Stop Smoking to Reduce Risk - and Lose Weight?

According to a study by Mayo Clinic researchers, smoking cigarettes significantly increases the risk of breast cancer for women with three or more relatives who have had breast or ovarian cancer.

Writing in the journal Cancer Epidemiology, Biomarkers and Prevention, Fergus Couch, Ph.D. and colleagues noted that their study adds to the considerable body of evidence that smoking increases breast cancer risk. "Women with a significant family history of breast and ovarian cancer might want to consider avoiding smoking," they wrote.

Yet, kicking the habit is often extremely difficult-especially for women. One reason: Numerous studies have shown that a major concern for women who quit smoking is the subsequent weight they will gain as a result.

Now, researchers at the University of Pittsburgh School of Medicine have reported success with a novel smoking cessation program for women that also addresses their fears of weight gain from kicking the habit.

The researchers, led by Drs. Kenneth Perkins and Marsha Marcus, published their findings in the Journal of Consulting and Clinical Psychology.

Perkins and Marcus randomly assigned 219 women smokers who wanted to stop smoking but were worried about gaining weight, to different smoking cessation programs. These ranged from standard anti-smoking therapy (where weight gain was not addressed), to programs that also targeted the women's concerns about gaining weight.

One year after treatment, 21 percent of the women who received combination therapy to both quit smoking as well as allay their concerns about weight gain had completely quit the habit (with no relapses). In contrast, only 9 percent of the standard therapy group was able to quit smoking.

Not surprisingly, the women in the group receiving additional weight-gain counseling fared the best in terms of preventing weight gain after quitting. At one-year follow-up after treatment, they had gained significantly less weight than women in the standard anti-smoking therapy group.

Perkins said these results indicate that a critical factor influencing smoking relapse in women may be an "over-concern about weight gain," and that more smoking cessation programs should specifically address such perceptions in order to increase their effectiveness.

Dr. Alan Leshner, the Director of the National Institute on Drug Abuse, concurred. "Quitting smoking tends to be harder for women than for men, and part of this disparity is attributable to women's greater fear of gaining a lot of weight if they quit," he said.

"It would be an important clinical advance if we find a way to successfully address those concerns, making it easier for more women to stop smoking."

SOURCES:
Cancer Epidemiology, Biomarkers and Prevention, May 2001
Journal of Consulting and Clinical Psychology, August 2001
National Institute on Drug Abuse (http://www.drugabuse.gov)

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