruited, 37 were randomised to the treatment group and 39 to the control group. Change in weight was analysed in long-term abstainers (13 treatment, 14 control) only because the aim was to prevent weight gain associated with smoking cessation. Abstinence was analysed on an intention-to-treat basis (37 treatment, 39 control). At 12 weeks weight gain was less in the treatment than the control group with an adjusted mean difference of −2.3 kg 95% CI (−4.4 to -0.1). Craving scores were lower (Mood and Physical Symptoms Scale craving domain −1.6 (–2.7 to –0.5)) and quit rates were higher in the treatment than the control group (32% vs 21%), although the trial was not powered to superiority in cravings and quit rates. No adverse events or side effects were reported.Conclusion In people who are obese and want to quit smoking, these data provide modest encouragement that providing weight management at the time of quitting may be helpful. Those who are not obese, but who are informed about potential weight gain during their quit attempt, were uninterested in a weight management programme.Trial registration number ISRCTN65705512
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spelling doaj-art-45ff41fdab734287a0f6fa608c67e5872024-12-07T02:20:08ZengBMJ Publishing GroupBMJ Open2044-60552020-01-0110110.1136/bmjopen-2019-032271Referral to Slimming World in UK Stop Smoking Services (SWISSS) versus stop smoking support alone on body weight in quitters: results of a randomised controlled trialPaul Aveyard0Marcus Munafò1Amanda Lewis2Andrew Farmer3Deborah Lycett4NIHR Oxford Biomedical Research Centre, John Radcliffe Hospital, Oxford, UKSchool of Experimental Psychology, University of Bristol, Bristol, UK5 Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall, Bristol, UK3 Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UKFaculty of Health and Life Sciences, Coventry University, Coventry, West Midlands, UKIntroduction Most people who stop smoking gain weight. Dietary modification may seem an obvious solution, but food restriction may increase cigarette craving and smoking relapse.Trial design An unblinded parallel randomised controlled trial.Methods Participants were adult smokers with a body mass index greater or equal to 23 kg/m2. Setting was National Health Service commissioned Stop Smoking Services, interventions were referral to a commercial weight management programme, plus stop smoking support (treatment group), compared with stop smoking support alone (control group). Objective was to compare weight change between interventions in smoking abstainers and not abstinent rates in all. Primary outcome was change in weight (kg) at 12 weeks. Randomisation sequence was computer generated and concealed until allocation.Results Seventy-six participants were recruited, 37 were randomised to the treatment group and 39 to the control group. Change in weight was analysed in long-term abstainers (13 treatment, 14 control) only because the aim was to prevent weight gain associated with smoking cessation. Abstinence was analysed on an intention-to-treat basis (37 treatment, 39 control). At 12 weeks weight gain was less in the treatment than the control group with an adjusted mean difference of −2.3 kg 95% CI (−4.4 to -0.1). Craving scores were lower (Mood and Physical Symptoms Scale craving domain −1.6 (–2.7 to –0.5)) and quit rates were higher in the treatment than the control group (32% vs 21%), although the trial was not powered to superiority in cravings and quit rates. No adverse events or side effects were reported.Conclusion In people who are obese and want to quit smoking, these data provide modest encouragement that providing weight management at the time of quitting may be helpful. Those who are not obese, but who are informed about potential weight gain during their quit attempt, were uninterested in a weight management programme.Trial registration number ISRCTN65705512https://bmjopen.bmj.com/content/10/1/e032271.full
spellingShingle Paul Aveyard
Marcus Munafò
Amanda Lewis
Andrew Farmer
Deborah Lycett
Referral to Slimming World in UK Stop Smoking Services (SWISSS) versus stop smoking support alone on body weight in quitters: results of a randomised controlled trial
BMJ Open
title Referral to Slimming World in UK Stop Smoking Services (SWISSS) versus stop smoking support alone on body weight in quitters: results of a randomised controlled trial
title_full Referral to Slimming World in UK Stop Smoking Services (SWISSS) versus stop smoking support alone on body weight in quitters: results of a randomised controlled trial
title_fullStr Referral to Slimming World in UK Stop Smoking Services (SWISSS) versus stop smoking support alone on body weight in quitters: results of a randomised controlled trial
title_full_unstemmed Referral to Slimming World in UK Stop Smoking Services (SWISSS) versus stop smoking support alone on body weight in quitters: results of a randomised controlled trial
title_short Referral to Slimming World in UK Stop Smoking Services (SWISSS) versus stop smoking support alone on body weight in quitters: results of a randomised controlled trial
title_sort referral to slimming world in uk stop smoking services swisss versus stop smoking support alone on body weight in quitters results of a randomised controlled trial
url https://bmjopen.bmj.com/content/10/1/e032271.full
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