Obesity Prevention After Smoking Cessation in Menopause
Obesity Prevention After Smoking Cessation in Menopause
This study addresses the high risk of weight gain associated with smoking cessation in women.
 The obesity prevention pilot study is designed for the primary prevention of weight gain that
 can lead to overweight in normal-weight women, that can progress to obesity in women who are
 already overweight, and for the prevention of additional weight gain in obese women with BMI
 greater than or equal to 30.0. Fat and other macronutrient intake, specifically, sugar,
 complex carbohydrates, and protein, are analyzed as a target for individually tailored,
 weight control intervention following smoking cessation in Caucasian and African American
 women.
Middle-aged women, especially African Americans, who quit smoking are at high risk for weight
 gain, overweight, and obesity. Postcessation weight gain has been attributed to increased
 food intake, which in turn, has been ascribed to a selective increase in high-sugar and other
 high-carbohydrate foods with a high-fat content. This study compares the relative
 effectiveness, for postmenopausal Caucasian and African American women, of following an
 empirically validated smoking cessation program with either 1) a group cessation maintenance
 program with standard exercise advice and food pyramid instructions for healthy eating or 2)
 an individually tailored, dietary-control, exercise, weight-management and
 cessation-maintenance program. Effectiveness is assessed by weight change from baseline to
 postcessation months 6, 12, and 20.

 The second aim is to assess overall fat and other specific macronutrient intake (sugar,
 complex carbohydrates, and protein) and total caloric intake with the use of a novel
 macronutrient self-selection paradigm in Caucasian and African-American postmenopausal women
 at baseline prior to smoking cessation, after being abstinent for one week, and again at 6,
 12, and 20 months postcessation.

 The third aim is to assess whether there is differential responsiveness on the above measures
 in postmenopausal Caucasian vs. African-American women.
Inclusion Criteria:

 -  Female aged 45 - 59 at time of enrollment

 -  African-American or Caucasian; able to confirm racial heritage of past two generations
 in family

 -  Postmenopausal

 -  Smokers (more than 10 cigarettes per day for 1 year or more)

 -  Written physician approval to participate in program and medical clearance that use of
 over-the-counter nicotine replacement is not contraindicated based on patient's
 medical status

 Exclusion Criteria

 -  Men

 -  Age below 45 or above 59

 -  Nonsmokers

 -  Currently in a standardized weight-reduction program or taking medications for weight
 loss

 -  History or presence of significant psychiatric illness (e.g., eating disorders,
 psychosis, psychoactive substance abuse, major depression)

 -  History of presence of severe physical illness (e.g., renal failure, hepatic failure,
 cancer, immunological disease)

 -  Unable to complete long-term study commitment, including anticipating moving out of
 study area prior to completion of the study

 -  Unable to confirm racial heritage of past two generations in family.