Pomerleau et al identified a group of smokers who are predominantly female and who integrate smoking with weight control. This combination may have several important implications for management. The authors are from the University of Michigan.


Features of the weight-control smoker:

(1) The patient integrates smoking with dieting to avoid weight gain.

(2) The patient experiences less hunger when smoking and believes that smoking is crucial for controlling her appetite.

(3) The person is reluctant to stop smoking because of concerns over weight gain afterwards. Concern about weight gain may trump concerns about the hazards of smoking.

(4) Some patients may be subject to disinhibited or binge eating. This may be masked or controlled by nicotine.


These patients often do experience significant weight gain if they stop smoking..


Because smoking, appetite, body image and psyche are all tied up for these patients, addressing one problem may unmask other problems, all of which may contribute to a high rate of treatment failure. Management often requires treatment of all the issues (anger, depression, distorted body image, nicotine withdrawal, disordered eating).


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