Publication Date



Open access

Embargo Period


Degree Type


Degree Name

Doctor of Philosophy (PHD)


Psychology (Arts and Sciences)

Date of Defense


First Committee Member

Monica Webb Hooper

Second Committee Member

Neil Schneiderman

Third Committee Member

Michael H. Antoni

Fourth Committee Member

Patrice G. Saab

Fifth Committee Member

Dominique L. Musselman

Sixth Committee Member

William Wohlgemuth


Research has shown that African Americans gain more than average weight after smoking cessation. However, few studies have examined 1) the pattern of weight gain and 2) factors associated with weight gain among African American smokers. The current study aimed to examine biopsychosocial predictors of weight gain in a sample of treatment-seekers. Data were drawn from a randomized controlled trial (RCT) testing the efficacy of a culturally specific cognitive behavioral therapy (CBT) smoking cessation intervention among African Americans. Participants (N=342) completed assessments at baseline, the end of counseling (EOC), 3-, 6-, and 12-month follow ups. Baseline measures included salivary cortisol, depressive symptoms, and weight concern. Weight and self-reported smoking status were measured at all assessments. Random effects multilevel modeling was used to examine the pattern and predictors of weight gain over twelve months post CBT. Cross-level interactions of the biopsychosocial factors and smoking status on weight were explored. Results revealed that weight significantly increased among abstainers over twelve months post CBT. In the full sample, controlling for intervention condition and baseline obesity, smoking status positively predicted weight gain; abstinence was associated with increased weight. Exploratory analyses indicated that depressive symptoms moderated the association between smoking status and weight. In this sample, weight gain was comparable to previous post-cessation weight gain research. We found that psychosocial factors emerged as important in predicting weight gain. Future research examining predictors of weight gain in African American smokers will inform smoking cessation interventions and help elucidate factors contributing to tobacco- and obesity-related health disparities.


smoking cessation; post-cessation weight gain; health disparities; African American smokers; minority health; depressive symptoms