The Impact of Tobacco Use on Weight Loss During a Peer-Led Healthy Lifestyle Intervention for People With Serious Mental Illness Living in Permanent Supportive Housing

Purpose: Over 50% of people with serious mental illness (SMI) smoke cigarettes. This study evaluated whether tobacco use impacted weight loss outcomes during a peer-led healthy lifestyle intervention (PGLB) for people with SMI living in permanent supportive housing (PSH). Method: Data from an effectiveness trial of PGLB examined whether baseline tobacco use moderated the effectiveness of the intervention compared to usual care (UC) in helping participants lose weight. PGLB was conducted in three sites in two U.S. cities between 2015 and 2018. Results: 63% of participants were current cigarette smokers. Smoking did not moderate the effect of the intervention. However, baseline tobacco use predicted greater weight loss ( b = −4.1, p = .022) over the course of the trial, regardless of treatment group. Discussion: Tobacco use was a significant driver of weight loss for study participants. Findings have implications for offering tobacco cessation treatment during healthy lifestyle interventions for people with SMI.