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Abrantes AM, Browne J, Uebelacker LA, Anderson BJ, Barter S, Shah Z, Kunicki ZJ, Caviness C, Price LH, Desaulniers J, Brown RA. Randomized Controlled Trial of Aerobic Exercise for Smoking Cessation Among Individuals With Elevated Depressive Symptoms. Nicotine Tob Res 2024; 26:634-638. [PMID: 37819741 PMCID: PMC11033564 DOI: 10.1093/ntr/ntad201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Revised: 08/28/2023] [Accepted: 10/09/2023] [Indexed: 10/13/2023]
Abstract
INTRODUCTION Adults with depression have higher rates of cigarette smoking and are more likely to relapse than those without depression. Pharmacological, psychological, and combined interventions have largely yielded small improvements in smoking outcomes for adults with depression. Aerobic exercise (AE) may facilitate smoking cessation in this subpopulation. METHODS This study was a 12-week two-arm randomized controlled trial that evaluated the effect of a moderate-intensity AE program compared to a health education contact (HEC) control on smoking cessation in adults with elevated depressive symptoms (mild to severe). Participants (n = 231) were randomized to AE or HEC and received smoking cessation treatment (telephone counseling and nicotine replacement therapy). Primary (biologically confirmed 7-day point prevalence abstinence) and secondary (depressive symptoms, objective and self-reported physical activity, and cardiorespiratory fitness) outcomes were assessed at baseline, 3, 6, and 12 months. Data were analyzed with mixed-effects generalized linear models controlling for age, gender, nicotine dependence, history of major depression disorder, and month of follow-up assessment. RESULTS There were no significant differences in primary or secondary outcomes between the AE and HEC groups. CONCLUSIONS The AE program was not superior to HEC in facilitating smoking cessation, increases in physical activity, or improved depressive symptoms. Given evidence for the positive acute effects of exercise on mood and smoking urges, future research should consider testing alternative exercise approaches for aiding smoking cessation beyond structured, AE programs. IMPLICATIONS This study found that an adjunctive aerobic exercise (AE) program was not superior to a health education contact control for adults with elevated depressive symptoms, all of whom also received standard smoking cessation treatment. This finding adds to the growing body of literature that structured AE programs for smoking cessation may have limited efficacy for cessation outcomes. Future research is needed to test alternative methods of integrating AE into smoking cessation treatment, such as strategically using exercise to manage cravings and low mood in the moment.
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Affiliation(s)
- Ana M Abrantes
- Behavioral Medicine and Addictions Research, Butler Hospital, Providence, RI, USA
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA
| | - Julia Browne
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA
- Department of Psychology and School of Nursing, Research Service, VA Providence Healthcare System, Providence, RI, USA
| | - Lisa A Uebelacker
- Behavioral Medicine and Addictions Research, Butler Hospital, Providence, RI, USA
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA
| | - Bradley J Anderson
- Behavioral Medicine and Addictions Research, Butler Hospital, Providence, RI, USA
| | - Sarah Barter
- Behavioral Medicine and Addictions Research, Butler Hospital, Providence, RI, USA
| | - Zainab Shah
- Behavioral Medicine and Addictions Research, Butler Hospital, Providence, RI, USA
| | - Zachary J Kunicki
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA
| | - Celeste Caviness
- Behavioral Medicine and Addictions Research, Butler Hospital, Providence, RI, USA
| | - Lawrence H Price
- Behavioral Medicine and Addictions Research, Butler Hospital, Providence, RI, USA
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA
| | - Julie Desaulniers
- Behavioral Medicine and Addictions Research, Butler Hospital, Providence, RI, USA
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Chen H, Yang Y, Miyai H, Yi C, Oliver BG. The effects of exercise with nicotine replacement therapy for smoking cessation in adults: A systematic review. Front Psychiatry 2022; 13:1053937. [PMID: 36506415 PMCID: PMC9730281 DOI: 10.3389/fpsyt.2022.1053937] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 11/08/2022] [Indexed: 11/25/2022] Open
Abstract
Objective This systematic review aimed to evaluate the efficacy of exercise programmes with nicotine replacement therapy (NRT) for smoking cessation in adults. Introduction Nicotine addiction is mediated by dopamine. Exercise can also activate the dopamine reward system. Therefore, exercise may effectively facilitate NRT to reduce cigarette cravings and withdrawal symptoms. Inclusion criteria Clinical trials between 2000 and 2022 used exercise protocols of any intensity for smoking cessation, in current smokers or recent quitters of both genders, aged 18-70, without severe diseases and pregnancy. Mental disorders were not excluded, as exercise can improve mental health status. Therefore, it may be as effective among people with mental health issues as the general population in preventing nicotine cravings and supporting abstinence. Methods Four databases (PubMed, Embase, Cochrane, and Medline) were searched for papers in English using the terms "nicotine replacement therapy', "exercise," and "smoking cessation." Titles and abstracts were screened for potentially eligibility before full texts were reviewed. Sample size, gender, study duration, and age was then extracted. The certainty of the evidence was assessed using Joanna Briggs Institute's (JBI's) GRADE approach. Results Seventeen studies were identified with a total of 3,191 participants. Three studies are not a randomised control study. There was moderate-high quality evidence that exercise can aid NRT in promoting smoking cessation in the short term. Several studies reported temporary reductions in cravings; however, only one trial reported a decrease in cigarette consumption due to exercise intervention and one demonstrated increased smoking abstinence at 1 year of the intervention. Conclusion Exercise with NRT aids smoking cessation in the short term, but no evidence suggests its efficacy in the long term when combined. Future trials should include larger sample sizes and strategies to increase exercise adherence.
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Affiliation(s)
- Hui Chen
- Research Centre, The Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen, China
- Faculty of Science, School of Life Sciences, University of Technology Sydney, Ultimo, NSW, Australia
| | - Yang Yang
- Research Centre, The Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen, China
| | - Hanna Miyai
- Faculty of Science, School of Life Sciences, University of Technology Sydney, Ultimo, NSW, Australia
| | - Chenju Yi
- Research Centre, The Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen, China
| | - Brian G. Oliver
- Faculty of Science, School of Life Sciences, University of Technology Sydney, Ultimo, NSW, Australia
- Respiratory Cellular and Molecular Biology, Woolcock Institute of Medical Research, The University of Sydney, Glebe, NSW, Australia
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Schöttl SE, Niedermeier M, Kopp-Wilfling P, Frühauf A, Bichler CS, Edlinger M, Holzner B, Kopp M. Add-on exercise interventions for smoking cessation in people with mental illness: a systematic review and meta-analysis. BMC Sports Sci Med Rehabil 2022; 14:115. [PMID: 35729669 PMCID: PMC9210718 DOI: 10.1186/s13102-022-00498-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 06/07/2022] [Indexed: 11/10/2022]
Abstract
BACKGROUND Smoking is the most common substance use disorder among people with mental illness. In contrast to people without mental illness, among whom the proportion of smokers has declined in recent decades, the proportion of smokers among people with mental illness remains high. There is a growing body of literature suggesting the use of exercise interventions in combination with smoking cessation in people without mental illness, but to our knowledge the available studies on this treatment option in people with mental illness have not been systematically reviewed. Therefore, this systematic review and meta-analysis aims to assess the effectiveness of exercise interventions as an adjunctive treatment for smoking cessation in people with mental illness. METHODS Electronic databases (PubMed, Web of Science, PsycInfo, Sport Discus and Base) were searched for randomised controlled trials and prospective single-group studies that investigated exercise interventions in combination with smoking cessation programmes alone or in comparison with a control group in people with mental illness. A meta-analysis using the Mantel-Haenszel fixed-effect model was conducted to estimate the overall effect of treatment on smoking cessation (abstinence rate at the end of the intervention and at 6-month follow-up). RESULTS Six studies, five randomised controlled trials and one study with a prospective single-group design, were included in the systematic review and four randomised controlled trials were included in the meta-analysis. The meta-analysis found a significantly higher abstinence rate after additional exercise at the end of the intervention [risk ratio (RR) 1.48, 95% confidence interval (CI) 1.13-1.94], but not at the 6-month follow-up (RR 1.34, 95% CI 0.89-2.04). CONCLUSIONS Exercise appears to be an effective adjunctive therapy to temporarily increase abstinence rates in individuals with mental illness at the end of the intervention. However, due to the small number of included studies and some risk of bias in the included studies, the results should be treated with caution. Therefore, future studies with larger samples are needed to provide a more accurate estimate of the effect in people with mental illness. Registration The systematic review and meta-analysis were registered in the International Prospective Register of Systematic Reviews (PROSPERO) (registration number: CRD42020178630).
