Smoking cessation with weight-gain prevention

Domain II · Behavioural & cognitive

What it is

This is not one therapy. It is a research tradition and a set of programmes that add work on weight, or on weight worry, to standard smoking-cessation treatment. They serve smokers (in the trials, mostly women) for whom fear of gaining weight blocks quitting or drives relapse. There are two…

Format

• Format: closed groups of weight-concerned women; 10 sessions of 90 minutes over 7 weeks. Weight-concern sessions are interspersed with standard cessation counselling. In the original trial no medication was given. Levine et al. (2010) added bupropion or placebo for 6 months alongside about 3 months…
• The session-by-session order of the original manual is not given in the sources. The manual is published in Perkins, Conklin & Levine (2008), Cognitive-Behavioral Therapy for Smoking Cessation.

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Does it involve intense or unusual breathing? Have you been told about the medical conditions for which that is not advised?
• Does it involve fasting, a special diet or 'detox'? Have you discussed this with your doctor?
• Is it a group, retreat or community? How do they respond if someone wants to leave or raises a concern?
• How do you and the practitioner understand what is happening, in spiritual or cultural terms? Is that a source of comfort, worry, or both?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• goals that are too many or too large. Being working: at least partial goal completion each week.
• partners who sabotage, or who make weight comments. Being working: the client reports concrete help received.
• reluctant compliance. Explore what makes willingness hard. Being working: the quit date is kept despite worry.
• psychoeducation drifting into reassurance or disputing. Being working: clients openly share their weight fears.
• covert restriction such as skipped breakfasts. Being working: no meal-skipping, and hunger-linked urges decline.

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.