BACKGROUND-AIM:
Food addiction is a controversial construct that has gained scientific attention. To date, no studies have specifically examined food addiction in individuals with both tobacco use disorder and excess weight who are undergoing smoking cessation treatment. The primary objective of the present study is to investigate food addiction in this population. Specifically, the study aims to: (1) evaluate the prevalence of food addiction; (2) identify variables associated with food addiction in this population; and (3) examine the impact of food addiction on the effectiveness of smoking cessation treatment.

METHODS:
A total of 120 adults (Mage=52.73, SD=10.91; 54.1% female) with tobacco use disorder and overweight or obesity (MBMI=31.75 ± 4.31) received behavioral treatment aimed at promoting smoking cessation and preventing weight gain in an 8-week randomized clinical trial. Participants were randomly assigned to either cognitive-behavioral treatment for both smoking cessation and weight control (n=60) or the same treatment plus contingency management for smoking cessation (n=60). Food addiction was assessed using the Spanish adaptation of the Yale Food Addiction Scale 2.0. Several instruments were also used to assess tobacco-related variables, eating-related variables, and transdiagnostic clinical variables. Tobacco exposure was assessed via urine cotinine levels, and body weight was measured using a calibrated medical scale. Group comparisons (with vs. without food addiction) were conducted, and logistic regression analyses were performed to examine the predictive value of participant characteristics on the presence of food addiction.

RESULTS:
The prevalence of food addiction in the total sample was 25% (30/120). Smokers with food addiction were younger and presented higher nicotine dependence, a greater number of binge-eating episodes, higher levels of depression, anxiety, and stress, more difficulties in emotional regulation, and higher impulsivity. In addition, the presence of binge eating and depression predicted the onset of food addiction. At end of treatment, the group with food addiction achieved 86.6% 7-day point-prevalence smoking abstinence rates compared to 70% in the group without food addicton and no differences were found between the two groups in smoking abstinence variables (p = 071).

CONCLUSIONS:
It is important to highlight the relevance of examining factors that may influence the effectiveness of treatments for tobacco use disorder and obesity, such as food addiction. This study found a 25% prevalence of food addiction among individuals with obesity seeking smoking cessation treatment and identified greater difficulties in this subgroup. The combined intervention was effective in promoting abstinence regardless of the presence of food addiction. These findings underscore the need to further clarify and refine the food addiction construct in order to develop effective interventions that can simultaneously enhance treatment outcomes for both tobacco use disorder and obesity.