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Affiliation(s)
- Stefanie E. Schöttl
- Department of Sport Science, University of Innsbruck, Fürstenweg 185, 6020 Innsbruck, Austria
| | - Martin Niedermeier
- Department of Sport Science, University of Innsbruck, Fürstenweg 185, 6020 Innsbruck, Austria
| | - Prisca Kopp-Wilfling
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatry I, Medical University of Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria
| | - Anika Frühauf
- Department of Sport Science, University of Innsbruck, Fürstenweg 185, 6020 Innsbruck, Austria
| | - Carina S. Bichler
- Department of Sport Science, University of Innsbruck, Fürstenweg 185, 6020 Innsbruck, Austria
| | - Monika Edlinger
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatry I, Medical University of Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria
| | - Bernhard Holzner
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatry I, Medical University of Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria
| | - Martin Kopp
- Department of Sport Science, University of Innsbruck, Fürstenweg 185, 6020 Innsbruck, Austria
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Carroll ME. Voluntary exercise as a treatment for incubated and expanded drug craving leading to relapse to addiction: Animal models. Pharmacol Biochem Behav 2021; 208:173210. [PMID: 34116079 DOI: 10.1016/j.pbb.2021.173210] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Revised: 05/25/2021] [Accepted: 05/26/2021] [Indexed: 02/08/2023]
Abstract
Drug addiction is a chronic relapsing disorder, as more than 80% of former drug users relapse within a year after quit attempts have ended. This review examines incubated craving that develops over long periods of weeks to months after addictive drug use ends, when rats are given a small priming exposure to the formerly used drug, and a large amount of drug seeking occurs, reflecting large increases in craving over time. Expanded craving occurs when not only the recently-used drug, but other related or unrelated drugs of abuse elicit drug seeking that leads to relapse behavior, including common drugs like caffeine or nicotine, Thus, expanded craving is an increase in the conditions that elicit relapse, such as, a variety of drugs, and it persists weeks after drug use ends. Incubated and expanded craving occur with several drugs of abuse, and these forms of craving, can last for weeks to months and end in relapse. Voluntary physical exercise, blocked incubated cocaine craving, and expanded heroin craving elicited by multiple conditions was reduced in female and male rats. This review examines voluntary physical exercise as a long-term, self-initiated, and self-sustainable treatment that reduces long-term drug craving leading to relapse.
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Affiliation(s)
- Marilyn E Carroll
- Department of Psychiatry and Behavior Science, 621 Park Ave, University of Minnesota, Minneapolis, MN 55455, United States of America.
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Peiffer G, Underner M, Perriot J, Fond G. [COPD, anxiety-depression and cognitive disorders: Does inflammation play a major role?]. Rev Mal Respir 2021; 38:357-371. [PMID: 33820658 DOI: 10.1016/j.rmr.2021.03.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 01/11/2021] [Indexed: 02/08/2023]
Abstract
COPD is a chronic respiratory disease, often associated with extrapulmonary manifestations. Co-morbidities, including anxiety, depression and cognitive impairment, worsen its progression and quality of life. The prevalence of these disorders is high, yet they are often poorly understood and inadequately managed. In the development of psychological disorders, there is accumulated evidence highlighting the major role of systemic inflammation, as well as chronic disease, genetics, the consequences of smoking, hypoxaemia, oxidative stress, and the gut microbiome In addition to traditional treatments such as bronchodilatator medications, respiratory rehabilitation and smoking cessation, systemic inflammation is an interesting therapeutic target, with the use of anti-inflammatory drugs, anti-cytokines, and nutritional interventions.
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Affiliation(s)
- G Peiffer
- Service de pneumologie - tabacologie, CHR Metz-Thionville, 57085 Metz cedex 3, France.
| | - M Underner
- Unité de recherche clinique, université de Poitiers, centre hospitalier Henri-Laborit, 86021 Poitiers, France
| | - J Perriot
- Dispensaire Émile-Roux, CLAT 63, centre de tabacologie, 63100 Clermont-Ferrand, France
| | - G Fond
- CEReSS, hôpital de la Conception, Marseille Université, Assistance publique-Hôpitaux de Marseille (AP-HM), Marseille, France
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Cooper CB, Paine R, Curtis JL, Kanner RE, Martinez CH, Meldrum CA, Bowler R, O'Neal W, Hoffman EA, Couper D, Quibrera M, Criner G, Dransfield MT, Han MK, Hansel NN, Krishnan JA, Lazarus SC, Peters SP, Barr RG, Martinez FJ, Woodruff PG. Novel Respiratory Disability Score Predicts COPD Exacerbations and Mortality in the SPIROMICS Cohort. Int J Chron Obstruct Pulmon Dis 2020; 15:1887-1898. [PMID: 32821092 PMCID: PMC7417644 DOI: 10.2147/copd.s250191] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Accepted: 07/03/2020] [Indexed: 12/24/2022] Open
Abstract
Rationale Some COPD patients develop extreme breathlessness, decreased exercise capacity and poor health status yet respiratory disability is poorly characterized as a distinct phenotype. Objective To define respiratory disability in COPD based on available functional measures and to determine associations with risk for exacerbations and death. Methods We analyzed baseline data from a multi-center observational study (SPIROMICS). This analysis includes 2332 participants (472 with severe COPD, 991 with mild/moderate COPD, 726 smokers without airflow obstruction and 143 non-smoking controls). Measurements We defined respiratory disability by ≥4 of 7 criteria: mMRC dyspnea scale ≥3; Veterans Specific Activity Questionnaire <5; 6-minute walking distance <250 m; St George’s Respiratory Questionnaire activity domain >60; COPD Assessment Test >20; fatigue (FACIT-F Trial Outcome Index) <50; SF-12 <20. Results Using these criteria, respiratory disability was identified in 315 (13.5%) participants (52.1% female). Frequencies were severe COPD 34.5%; mild-moderate COPD 11.2%; smokers without obstruction 5.2% and never-smokers 2.1%. Compared with others, participants with disability had more emphysema (13.2 vs. 6.6%) and air-trapping (37.0 vs. 21.6%) on HRCT (P<0.0001). Using principal components analysis to derive a disability score, two factors explained 71% of variance, and a cut point −1.0 reliably identified disability. This disability score independently predicted future exacerbations (ß=0.34; CI 0.12, 0.64; P=0.003) and death (HR 2.97; CI 1.54, 5.75; P=0.001). Thus, participants with disability by this criterion had almost three times greater mortality compared to those without disability. Conclusion Our novel SPIROMICS respiratory disability score in COPD was associated with worse airflow obstruction as well as airway wall thickening, lung parenchymal destruction and certain inflammatory biomarkers. The disability score also proved to be an independent predictor of future exacerbations and death. These findings validate disability as an important phenotype in the spectrum of COPD.
