1. 2009 Papers of Interest
David Tinkelman

2. Pregnancy and Smoking

3. Smoking increases risk to both mother and fetus
NRT During Pregnancy: Recommended or not recommended Osahchy, Kazmin and Koren Hospital for Sick Children, Toronto, ON Journal of Obstetrics and Gynecology in Canada Aug 2009 pg744
Literature Review
Smoking increases risk to both mother and fetus
Behavioral therapy is modestly effective
NRT is not as effective in pregnant women in some studies as in women who are not pregnant
Conclusion: In pregnant women who smoke >10 cigarettes a day, NRT is safe and increases the potential for attaining smoking cessation. Should be done under physician guidance and monitoring.

4. NRT is safe in pregnancy Modest effects from behavioral interventions
Smoking in Pregnancy and lactation: a review of risks and cessation strategies Einarson and Riordan Hosp for Sick Children Toronto European Journal of Clinical Pharmacology. 2009; Vol 65 pg 325 Review of the Literature
NRT is safe in pregnancy
Modest effects from behavioral interventions
Varied results in use of NRT
Conclusion: NRT is safe and increases the potential for attaining smoking cessation. Should be done under physician guidance and monitoring.

5. Issue: NRT in Pregnancy

6. Smoking and Weight Gain

7. Behavioral intervention to promote smoking cessation and prevent weight gain: a systemic review and meta-analysis Spring, Howe, et al. Northwestern Univ Addiction Vol 104 pg 1472 Literature Review
There is no harm in providing both programs at the same time. One does not interfere with the other.
There is significant short term benefit for both smoking cessation and weight control in a combined approach.
However, limited long term added benefit for weight control in long term.
Conclusion: Because of the short term nature of the weight intervention, there are limited sustained behavioral changes to support long term weight loss. May not be cost effective to do both at same time.

8. Some smoking individuals are also binge eaters.
Self-reported weight gain following smoking cessation: A function of binge eating behavior White, Masheb and Grilo Yale University International Journal of Eating Disorders August, on line
Some smoking individuals are also binge eaters.
These individuals are likely to gain significant weight with smoking cessation and have a higher relapse rate.
Conclusion: In individuals who have had significant difficulty in previous smoking cessation efforts due to weight gain, it may be important to identify if these are binge eaters. Once identifying this sub-group, it may be possible to address this likely situation early in the cessation process.

9. Issue: Weight Gain and Smoking Cessation

10. Identification of Why People Smoke

11. Survey of 2133 smokers as to why they smoke
Self-perceived smoking motives and their correlates in a general population sample Fidler and West University College London Nicotine Tobacco Research Vol 11, pg 1182
Survey of 2133 smokers as to why they smoke
Reasons differ in men and women and by age
Women: stress relief; weight control
Men: enjoy smoking , enjoy being a smoker
Older smokers: enjoy smoking, enjoy being a smoker and much less likely for stress relief
Conclusion: While stress relief and weight control are common, many enjoy the act of smoking and being a smoker.

12. Study of 92 heavy social drinkers examining trails of hostility
Hostility and smoking cessation treatment outcome in heavy social drinkers Kahler, Spillane et al Brown University Psychology of Addictive Behavior Vol 23. pg 67
Study of 92 heavy social drinkers examining trails of hostility
Those with a cognitive component of hostility, bitterness about their lives and a sense they have received a raw deal out of life have poor smoking cessation outcomes
Conclusion: Identifying individuals who are both smokers and heavy social drinkers may identify those who are embittered about their lives. Addressing these feeling may be needed to improve any likelihood of a successful smoking cessation effort.

13. Issue: Identifying why someone smokes may help determine approaches to cessation