(Open randomised trial of intermittent very low energy diet together with nicotine gum for stopping smoking in women who gained weight in previous attempts to quit)
(Commentary: results are unlikely to be as good in routine practice)
Combining smoking cessation programme with an intervention to control weight can help women to stop smoking without putting on weight, report researchers from Sweden in this week's BMJ. The team, led by Tobias Danielsson from the Karolinska Hospital in Stockholm, found that half the women who participated in a programme of using nicotine gum as well as eating a very low calorie diet, had stopped smoking after 16 weeks and their weight had fallen by an average of 2.1kg. This compared with a cessation rate of 35 per cent and a weight gain of 1.6kg in the control group who did not participate in the diet.
The team studied 287 female smokers aged between30 and 60 years who had quit smoking before, but had started again because of weight concerns. After 12 months 28 per cent of the diet group were still not smoking, compared to 16 per cent in the control group. However, of the non-smokers, the mean weight increase was 2.5kg among the dieters and 3.8kg in the control group.
They say that their study shows that smoking can be stopped for up to a year with acceptable weight control in a group of women selected for their previous weight control problems when attempting to stop smoking.
In reality, such dramatic results may not be practicable in primary care, reports Dr Kevin Jones in an accompanying commentary. For example, he points out that the women who participated in the Swedish study attended eleven 45 minute group sessions as part of their 16 week programme, which would not only be expensive but also nearly impossible to provide in routine practice. He also says that the low energy diet was provided for free, which would be unlikely to happen outside a research setting.
Contact:
Tobias Danielsson, Obesity Unit, Huddinge University Hospital, Sweden tobias.danielsson@medhs.ki.se
Professor Stephan Rossner, As above stephan.rossner@medhs.ki.se
Dr Kevin Jones, Senior Lecturer, Department of Primary Health Care, School of Health Sciences Medical School, Newcastle upon Tyne k.p.jones@ncl.ac.uk