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Affiliation(s)
- Christopher B Cooper
- Departments of Medicine and Physiology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Robert Paine
- Section of Pulmonary and Critical Care Medicine, Department of Veterans Affairs Medical Center, University of Utah, Salt Lake City, UT, USA
| | - Jeffrey L Curtis
- Pulmonary and Critical Care Medicine Division, Department of Internal Medicine, University of Michigan Health System, Ann Arbor, MI, USA.,Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, MI, USA
| | - Richard E Kanner
- Section of Pulmonary and Critical Care Medicine, Department of Veterans Affairs Medical Center, University of Utah, Salt Lake City, UT, USA
| | - Carlos H Martinez
- Pulmonary and Critical Care Medicine Division, Department of Internal Medicine, University of Michigan Health System, Ann Arbor, MI, USA
| | - Catherine A Meldrum
- Pulmonary and Critical Care Medicine Division, Department of Internal Medicine, University of Michigan Health System, Ann Arbor, MI, USA
| | - Russell Bowler
- National Jewish Health, University of Colorado School of Medicine, Denver, CO, USA
| | - Wanda O'Neal
- University of North Carolina Marisco Lung Institute, Chapel Hill, NC, USA
| | - Eric A Hoffman
- Department of Radiology, University of Iowa, Iowa City, IA, USA
| | - David Couper
- University of North Carolina Marisco Lung Institute, Chapel Hill, NC, USA
| | - Miguel Quibrera
- University of North Carolina Marisco Lung Institute, Chapel Hill, NC, USA
| | - Gerald Criner
- Department of Pulmonary and Critical Care Medicine, Temple University, Philadelphia, PA, USA
| | - Mark T Dransfield
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - MeiLan K Han
- Pulmonary and Critical Care Medicine Division, Department of Internal Medicine, University of Michigan Health System, Ann Arbor, MI, USA
| | - Nadia N Hansel
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Jerry A Krishnan
- Department of Medicine, University of Illinois at Chicago, Chicago, IL, USA
| | - Stephen C Lazarus
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | | | - R Graham Barr
- Department of Medicine, Columbia University Medical Center, New York, NY, USA
| | - Fernando J Martinez
- Joan and Sanford I Weill Department of Medicine, Division of Pulmonary and Critical Care Medicine, Weill Cornell Medicine, New York, NY, USA
| | - Prescott G Woodruff
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, USA
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Underner M, Perriot J, Brousse G, de Chazeron I, Schmitt A, Peiffer G, Harika-Germaneau G, Jaafari N. Arrêt et réduction du tabac chez le patient souffrant de schizophrénie. L'ENCEPHALE 2019; 45:345-356. [PMID: 31153585 DOI: 10.1016/j.encep.2019.04.067] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Revised: 04/18/2019] [Accepted: 04/22/2019] [Indexed: 02/08/2023]
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Mas S, Bernard P, Gourlan M. Determinants of physical activity promotion by smoking cessation advisors. PATIENT EDUCATION AND COUNSELING 2018; 101:1942-1946. [PMID: 29793785 DOI: 10.1016/j.pec.2018.05.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Revised: 05/14/2018] [Accepted: 05/15/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE To investigate the cross-sectional association between personal physical activity (PA) level, Theory of Planned Behavior (TPB) constructs toward PA promotion, and PA promotion behavior among smoking cessation advisors. METHOD 149 smoking cessation advisors were invited to complete online questionnaires. Hypotheses were tested using Bayesian path analysis. RESULTS Attitudes and perceived behavioral control (PBC) of smoking cessation advisors were related to PA promotion intentions; intentions were in turn related to PA promotion behaviors. Advisors' personal PA level was indirectly associated with PA promotion behaviors through PBC and PA promotion intentions. CONCLUSION The TPB is a relevant theoretical framework with which to explore determinants of PA promotion behavior among smoking cessation advisors. The PA level of health care professionals may be linked to PA promotion behavior through some TPB constructs. PRACTICE IMPLICATIONS Smoking cessation advisor training should include education on attitude development (e.g., PA benefits on smoking cessation), PBC (e.g., modality of PA prescription) and PA promotion intentions (e.g., goal setting). Smoking cessation advisors should also be encouraged to regularly practice PA in order to improve their PA promotion behaviors.
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Affiliation(s)
- Sébastien Mas
- Epsylon Laboratory EA 4556, Paul-Valéry University of Montpellier, Montpellier, France; Epidaure Prevention Department of the Montpellier Cancer Institute, Montpellier, France.
| | - Paquito Bernard
- Université du Québec à Montréal, Montréal, Quebec, Canada; Research Center, University Institute of Mental Health at Montreal, Montréal, Quebec, Canada.
| | - Mathieu Gourlan
- Epsylon Laboratory EA 4556, Paul-Valéry University of Montpellier, Montpellier, France; Epidaure Prevention Department of the Montpellier Cancer Institute, Montpellier, France.
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Bernard P, Doré I, Romain AJ, Hains-Monfette G, Kingsbury C, Sabiston C. Dose response association of objective physical activity with mental health in a representative national sample of adults: A cross-sectional study. PLoS One 2018; 13:e0204682. [PMID: 30356252 PMCID: PMC6200189 DOI: 10.1371/journal.pone.0204682] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Accepted: 09/12/2018] [Indexed: 12/13/2022] Open
Abstract
Although higher physical activity (PA) levels are associated with better mental health, previous findings about the shape of the dose–response relationship between PA and mental health are inconsistent. Furthermore, this association may differ according to sedentary levels. We investigated the cross-sectional dose-response associations between objectively measured PA and mental health in a representative national sample of adults. We also examined whether sedentary time modified the PA—mental health associations. Based on 2007–2013 Canadian Health Measures Survey data, PA and sedentary time were measured using accelerometry among 8150 participants, aged 20 to 79 years. Generalized additive models with a smooth function were fitted to examine associations between minutes per day of moderate and vigorous PA (MVPA), light PA (LPA), daily steps (combined or not with sedentary time) and self-rated mental health. A significant curvilinear relationship between average daily minutes of MVPA and mental health was observed, with increasing benefits up to 50 minutes/day. For LPA, a more complex shape (monotonic and curvilinear) was found. For daily steps, inverted U-shaped curve suggested increasing benefits until a plateau between 5 000 and 16 000 steps. The MVPA-LPA combination was significantly associated with mental health but with a complex pattern (p < 0.0005E-06). The tested PA-sedentary time combinations showed that increasing sedentary time decreased the positive PA-mental health associations. Non-linear dose-response patterns between the PA modalities and self-reported mental health were observed. Optimal doses of daily minutes of MVPA, LPA, MVPA combined with LPA and daily steps are independently associated with better mental health in adults. The results also suggest that PA-mental health associations could be hampered by daily sedentary time.
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Affiliation(s)
- Paquito Bernard
- Department of Physical Activity Sciences, Université du Québec à Montréal, Montréal, Québec, Canada
- Research Center, University Institute of Mental Health at Montreal, Montréal, Québec, Canada
- * E-mail:
| | - Isabelle Doré
- Research Center, Centre Hospitalier de l'Université de Montréal (CRCHUM), Montréal, Québec, Canada
- University of Toronto, Faculty of Kinesiology and Physical Education, Toronto, Ontario, Canada
| | - Ahmed-Jérôme Romain
- Research Center, Centre Hospitalier de l'Université de Montréal (CRCHUM), Montréal, Québec, Canada
| | - Gabriel Hains-Monfette
- Department of Physical Activity Sciences, Université du Québec à Montréal, Montréal, Québec, Canada
- Research Center, University Institute of Mental Health at Montreal, Montréal, Québec, Canada
| | - Celia Kingsbury
- Department of Physical Activity Sciences, Université du Québec à Montréal, Montréal, Québec, Canada
- Research Center, University Institute of Mental Health at Montreal, Montréal, Québec, Canada
| | - Catherine Sabiston
- University of Toronto, Faculty of Kinesiology and Physical Education, Toronto, Ontario, Canada
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Witt DR, Patten CA. Treatment of Tobacco Use Disorder and Mood Disorders in Adolescents. CURRENT ADDICTION REPORTS 2018. [DOI: 10.1007/s40429-018-0216-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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Zvolensky MJ, Rosenfield D, Garey L, Kauffman BY, Langdon KJ, Powers MB, Otto MW, Davis ML, Marcus BH, Church TS, Frierson GM, Hopkins LB, Paulus DJ, Baird SO, Smits JAJ. Does exercise aid smoking cessation through reductions in anxiety sensitivity and dysphoria? Health Psychol 2018; 37:647-657. [PMID: 29708388 DOI: 10.1037/hea0000588] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Research shows that high anxiety sensitivity (AS) and dysphoria are related to poor smoking cessation outcomes. Engaging in exercise may contribute to improvement in smoking cessation outcomes through reductions in AS and dysphoria. In the current study, we examined whether exercise can aid smoking cessation through reductions in AS and dysphoria. METHOD Participants were sedentary and low activity adult daily smokers (N = 136) with elevated AS who participated in a randomized controlled trial comparing smoking cessation treatment (ST) plus an exercise intervention (ST + EX) to ST plus wellness education (ST + CTRL). Self-reported smoking status was assessed in-person weekly from baseline through week 16 (end of-treatment; EOT), at week 22 (4 months postquit day), and at week 30 (6 months postquit day), and verified biochemically. RESULTS Results indicated that both AS and dysphoria at 6-month follow-up were significantly lower in the ST + EX group compared to the ST + CTRL group (controlling for baseline levels). Moreover, reductions in AS and dysphoria emerged as independent mechanisms of action explaining success in quitting. CONCLUSIONS These novel findings offer clinically significant evidence suggesting that vigorous-intensity exercise can effectively engage affective constructs in the context of smoking cessation. (PsycINFO Database Record
