This is my first posting to Click4HP. I very much enjoy the diverse issues
discussed in this forum. Thanks to Alison and Liz for your leadership. I
offer a few comments in response to Sherri Ross' inquiry, and on the issue
of women and tobacco reduction more generally.

There appear to be some nicotine-related metabolic changes that occur when
people quit smoking. However, research suggests that these are are temporary
and moderate, and that metabolism will re-adjust over time.  For instance,a
recent review by Perkins (1993) concluded that:

    -nicotine causes modest short-term increases in metabolism;  lack of
nicotine causes short-term decreases in metabolism. Both of these effects
are temporary .

      -there may be a temporary  increase in eating (several weeks or
months) following smoking cessation and a temporary decrease in eating if
the person relapses after quitting

      -body weight is decreased in smokers, and increases to the weight of
nonsmokers after cessation, then returns to the precessation level following
relapse; this suggests that smoking changes the set point for body weight

About 75% of women who quit smoking have some degree of weight gain, on
average between five and 10 pounds. However, this can be addressed through
healthy diet and increased physical activity, and the knowledge that the
body's metabolism will adapt to the absence of nicotine. Also, health
professionals can point out that any health risks of weight gain are far
less than the risks of continuing to smoke.

Messages about weight gain raise fears among women in particular -- not
surprising given  the messages women receive from society about the ideal
female body. Woman-centred tobacco reduction programs address this issue,
encourging women to question and  critique such messages and promoting a
healthy body image regardless of size.

Health professionals who are working with women concerned about weight gain
if they quit smoking might find the following material from two
woman-centred programs useful:

Catching Our Breath (self-help journal in book form is available from the
Women's Health Clinic in Winnipeg) - chapter called Freeing the Body
questions societal  ideals about body image, and talks about developing a
healthy body image, as well as promoting physical activity

Stop Smoking: A Program for Women (facilitator's guide available from the
Canadian Public Health Association) - chapter called Healthy Weight covers
healthy eating patterns and physical activity.

Both of the above programs address self-esteem issues.

Women and tobacco use is a strong interest of mine, and the focus of a
number of research and evaluation projects in which I am involved. I
recently wrote Women and Tobacco: A Framework for Action, the background
paper for the 2nd National Workshop on Women and Tobacco in Ottawa in 1995.
Health Canada sponsored this project and that paper, as well as a number of
other literature and program reviews on women and tobacco.

For members of this list who are interested in women and tobacco issues and
woman-centred tobacco reduction approaches, these papers can be obtained
from Health Canada's Women and Tobacco Reduction Programs (though with all
the re-organizing happening with Health Canada programs you may be safer to
contact your regional Health Canada office for information on ordering
publications).

Hope to see lots of great discussion on this issue!

Tammy Horne, Ph.D.
WellQuest Consulting Ltd.
Edmonton, Alberta  T5M 0N3
Ph (403) 451-6145
Fx (403) 451-5280
[log in to unmask]
http://www.web.net/~tamhorne (home page focuses on research, planning,
evaluation, women's health, general health promotion)