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Cognitiveand Behavioral Practice, 10, 131-138. Wolf, A. M., & Colditz, G. A. (1998). Current estimates of the economic costs of obesity in the United States. Obesity Research, 6, 97-106. Yager,J., Andersen, A., Devlin, M., Egger, H., Herzog, D., Mitchell,J, et al. (2000). Practice guidelines for the treatment of patients with eating disorders (Revision). American Journal of Psychiatry 57(Suppl. 1), 1-39. Address correspondence to Lucene Wisniewski, Ph.D., Director, Eating Disorder Programs; UHHS/Laurelwood Hospital, 35900 Euclid Avenue, Suite 1700, Willoughb)~OH 44094; e-mail:Lucene.Wisniewski@ uhhs.com. Received: January 2002 Accepted: August 1, 2002 • • • • • • • • • • • • • • • • • • • • • • • • • • • • • Women, Weight, and Smoking: A Cognitive Behavioral Approach to Women's Concerns About Weight Gain Following Smoking Cessation Michele D. Levine, Marsha D. Marcus, and Kenneth A. Perkins, University of Pittsburgh School of Medicine Many women endorse concerns about the weight gain that commonly accompanies an attempt to quit smoking. These weight-concerned women smokers also are less likely to be successful in their cessation efforts, and several approaches to treating postcessation weight concerns among smokers have been studied. We recently have documented the superiority of a cognitive-behavioral treatment (CBT) designed to decrease women's concerns about postcessation weight gain as compared to previously studied approaches. In this article, we briefly review the literature on weight concerns for women smokers and present details of a cognitive-behavioral approach to women's concerns about smoking-related weight gain and its integration into standard smoking cessation treatment program. In ad- dition, ongoing treatment research to improve the longer-term outcome of weight-concerned women smokers is discussed. D ESPITE CONSIDERABLE ATTENTION to the dangers of smoking, rates of smoking among women remain high. The recent surgeon general's report on women's smoking estimated that 22% of women smoke. Notably, 30% of American high school females report smoking within the past month (U.S. Department of Health and Human Services, 2001), and the prevalence of smoking among young women is higher than that among young men (Escobedo & Peddicord, 1997). Taken together, these data suggest that future smokers in the United States are more likely to be female. Cognitive and Behavioral Practice 10, 105-11 i, 2003 1077-7229/03/105-11151.00/0 Copyright © 2003 by Association for Advancement of Behavior Therapy. All rights of reproduction in any form reserved. In addition to the many negative health consequences associated with smoking for individuals of both genders, women are at higher risk for additional smoking-related diseases (Kure, Ryberg, Hewer, et al., 1996; Prescott, Hippe, Schrohr, de Heis, & Vestbo, 1998; Zang 8e Wyndei; ]996). Women also suffer additional health conse- quences from smoking that do not affect men, including reproductive complications and menstrual dysfunction (Baron, LaVecchia, & Levi, 1990). Thus, understanding and treating women's smoking is clearly an important public health priority. There is a well-established relationship between smok- ing and body weight. Smokers tend to weigh less than nonsmokers, and smoking cessation often is accompa- nied by weight gain (Hudmon, Gritz, Clayton, & Niesen- baum, 1999; Klesges et al., 1997; Streater, Sargent, &