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Affiliation(s)
| | | | - Lorra Garey
- Department of Psychology, University of Houston
| | | | | | - Mark B Powers
- Department of Psychology, The University of Texas at Austin
| | | | | | - Bess H Marcus
- Department of Family Medicine and Public Health, University of California at San Diego
| | - Timothy S Church
- Pennington Biomedical Research Center, Louisiana State University
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Lynch WJ, Tan L, Narmeen S, Beiter R, Brunzell DH. Exercise or saccharin during abstinence block estrus-induced increases in nicotine-seeking. Physiol Behav 2017; 203:33-41. [PMID: 29080668 DOI: 10.1016/j.physbeh.2017.10.026] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Revised: 09/29/2017] [Accepted: 10/23/2017] [Indexed: 12/11/2022]
Abstract
Recent evidence suggests that adolescent and young adult females may be particularly responsive to nicotine use interventions that include exercise or environmental enrichment. This possibility was addressed in the current study by comparing the efficacy of exercise versus non-exercise environmental enrichment (saccharin) during abstinence at reducing subsequent nicotine-seeking/relapse vulnerability in an adolescent-onset rat model. The efficacy of each intervention was examined as a function of estrous cycle phase given findings indicating that hormonal status influences relapse vulnerability and treatment outcome in females. Once adolescent female rats acquired nicotine self-administration, they were given 23-h/day access to nicotine (0.01mg/kg/infusion) for 10days. Following the last self-administration session, rats began a 10-day forced abstinence period with 2-h/day access to an unlocked wheel (exercise, n=15), a bottle containing a saccharin-sweetened solution (0.25%; saccharin, n=19), or without access to a wheel or saccharin (control, n=20). Nicotine-seeking, as assessed under an extinction/cued-induced reinstatement procedure, was examined on day 11 of abstinence. Levels of nicotine-seeking were highest in females tested during estrus as compared to females tested during non-estrus phases. Exercise or saccharin during abstinence reduced nicotine-seeking in females tested during estrus, but neither affected the low levels of nicotine-seeking observed in females tested during non-estrus phases, presumably due to a floor effect. These results demonstrate that exercise or saccharin during abstinence decrease nicotine-seeking, and suggest that either would be effective as an early intervention for nicotine use and addiction in females.
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Affiliation(s)
- Wendy J Lynch
- Department of Psychiatry and Neurobehavioral Sciences, University of Virginia, Charlottesville, VA 22902, USA.
| | - Lillian Tan
- Department of Psychiatry and Neurobehavioral Sciences, University of Virginia, Charlottesville, VA 22902, USA
| | - Syeda Narmeen
- Department of Psychiatry and Neurobehavioral Sciences, University of Virginia, Charlottesville, VA 22902, USA
| | - Rebecca Beiter
- Department of Psychiatry and Neurobehavioral Sciences, University of Virginia, Charlottesville, VA 22902, USA
| | - Darlene H Brunzell
- Department of Pharmacology and Toxicology, Virginia Commonwealth University, Richmond, VA 23298, USA
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Romain AJ, Bernard P. Élargir les soins somatiques en psychiatrie à la prévention. Encephale 2017; 43:298-299. [DOI: 10.1016/j.encep.2016.07.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Revised: 07/08/2016] [Accepted: 07/11/2016] [Indexed: 11/29/2022]
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Abrantes AM, Farris SG, Garnaat SL, Minto A, Brown RA, Price LH, Uebelacker LA. The Role of Physical Activity Enjoyment on the Acute Mood Experience of Exercise among Smokers with Elevated Depressive Symptoms. Ment Health Phys Act 2017; 12:37-43. [PMID: 28989344 PMCID: PMC5625337 DOI: 10.1016/j.mhpa.2017.02.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
PROBLEM Depressive symptoms are consistently shown to be related to poor smoking cessation outcomes. Aerobic exercise is a potential treatment augmentation that, given its antidepressant and mood enhancing effect, may bolster cessation outcomes for smokers with elevated depressive symptoms. Lower enjoyment of physical activity may inhibit the acute mood enhancing effects of aerobic exercise. The current study investigated the associations between depressive symptoms, physical activity enjoyment and the acute mood experience from exercise among low-active smokers with elevated depressive symptoms. METHOD Daily smokers with elevated depressive symptoms (N=159; Mage = 45.1, SD = 10.79; 69.8% female) were recruited for a randomized controlled exercise-based smoking cessation trial. Participants self-reported levels of depressive symptoms, physical activity enjoyment, and rated their mood experience (assessed as "mood" and "anxiety") before and after a standardized aerobic exercise test. RESULTS Hierarchical regression analysis revealed that depressive symptom severity accounted for significant unique variance in physical activity enjoyment (R2 =.041, t = -2.61, p = .010), beyond the non-significant effects of gender and level of tobacco dependence. Additionally, physical activity enjoyment was a significant mediator of the association between depressive symptom severity and acute mood experience ("mood" and "anxiety") following the exercise test. CONCLUSIONS Physical activity enjoyment may explain, at least in part, how depressive symptom severity is linked to the acute mood experience following a bout of activity. Interventions that target increasing physical activity enjoyment may ultimately assist in enhancing the mood experience from exercise, and therefore improve smoking cessation likelihood, especially for smokers with elevated depressive symptoms.
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Affiliation(s)
- Ana M. Abrantes
- Butler Hospital, Providence, Rhode Island
- Alpert Medical School of Brown University, Providence, Rhode
Island
| | - Samantha G. Farris
- Butler Hospital, Providence, Rhode Island
- Alpert Medical School of Brown University, Providence, Rhode
Island
- The Miriam Hospital, Providence, Rhode Island
| | - Sarah L. Garnaat
- Butler Hospital, Providence, Rhode Island
- Alpert Medical School of Brown University, Providence, Rhode
Island
| | | | - Richard A. Brown
- Alpert Medical School of Brown University, Providence, Rhode
Island
- University of Texas at Austin, Austin, Texas
| | - Lawrence H. Price
- Butler Hospital, Providence, Rhode Island
- Alpert Medical School of Brown University, Providence, Rhode
Island
| | - Lisa A. Uebelacker
- Butler Hospital, Providence, Rhode Island
- Alpert Medical School of Brown University, Providence, Rhode
Island
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Lee YY, Khoo S, Morris T, Hanlon C, Wee LH, Teo EW, Adnan Y. A mixed-method study of the efficacy of physical activity consultation as an adjunct to standard smoking cessation treatment among male smokers in Malaysia. SPRINGERPLUS 2016; 5:2012. [PMID: 27933267 PMCID: PMC5122530 DOI: 10.1186/s40064-016-3675-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Accepted: 11/11/2016] [Indexed: 11/10/2022]
Abstract
BACKGROUND This study examined the effectiveness of using Physical Activity Consultation (PAC) as an addition to the standard smoking cessation treatment in Malaysia. We explored participants' experiences in terms of physical activity and smoking abstinence with the combined PAC and smoking cessation intervention. METHODS Walk-in smokers from a local smoking cessation clinic volunteered for the 8-week intervention program, while undergoing standard smoking cessation treatment. In Week 1, a facilitator conducted a face-to-face intervention to explore participants' involvement in physical activity and helped to set physical activity strategies and goals for participants to increase physical activity levels. Participants were provided with follow-up phone calls at Weeks 3 and 6. Participants answered questionnaires that measured smoking withdrawal (Shiffman-Jarvik Withdrawal Scale), cessation self-efficacy (Cessation Self-efficacy Questionnaire), physical activity involvement (International Physical Activity Questionnaire), and mood (Brunel Mood Scale) upon recruitment, at post-intervention and at follow-up 3 months after the intervention ended. Participants also responded to interviews about their experiences with the PAC and smoking cessation treatment at post-intervention and at 3-month follow-up. RESULTS Seven participants completed the program until follow-up. All were successfully abstinent. Only two participants increased physical activity levels, whereas others maintained their physical activity levels or showed slight decreases. Several themes were identified in this study, including participants' experiences with withdrawal symptoms, smoking cessation self-efficacy, triggers to smoking cessation, thoughts on standard smoking cessation treatment in Malaysia, physical activity involvement, mood, and thoughts and beliefs on combining smoking cessation and physical activity. CONCLUSIONS This study suggests PAC was helpful in maintaining or increasing the overall physical activity levels of participants and could assist with smoking abstinence. Findings showed that all participants who stayed in the program were successfully abstinent. In general, the findings in this study provided promising results for further research on PAC as an adjunct to smoking cessation treatments in Malaysia. Trial registration This intervention is registered with the Australian New Zealand Clinical Trials Registry (Trial registration number: ACTRN12616000269437).
