Simultaneous weight intervention to stop smoking

Investigator: Jayson Spas

Mentor: Joseph Rossi, University of Rhode Island

Scientific Theme: Neuroscience

Abstract: Smoking and obesity are the first and second leading causes of preventable deaths in the United States (US). Standard intervention for both behaviors is either behavioral, pharmacologic or a combination of both. Acceptance and Commitment Therapy (ACT) is a well-established, empirically supported treatment with proven efficacy for both smoking cessation and weight loss. ACT provides a theoretical framework and a common clinical pathway for smoking cessation and weight loss intervention because it shows that experiential avoidance, the tendency to avoid difficult thoughts or feelings, is the mechanism of action that triggers unhealthy forms of behavioral avoidance such as smoking and excess eating. Despite this, to date, there are no ACT studies that simultaneously target smoking cessation and weight loss. Therefore, the specific aims of this project are to develop and test a novel ACT-based intervention that simultaneously targets smoking cessation and weight loss. Phase 1 will pilot test a novel ACT-based intervention having refined two existing ACT treatment protocols with proven efficacy for smoking cessation and weight loss as separate behaviors. This effort will result in clinician and patient manuals, as well as clinician training materials, tailored to overweight smokers. Phase 2 will be a preliminary randomized controlled trial (RCT) comparing the novel ACT intervention to a general health control that equates for intervention time. The primary outcome will be 7-day point-prevalence abstinence from smoking and lower weight from baseline. Participant reports of abstinence and lower weight will always be objectively verified by 1) saliva cotinine samples, 2) expired carbon monoxide levels, and 3) weigh-ins during intervention and at the 12- and 26-week follow-up assessments. Data produced from this research will provide the pilot data to submit an application for an R01 to test this intervention on a larger scale, the next step in this programmatic line of research. This award provides a substantial step forward in the PI achieving his long-term career goal of becoming an independent principal investigator who develops and tests innovative interventions in order to make significant theoretical,
methodological and applied contributions to science and who helps the NIH turn discovery into health.

Human Health Relevance: The aims of this project are to 1) develop and 2) test a novel ACT-based intervention that simultaneously targets smoking cessation and weight loss. With established efficacy, this intervention could be used to treat the many individuals affected by both conditions. Helping overweight smokers quit smoking and maintain a healthy weight will help extend healthy life, reduce the burdens of disability and improve quality of life.