Tobacco and Cognitive Behavioral Therapy


The title of this post references tobacco rather than smoking, because it seems to be a nuance that is appreciated. The Association for Behavioral and Cognitive Therapies (ABCT) webpage titled “Tobacco Dependence” explains right away that it encompasses not only cigarettes, but pipes, cigars, chaw, and snuff.

Even in the monolithic realm of cigarettes, the page says,

Everyone is different, smokes for different reasons, and can be more or less heavily dependent on smoking. Dependent means that you have difficulty stopping smoking even when you really want to stop.

It would it be fair to say, all this applies to compulsive overeaters. In looking at the claims for ending tobacco dependence, it is well to remember the widespread belief that all addictions are one addiction. The interesting parts are the conditions that could also apply to eating disorders that tend to result in obesity.

Overcoming addiction

The move is to shake off the automatic habits that remind you of how much you want to smoke (or drink, or eat.) The patient is advised to find alternate activities with equivalent psychological benefits.

This is a major sticking point. All too often, the person trying not to eat takes up smoking instead, and the person trying not to smoke takes up eating. How does Cognitive Behavioral Therapy (CBT) deal with what some call cross-addiction?

With nicotine, physical dependency counts for a lot, and withdrawal can be very unpleasant. Opinions differ on whether food is addictive in the same way.

Now, we really get into the principles that apply across the board, such as, that which has been learned can be unlearned. As the old saying goes, “It’s worse than bad — it’s useless!” A person can unlearn the old, counterproductive ways, and substitute new behaviors and new coping skills.

Acquiring specific goals is the name of the CBT game, no matter what the issue. It’s all about new ways of acting, feeling, thinking, and also of tackling health problems, which have a way of influencing all other aspects of life.

The ABCT offers factsheets on how this type of therapy has played out is more than 70 different scenarios, ranging from traumatic brain injury to hoarding to bullying. Alcohol Abuse is here, and Child Mood Disorders, Drug Use and Abuse, Eating Disorders, Misuse of Legal Stimulants by Children & Adolescents, and Opioid Use Disorder, all of which share some characteristics with childhood obesity.

The Eating Disorders factsheet names obesity, bulimia, and anorexia nervosa as the three major diagnoses, and bravely states, “We do not understand all the causes of obesity.” But in the real world, things sometimes work even though we don’t quite have all the cause-and-effect details figured out yet.

For, Barbara Robb wrote:

Research published in 2016 in the journal Substance Abuse: Research and Treatment examined 92 published articles about smoking cessation strategies and found that CBT was consistently effective in helping people quit smoking. The therapy also doesn’t carry the side effects of certain medication-based treatments, the researchers reported.

Your responses and feedback are welcome!

Source: “Tobacco Dependence,”, undated
Source: “Fact Sheets,”, undated
Source: “How Cognitive Behavior Therapy Can Help You Quit Smoking,”, undated
Photo credit: Michele Ahin (MicheleLovesArt) on Visualhunt/CC BY-SA

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OVERWEIGHT: What Kids Say explores the obesity problem from the often-overlooked perspective of children struggling with being overweight.

About Dr. Robert A. Pretlow

Dr. Robert A. Pretlow is a pediatrician and childhood obesity specialist. He has been researching and spreading awareness on the childhood obesity epidemic in the US for more than a decade.
You can contact Dr. Pretlow at:


Dr. Pretlow’s invited presentation at the American Society of Animal Science 2020 Conference
What’s Causing Obesity in Companion Animals and What Can We Do About It

Dr. Pretlow’s invited presentation at the World Obesity Federation 2019 Conference:
Food/Eating Addiction and the Displacement Mechanism

Dr. Pretlow’s Multi-Center Clinical Trial Kick-off Speech 2018:
Obesity: Tackling the Root Cause

Dr. Pretlow’s 2017 Workshop on
Treatment of Obesity Using the Addiction Model

Dr. Pretlow’s invited presentation for
TEC and UNC 2016

Dr. Pretlow’s invited presentation at the 2015 Obesity Summit in London, UK.

Dr. Pretlow’s invited keynote at the 2014 European Childhood Obesity Group Congress in Salzburg, Austria.

Dr. Pretlow’s presentation at the 2013 European Congress on Obesity in Liverpool, UK.

Dr. Pretlow’s presentation at the 2011 International Conference on Childhood Obesity in Lisbon, Portugal.

Dr. Pretlow’s presentation at the 2010 Uniting Against Childhood Obesity Conference in Houston, TX.

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