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Affiliation(s)
- Yuin Yi Lee
- Sports Centre, University of Malaya, Kuala Lumpur, Malaysia
| | - Selina Khoo
- Sports Centre, University of Malaya, Kuala Lumpur, Malaysia
| | - Tony Morris
- Institute of Sport, Exercise and Active Living (ISEAL), College of Sport and Exercise Science, Victoria University, Melbourne, Australia
| | - Clare Hanlon
- Institute of Sport, Exercise and Active Living (ISEAL), College of Sport and Exercise Science, Victoria University, Melbourne, Australia
| | - Lei-Hum Wee
- Faculty of Health Sciences, National University of Malaysia, Kuala Lumpur, Malaysia
| | - Eng Wah Teo
- Sports Centre, University of Malaya, Kuala Lumpur, Malaysia
| | - Yuhanis Adnan
- Sports Centre, University of Malaya, Kuala Lumpur, Malaysia
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Ussher M, Lewis S, Aveyard P, Manyonda I, West R, Lewis B, Marcus B, Riaz M, Taylor AH, Barton P, Daley A, Essex H, Esliger D, Coleman T. The London Exercise And Pregnant smokers (LEAP) trial: a randomised controlled trial of physical activity for smoking cessation in pregnancy with an economic evaluation. Health Technol Assess 2016; 19:vii-xxiv, 1-135. [PMID: 26491878 DOI: 10.3310/hta19840] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Smoking during pregnancy is the main preventable cause of poor birth outcomes. Improved methods are needed to help women to stop smoking during pregnancy. Pregnancy provides a compelling rationale for physical activity (PA) interventions as cessation medication is contraindicated or ineffective, and an effective PA intervention could be highly cost-effective. OBJECTIVE To examine the effectiveness and cost-effectiveness of a PA intervention plus standard behavioural support for smoking cessation relative to behavioural support alone for achieving smoking cessation at the end of pregnancy. DESIGN Multicentre, two-group, pragmatic randomised controlled trial and economic evaluation with follow-up at the end of pregnancy and 6 months postnatally. Randomisation was stratified by centre and a computer-generated sequence was used to allocate participants using a 1 : 1 ratio. SETTING 13 hospitals offering antenatal care in the UK. PARTICIPANTS Women between 10 and 24 weeks' gestation smoking five or more cigarettes a day before pregnancy and one or more during pregnancy. INTERVENTIONS Participants were randomised to behavioural support for smoking cessation (control) or behavioural support plus a PA intervention consisting of supervised treadmill exercise plus PA consultations. Neither participants nor researchers were blinded to treatment allocation. MAIN OUTCOME MEASURES The primary outcome was self-reported, continuous smoking abstinence between a quit date and end of pregnancy, validated by expired carbon monoxide and/or salivary cotinine. Secondary outcomes were maternal weight, depression, birth outcomes, withdrawal symptoms and urges to smoke. The economic evaluation investigated the costs of the PA intervention compared with the control intervention. RESULTS In total, 789 women were randomised (n = 394 PA, n = 395 control). Four were excluded post randomisation (two had been enrolled twice in sequential pregnancies and two were ineligible and randomised erroneously). The intention-to-treat analysis comprised 785 participants (n = 392 PA, n = 393 control). There was no significant difference in the rate of abstinence at the end of pregnancy between the PA group (7.7%) and the control group (6.4%) [odds ratio for PA group abstinence 1.21, 95% confidence interval (CI) 0.70 to 2.10]. For the PA group compared with the control group, there was a 33% (95% CI 14% to 56%), 28% (95% CI 7% to 52%) and 36% (95% CI 12% to 65%) significantly greater increase in self-reported minutes of moderate- and vigorous-intensity PA from baseline to 1 week, 4 weeks and 6 weeks respectively. Accelerometer data showed that there was no significant difference in PA levels between the groups. There were no significant differences between the groups for change in maternal weight, depression, withdrawal symptoms or urges to smoke. Adverse events and birth outcomes were similar between the groups except for there being significantly more caesarean births in the control group than in the PA group (28.7% vs. 21.3%; p < 0.023). The PA intervention was less costly than the control intervention by £35 per participant. This was mainly attributable to increased health-care usage in the control group. However, there was considerable statistical uncertainty around this estimate. CONCLUSIONS During pregnancy, offering an intervention combining supervised exercise and PA counselling does not add to the effectiveness of behavioural support for smoking cessation. Only 10% of participants had PA levels accessed by accelerometer and it is, therefore, unclear whether or not the lack of an effect on the primary outcome is the result of insufficient increases in PA. Research is needed to identify the smoking populations most suitable for PA interventions and methods for increasing PA adherence. TRIAL REGISTRATION Current Controlled Trials ISRCTN48600346. FUNDING This project was funded by the NIHR Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 19, No. 84. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Michael Ussher
- Population Health Research Institute, St George's, University of London, London, UK
| | - Sarah Lewis
- Division of Epidemiology and Public Health and UK Centre for Tobacco and Alcohol Studies, University of Nottingham, Nottingham, UK
| | - Paul Aveyard
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Isaac Manyonda
- Department of Obstetrics and Gynaecology, St George's, University of London, and St George's Healthcare NHS Trust, London, UK
| | - Robert West
- Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, London, UK
| | - Beth Lewis
- School of Kinesiology, University of Minnesota, Minneapolis, MN, USA
| | - Bess Marcus
- Department of Family and Preventive Medicine, University of California, San Diego, San Diego, CA, USA
| | - Muhammad Riaz
- Population Health Research Institute, St George's, University of London, London, UK
| | - Adrian H Taylor
- Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth, UK
| | - Pelham Barton
- Health Economics Unit, School of Health and Population Sciences, University of Birmingham, Birmingham, UK
| | - Amanda Daley
- Primary Care Clinical Sciences, School of Health and Population Sciences, University of Birmingham, Birmingham, UK
| | - Holly Essex
- Department of Health Sciences, University of York, York, UK
| | - Dale Esliger
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Tim Coleman
- Division of Primary Care and UK Centre for Tobacco and Alcohol Studies, University of Nottingham, Nottingham, UK
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Underner M, Perriot J, Peiffer G, Meurice JC. Effets de l’activité physique sur le syndrome de sevrage et le craving à l’arrêt du tabac. Rev Mal Respir 2016; 33:431-43. [PMID: 26852188 DOI: 10.1016/j.rmr.2015.09.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2015] [Accepted: 09/01/2015] [Indexed: 02/08/2023]
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Underner M, Perriot J, Peiffer G, Meurice JC. Efficacité de l’activité physique dans l’aide à l’arrêt du tabac. Rev Mal Respir 2015; 32:1016-33. [PMID: 26051502 DOI: 10.1016/j.rmr.2015.01.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2014] [Accepted: 01/21/2015] [Indexed: 02/05/2023]
Affiliation(s)
- M Underner
- Service de pneumologie, unité de tabacologie, centre de lutte antituberculeuse (CLAT 86), pavillon René-Beauchant, CHU de Poitiers, BP 577, 86021 Poitiers cedex, France.
| | - J Perriot
- Dispensaire Émile-Roux, centre de tabacologie, centre de lutte antituberculeuse (CLAT 63), 63100 Clermont-Ferrand, France
| | - G Peiffer
- Service de pneumologie, centre hospitalier régional Metz-Thionville, 57038 Metz, France
| | - J-C Meurice
- Service de pneumologie, unité de tabacologie, centre de lutte antituberculeuse (CLAT 86), pavillon René-Beauchant, CHU de Poitiers, BP 577, 86021 Poitiers cedex, France
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Bernard P, Ninot G, Bernard PL, Picot MC, Jaussent A, Tallon G, Blain H. Effects of a six-month walking intervention on depression in inactive post-menopausal women: a randomized controlled trial. Aging Ment Health 2015; 19:485-92. [PMID: 25133492 DOI: 10.1080/13607863.2014.948806] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVES Physical inactivity and advanced age are associated with risk of depressive disorders. Physical activity can reduce depressive symptoms in older subjects with depressive disorders. We investigated whether a walking intervention program may decrease the occurrence of depressive symptoms in inactive post-menopausal women without depression. METHOD A total of 121 participants aged 57-75 years were randomly assigned to a six-month moderate intensity walking intervention (three times a week, 40 minutes per session, supervised and home-based) or to a control group (waiting list). Inactivity was assessed using the Physical Activity Questionnaire for the Elderly. Depression levels were measured pre- and post-intervention with the Beck depression inventory (BDI). Several baseline measures were considered as possible predictors of post-intervention BDI score. RESULTS Participants in the walking intervention showed a significant decrease in depression as compared with controls. Baseline cognitive-BDI subscore, subjective health status, body mass index and adherence were post-intervention BDI score predictors. CONCLUSION A six-month, three-session per week, moderate intensity walking intervention with a minimal 50% adherence rate reduces depression in post-menopausal women at risk for depression due to physical inactivity. This type of walking intervention could be considered as a widely accessible prevention strategy to prevent depressive symptoms in post-menopausal women at risk of depression.
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Affiliation(s)
- P Bernard
- a Laboratory EA4556 Epsylon , Montpellier 1 University , Montpellier , France
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Loprinzi PD, Herod SM, Walker JF, Cardinal BJ, Mahoney SE, Kane C. Development of a Conceptual Model for Smoking Cessation: Physical Activity, Neurocognition, and Executive Functioning. RESEARCH QUARTERLY FOR EXERCISE AND SPORT 2015; 86:338-346. [PMID: 26391913 DOI: 10.1080/02701367.2015.1074152] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
PURPOSE Considerable research has shown adverse neurobiological effects of chronic alcohol use, including long-term and potentially permanent changes in the structure and function of the brain; however, much less is known about the neurobiological consequences of chronic smoking, as it has largely been ignored until recently. In this article, we present a conceptual model proposing the effects of smoking on neurocognition and the role that physical activity may play in this relationship as well as its role in smoking cessation. METHODS Pertinent published peer-reviewed articles deposited in PubMed delineating the pathways in the proposed model were reviewed. RESULTS The proposed model, which is supported by emerging research, demonstrates a bidirectional relationship between smoking and executive functioning. In support of our conceptual model, physical activity may moderate this relationship and indirectly influence smoking behavior through physical activity-induced changes in executive functioning. CONCLUSIONS Our model may have implications for aiding smoking cessation efforts through the promotion of physical activity as a mechanism for preventing smoking-induced deficits in neurocognition and executive function.
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Yang X, Li S, Pan L, Wang Q, Li H, Han M, Zhang N, Jiang F, Jia C. Assessment of successful smoking cessation by psychological factors using the Bayesian network approach. PSYCHOL HEALTH MED 2015; 21:652-61. [PMID: 26264661 DOI: 10.1080/13548506.2015.1073337] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The association between psychological factors and smoking cessation is complicated and inconsistent in published researches, and the joint effect of psychological factors on smoking cessation is unclear. This study explored how psychological factors jointly affect the success of smoking cessation using a Bayesian network approach. A community-based case control study was designed with 642 adult male successful smoking quitters as the cases, and 700 adult male failed smoking quitters as the controls. General self-efficacy (GSE), trait coping style (positive-trait coping style (PTCS) and negative-trait coping style (NTCS)) and self-rating anxiety (SA) were evaluated by GSE Scale, Trait Coping Style Questionnaire and SA Scale, respectively. Bayesian network was applied to evaluate the relationship between psychological factors and successful smoking cessation. The local conditional probability table of smoking cessation indicated that different joint conditions of psychological factors led to different outcomes for smoking cessation. Among smokers with high PTCS, high NTCS and low SA, only 36.40% successfully quitted smoking. However, among smokers with low pack-years of smoking, high GSE, high PTCS and high SA, 63.64% successfully quitted smoking. Our study indicates psychological factors jointly influence smoking cessation outcome. According to different joint situations, different solutions should be developed to control tobacco in practical intervention.
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Affiliation(s)
- Xiaorong Yang
- a Department of Epidemiology and Biostatistics , Shandong University , Jinan 250012 , Shandong , P.R. China
| | - Suyun Li
- a Department of Epidemiology and Biostatistics , Shandong University , Jinan 250012 , Shandong , P.R. China
| | - Lulu Pan
- a Department of Epidemiology and Biostatistics , Shandong University , Jinan 250012 , Shandong , P.R. China
| | - Qiang Wang
- a Department of Epidemiology and Biostatistics , Shandong University , Jinan 250012 , Shandong , P.R. China
| | - Huijie Li
- a Department of Epidemiology and Biostatistics , Shandong University , Jinan 250012 , Shandong , P.R. China
| | - Mingkui Han
- a Department of Epidemiology and Biostatistics , Shandong University , Jinan 250012 , Shandong , P.R. China
| | - Nan Zhang
- a Department of Epidemiology and Biostatistics , Shandong University , Jinan 250012 , Shandong , P.R. China
| | - Fan Jiang
- a Department of Epidemiology and Biostatistics , Shandong University , Jinan 250012 , Shandong , P.R. China
| | - Chongqi Jia
- a Department of Epidemiology and Biostatistics , Shandong University , Jinan 250012 , Shandong , P.R. China
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Stubbs B, Vancampfort D, Bobes J, De Hert M, Mitchell AJ. How can we promote smoking cessation in people with schizophrenia in practice? A clinical overview. Acta Psychiatr Scand 2015; 132:122-30. [PMID: 25754402 DOI: 10.1111/acps.12412] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/17/2015] [Indexed: 12/14/2022]
Abstract
OBJECTIVE High rates of smoking and nicotine dependence are associated with increased physical comorbidity and premature death in people with schizophrenia. We conducted a clinical overview to establish how smoking cessation should be promoted in practice. METHOD Systematic clinical review of major electronic databases from inception till November 2014. RESULTS A growing body of evidence supports pharmacological interventions to assist smoking cessation. The most promising evidence is for bupropion with several meta-analyses demonstrating its effectiveness. Currently, there is limited evidence demonstrating the effectiveness of nicotine replacement therapy (NRT) and varenicline, although this is likely to be due to the paucity of research. There are no consistent data to suggest that pharmacological interventions increase adverse events. Behavioural and psychosocial interventions also demonstrate promise, particularly when combined with pharmacotherapy. Careful monitoring of antipsychotic levels (in particular clozapine) is essential, and the promotion of physical activity may be useful to negate potential weight gain and diabetes risk following smoking cessation. CONCLUSION Evidence from systematic reviews and meta-analyses suggests that smoking cessation interventions are effective in people with schizophrenia, although more long-term research is required. Promoting smoking cessation should be given utmost priority in clinical practice, and we offer practical strategies to facilitate this.
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Affiliation(s)
- B Stubbs
- School of Health and Social Care, University of Greenwich, Eltham, London, UK
| | - D Vancampfort
- KU Leuven Department of Rehabilitation Sciences, Leuven, Belgium
| | - J Bobes
- Department of Psychiatry, University of Oviedo - CIBERSAM, Oviedo, Spain
| | - M De Hert
- KU Leuven Department of Neurosciences, UPC KU Leuven, Kortenberg, Belgium
| | - A J Mitchell
- Department of Cancer and Molecular Medicine, University of Leicester, Leicester, UK
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Fernández del Río E, López-Durán A, Rodríguez-Cano R, Martínez Ú, Martínez-Vispo C, Becoña E. Facets of the NEO-PI-R and smoking cessation. PERSONALITY AND INDIVIDUAL DIFFERENCES 2015. [DOI: 10.1016/j.paid.2015.02.030] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Yang X, Hirvensalo M, Hintsanen M, Hintsa T, Pulkki-Råback L, Jokela M, Telama R, Tammelin T, Hutri-Kähönen N, Viikari JSA, Raitakari OT. Longitudinal associations between changes in physical activity and depressive symptoms in adulthood: the young Finns study. Int J Behav Med 2015; 21:908-17. [PMID: 24362904 DOI: 10.1007/s12529-013-9376-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Although previous studies have associated physical activity (PA) with lower depressive symptoms, the combined effects of the (1) frequency, (2) intensity, and (3) duration of long-term PA have not been examined in detail. PURPOSE We examined the dose-response association between changes in frequency, intensity, and duration of PA and depressive symptoms in men and women over 6 years. METHODS Participants comprised 1,959 healthy adults (833 men and 1,126 women), aged 24-39 years in 2001, drawn from the ongoing Young Finns Study. PA was assessed using a self-report questionnaire completed in connection with a medical examination in 2001 and 2007. Depressive symptoms were simultaneously assessed using a modified version of Beck's Depression Inventory in both phases. RESULTS High doses of PA at baseline were prospectively associated with fewer depressive symptoms in men, while moderate doses of PA at baseline were inversely associated with the prevalence of depressive symptoms in women. Associations between baseline PA and depressive symptom changes were mediated by social and health-related factors which differed between men and women. Long-term participation in regular PA in all dimensions remained remarkably stable (all p < 0.001). Compared to those who remained inactive, the persistently active participants in all dimensions, with the exception of women's intensity group, were more likely to show decreases in depressive symptoms independent of the included confounders. An increase in PA in certain groups was also independently associated with fewer depressive symptoms, particularly in women. CONCLUSIONS Regular and persistent participation in different doses of PA may provide short-term and long-term beneficial effects on depressive symptom changes. The results imply that the moderate to high doses of PA may serve as a buffer against depression in early midlife.
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Affiliation(s)
- Xiaolin Yang
- LIKES-Research Center for Sport and Health Sciences, Viitaniementie 15a, 40720, Jyväskylä, Finland,
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Bernard P, Ninot G, Quantin X. Self‐reported physical activity in smoking pre‐cessation is not a protective factor against relapse for all. Am J Addict 2015; 24:153-159. [DOI: 10.1111/ajad.12156] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2014] [Revised: 05/24/2014] [Accepted: 07/02/2014] [Indexed: 11/29/2022] Open
Affiliation(s)
- Paquito Bernard
- Laboratory Epsylon EA 4556Dynamics of Human Abilities and Health BehaviorsUniversity of MontpellierMontpellierFrance
- Department of Respiratory MedicineCHU MontpellierMontpellierFrance
| | - Gregory Ninot
- Laboratory Epsylon EA 4556Dynamics of Human Abilities and Health BehaviorsUniversity of MontpellierMontpellierFrance
| | - Xavier Quantin
- Laboratory Epsylon EA 4556Dynamics of Human Abilities and Health BehaviorsUniversity of MontpellierMontpellierFrance
- Department of Respiratory MedicineCHU MontpellierMontpellierFrance
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26
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Loprinzi PD, Walker JF. Nicotine Dependence, Physical Activity, and Sedentary Behavior among Adult Smokers. NORTH AMERICAN JOURNAL OF MEDICAL SCIENCES 2015; 7:94-9. [PMID: 25839000 PMCID: PMC4382772 DOI: 10.4103/1947-2714.153920] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Research has previously demonstrated an inverse association between smoking status and physical activity; however, few studies have examined the association between nicotine dependence and physical activity or sedentary behavior. AIM This study examined the association between nicotine dependence and accelerometer-determined physical activity and sedentary behavior. MATERIALS AND METHODS Data from the 2003-2006 National Health and Nutrition Examination Survey (NHANES) were used. A total of 851 adult (≥20 years) smokers wore an accelerometer for ≥4 days and completed the Fagerstrom Test for Nicotine Dependence scale. Regression models were used to examine the association between nicotine dependence and physical activity/sedentary behavior. RESULTS After adjusting for age, gender, race-ethnicity, poverty level, hypertension, emphysema, bronchitis, body mass index (BMI), cotinine, and accelerometer wear time, smokers 50 + years of age with greater nicotine dependence engaged in more sedentary behavior (β = 11.4, P = 0.02) and less light-intensity physical activity (β = -9.6, P = 0.03) and moderate-to-vigorous physical activity (MVPA; β = -0.14, P = 0.003) than their less nicotine dependent counterparts. CONCLUSION Older adults who are more nicotine dependent engage in less physical activity (both MVPA and light-intensity) and more sedentary behavior than their less nicotine dependent counterparts.
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Affiliation(s)
- Paul D Loprinzi
- Center for Health Behavior Research, Department of Health, Exercise Science and Recreation Management, University of Mississippi, Mississippi, USA
| | - Jerome F Walker
- Department of Respiratory Therapy, Lansing School of Nursing and Health Sciences, Bellarmine University, Louisville, Kentucky, USA
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Bernard P, Ninot G, Cyprien F, Courtet P, Guillaume S, Georgescu V, Picot MC, Taylor A, Quantin X. Exercise and Counseling for Smoking Cessation in Smokers With Depressive Symptoms: A Randomized Controlled Pilot Trial. J Dual Diagn 2015; 11:205-16. [PMID: 26683252 DOI: 10.1080/15504263.2015.1113842] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Despite various strategies to help smokers with depressive disorders to quit, the smoking relapse rate remains high. The purpose of this pilot study was to estimate the effects of adding an exercise and counseling intervention to standard smoking cessation treatment for smokers with depressive disorders. We hypothesized that the exercise and counseling intervention would lead to improved abstinence, reduced depressive symptoms, and increased physical activity. METHODS Seventy smokers with current depressive disorders were randomly assigned to standard smoking cessation treatment plus exercise and counseling (n = 35) or standard treatment plus a time-to-contact control intervention on health education (n = 35). Both programs involved 10 sessions over 8 weeks. The primary outcome was continuous abstinence since the quit date and was measured at week 8 (end of the intervention) and again at 12-, 24-, and 52-week follow-ups. RESULTS Nearly 60% of participants were female (n = 41), 38 (52.3%) were single, 37 (52.9%) had education beyond high school, and 32 (45.7%) met criteria for major depressive disorder or dysthymia. Participants in the two treatment conditions differed at baseline only in marital status (χ(2) = 4.28, df = 1, p =.04); and smoking abstinence self-efficacy, t(66) = -2.04, p =.04). The dropout rate did not differ significantly between groups and participants attended 82% and 75% of the intervention and control sessions, respectively. Intention-to-treat analysis showed that, at 12 weeks after the beginning of the intervention, continuous abstinence did not vary significantly between the intervention and control groups: 48.5% versus 28.5%, respectively, ORadj = 0.40, 95% CI [0.12-1.29], p =.12. There were no group differences in depressive symptoms, but the intervention group did outperform the control group on the 6-minute walking test (Mint = 624.84, SD = 8.17, vs. Mcon = 594.13, SD = 8.96, p =.015) and perceived physical control (Mint = 2.84, SD = 0.16, vs. Mcon = 2.27, SD = 0.18, p =.028). The sample was not large enough to ensure adequate statistical power. CONCLUSIONS This finding, while preliminary, suggests that an exercise and counseling intervention may yield better results than health education in improving smoking abstinence. This study is registered at www.clinincaltrials.gov under # NCT01401569.
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Affiliation(s)
- Paquito Bernard
- a Laboratory Epsylon EA 4556, Dynamics of Human Abilities and Health Behaviors, University of Montpellier , Montpellier , France.,b Department of Respiratory Medicine , University Hospital of Montpellier , Montpellier , France
| | - Gregory Ninot
- a Laboratory Epsylon EA 4556, Dynamics of Human Abilities and Health Behaviors, University of Montpellier , Montpellier , France
| | - Fabienne Cyprien
- c University Department of Adult Psychiatry, Hôpital Carémeau, University Hospital of Nîmes , Nîmes , France
| | - Philippe Courtet
- d INSERM Institut National Pour la Santé et la Recherche Médicale , Montpellier , France.,e University Department of Adult Psychiatry, Hôpital de la Colombière, University Hospital of Montpellier , Montpellier , France
| | - Sebastien Guillaume
- d INSERM Institut National Pour la Santé et la Recherche Médicale , Montpellier , France.,e University Department of Adult Psychiatry, Hôpital de la Colombière, University Hospital of Montpellier , Montpellier , France
| | - Vera Georgescu
- f Department of Medical Information , University Hospital of Montpellier, Montpellier-1 University , Montpellier , France
| | - Marie-Christine Picot
- f Department of Medical Information , University Hospital of Montpellier, Montpellier-1 University , Montpellier , France
| | - Adrian Taylor
- g Plymouth University Peninsula School of Medicine and Dentistry , Plymouth , UK
| | - Xavier Quantin
- a Laboratory Epsylon EA 4556, Dynamics of Human Abilities and Health Behaviors, University of Montpellier , Montpellier , France.,b Department of Respiratory Medicine , University Hospital of Montpellier , Montpellier , France
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Loprinzi PD, Kane CJ, Mahoney S, Walker JF. Physical activity and nicotine dependence among a national sample of young U.S. adults who smoke daily: evaluation of cross-sectional and longitudinal associations to determine which behavior drives this relationship. Physiol Behav 2014; 139:1-6. [PMID: 25446209 DOI: 10.1016/j.physbeh.2014.11.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2014] [Revised: 11/03/2014] [Accepted: 11/05/2014] [Indexed: 11/28/2022]
Abstract
The association between nicotine dependence and physical activity (PA) is relatively unknown. No study has concurrently examined the cross-sectional and longitudinal associations between PA and nicotine dependence, which was the primary purpose of this study. A secondary purpose was to examine how well nicotine dependence and PA behavior track over a two-year period. Data from the 2003-2005 National Youth Smoking Cessation Survey (NYSCS) were used, with young adults (18-24 yrs; n=1168) being followed over a two-year period. Physical activity was assessed using a questionnaire and nicotine dependence was assessed using the modified Fagerstrom Test for Nicotine Dependence scale. This study identified three notable findings: 1) baseline PA and nicotine dependence demonstrated a bidirectional, cross-sectional association (e.g., β=-0.23; 95% CI: -0.44 to -0.02; p=0.02); 2) when examined longitudinally, nicotine dependence influenced PA (OR=0.90; 95% CI: 0.82-0.99; p=0.04), but there was no evidence of the reverse pathway (i.e., PA influencing 2-year follow-up smoking status [OR=0.95; 95% CI: 0.66-1.39; p=0.82) or nicotine dependence (β=0.05; 95% CI: -0.14 to 0.24, p=0.61]); and 3) both PA (OR=3.52, 95% CI: 2.68-4.69; p<0.001) and nicotine dependence (β=0.52; 95% CI: 0.46-0.58, p<0.001) tracked relatively well over a two-year period during early adulthood. These findings suggest that both behaviors (physical activity and nicotine dependence) track over time, but nicotine dependence appears to be driving the cross-sectional relationship between nicotine dependence and physical activity, as opposed to the reverse pathway.
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Affiliation(s)
- Paul D Loprinzi
- Center for Health Behavior Research, Department of Health, Exercise Science, & Recreation Management, School of Applied Sciences, The University of Mississippi, University, MS 38677, United States.
| | - Christy J Kane
- Department of Respiratory Therapy, Lansing School of Nursing and Health Sciences, Bellarmine University, Louisville, KY, United States 40205
| | - Sara Mahoney
- Department of Exercise Science, Lansing School of Nursing and Health Sciences, Bellarmine University, Louisville, KY, United States 40205
| | - Jerome F Walker
- Department of Respiratory Therapy, Lansing School of Nursing and Health Sciences, Bellarmine University, Louisville, KY, United States 40205
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Ali MM, Amialchuk A, Heller LR. The influence of physical activity on cigarette smoking among adolescents: evidence from Add Health. Nicotine Tob Res 2014; 17:539-45. [PMID: 25187062 DOI: 10.1093/ntr/ntu171] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2014] [Accepted: 08/19/2014] [Indexed: 11/12/2022]
Abstract
INTRODUCTION This article explored the relationship between physical activity and smoking behavior among adolescents using rich longitudinal survey data from a nationally representative sample of adolescents. METHODS Several endogeneity-corrected models were estimated to ascertain the effect of exercise on both the probability of being a smoker and the intensity of cigarette smoking. RESULTS The analysis indicated that 1 additional weekly occurrence of exercise led to a 0.3% decline in the probability of being a smoker and led to a 4.1% reduction in the number of cigarettes smoked by a smoker during a month, a result that was robust to stratification by gender and race/ethnicity. Consistent with the national guidelines, frequencies of physical activity of at least 7 times per week appeared to exhibit the biggest benefits in terms of reduction in smoking for both genders and across races/ethnicities. CONCLUSIONS Reduction in health-damaging smoking behavior among adolescents could be an additional benefit of being physically active. This research documented a new pathway by which even moderate increases in physical activity could result in improved health outcomes by reducing smoking.
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Affiliation(s)
- Mir M Ali
- Analysis and Services Research Branch, Substance Abuse and Mental Health Services Administration, Rockville, MD
| | | | - Lauren R Heller
- Department of Economics, Campbell School of Business, Berry College, Mount Berry, GA
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Abstract
BACKGROUND Taking regular exercise may help people give up smoking by moderating nicotine withdrawal and cravings, and by helping to manage weight gain. OBJECTIVES To determine whether exercise-based interventions alone, or combined with a smoking cessation programme, are more effective than a smoking cessation intervention alone. SEARCH METHODS We searched the Cochrane Tobacco Addiction Group Specialized Register in April 2014, and searched MEDLINE, EMBASE, PsycINFO, and CINAHL Plus in May 2014. SELECTION CRITERIA We included randomized trials which compared an exercise programme alone, or an exercise programme as an adjunct to a cessation programme, with a cessation programme (which we considered the control in this review). Studies were required to recruit smokers or recent quitters and have a follow-up of six months or more. Studies that did not meet the full inclusion criteria because they only assessed the acute effects of exercise on smoking behaviour, or because the outcome was smoking reduction, are summarised but not formally included. DATA COLLECTION AND ANALYSIS We extracted data on study characteristics and smoking outcomes. Because of differences between studies in the characteristics of the interventions used we summarized the results narratively, making no attempt at meta-analysis. We assessed risk of selection and attrition bias using standard methodological procedures expected by The Cochrane Collaboration. MAIN RESULTS We identified 20 trials with a total of 5,870 participants. The largest study was an internet trial with 2,318 participants, and eight trials had fewer than 30 people in each treatment arm. Studies varied in the timing and intensity of the smoking cessation and exercise programmes offered. Only one included study was judged to be at low risk of bias across all domains assessed. Four studies showed significantly higher abstinence rates in a physically active group versus a control group at end of treatment. One of these studies also showed a significant benefit for exercise versus control on abstinence at the three-month follow-up and a benefit for exercise of borderline significance (p = 0.05) at the 12-month follow-up. Another study reported significantly higher abstinence rates at six month follow-up for a combined exercise and smoking cessation programme compared with brief smoking cessation advice. One study showed significantly higher abstinence rates for the exercise group versus a control group at the three-month follow-up but not at the end of treatment or 12-month follow-up. The other studies showed no significant effect for exercise on abstinence. AUTHORS' CONCLUSIONS Only two of the 20 trials offered evidence for exercise aiding smoking cessation in the long term. All the other trials were too small to reliably exclude an effect of intervention, or included an exercise intervention which may not have been sufficiently intense to achieve the desired level of exercise. Trials are needed with larger sample sizes, sufficiently intense interventions in terms of both exercise intensity and intensity of support being provided, equal contact control conditions, and measures of exercise adherence and change in physical activity in both exercise and comparison groups.
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Affiliation(s)
- Michael H Ussher
- Population Health Research Institute, St George's, University of London, Cranmer Terrace, London, UK, SW17 0RE
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