Acute Exercise Effects on Craving and Withdrawal Symptoms among Women Attempting to Quit Smoking Using Nicotine Replacement Therapy

Abstract

B ackground: Cigarette cravings are one of the most often expressed difficulties related to quitting.The effect of acute exercise on craving and withdrawal symptoms during a pharmacological based smoking cessation intervention is unknown. Methods: Participants included female smokers (n = 178) undertaking the Getting Physical on Cigarettes trial -a 14-week exercise-aided nicotine replacement therapy (NRT, i.e. patch) cessation program. They completed the Shiffman-Jarvik scale immediately before and after the first scheduled exercise session during weeks 5, 11, and 13. The first exercise session (week 5) occurred shortly after participants quit smoking (week 4) and began their 21 mg NRT patch dose. The second and third exercise bout coincided soon after participants stepped down their NRT strength to 14 mg (week 11) and 7 mg (week 13), respectively. Results: Significant reductions in cigarette craving were demonstrated following exercise at all three time points (i.e. week 5, 11, and 13). Significant reductions in psychological and sedation withdrawal symptoms were shown at week 5 and 11, but not at week 13. Significant increases in physical symptoms were found at week 5 and 11, but not week 13. No significant change in appetite was evident at any time point. Conclusions: An acute bout of moderate intensity exercise can alleviate cravings as well as psychological and sedation withdrawal symptoms in quitters during a 14-week exercise-aided NRT smoking cessation program. Promoting exercise among women using NRT is recommended.

A mixed-method study of the efficacy of physical activity consultation as an adjunct to standard smoking cessation treatment among male smokers in Malaysia

“…Success in achieving PA goals can also increase self-efficacy in achieving other goals, such as smoking cessation (Abrantes et al 2009; Horn et al 2013). While a number of studies have used PA to improve smoking cessation results, most of these studies used exercise prescription methods (Harper et al 2012; Horn et al 2013). Dale et al (2009) who prescribed PA to participants found that 70% of the participants did not maintain their PA after the prescription was removed.…”

Overcoming limitations in previous research on exercise as a smoking cessation treatment: Rationale and design of the “Quit for Health” trial

“…Moreover, participants enrolled in laboratory studies are typically asked to abstain from smoking for 12–24 hour prior to the study, but are not actively attempting to quit-smoking. These weaknesses of laboratory studies have been addressed to some extent by secondary analyses from exercise treatment studies in which acute effects of exercise have been shown to reduce cravings and withdrawal symptoms among women who are attempting to quit smoking using exercise as a monotherapy (Bock, Marcus, King, Borrelli, & Roberts, 1999) or as an adjunct to nicotine replacement therapy (Harper, Fitzgeorge, Tritter, & Prapavessis, 2012; Williams et al, 2011). However, two of the latter studies also showed that the effects of exercise on cravings and withdrawal symptoms dissipated by the time of the next assessment—i.e., one to seven days later (Bock et al, 1999; Williams et al, 2011).…”

Exercise to Enhance Smoking Cessation: the Getting Physical on Cigarette Randomized Control Trial

“…Post-leisure exercise also could not be discriminated by smoking status or the interaction of treatment group by smoking status. There was, however, a significant time effect indicating that all participants increased their post-leisure exercise from baseline, and this increase approached the bottom range of MET units per week (14)(15)(16)(17)(18)(19)(20)(21)(22)(23) [58] and lower end of energy expenditure (1000 kcal per week) [59] for achieving some health benefit. Overall, these findings are consistent with other similar trials that have yet to demonstrate an effective approach to increasing postintervention exercise in a way that may impact smoking cessation [27].…”

“…They include hypotheses such as changes in stress and activation [13]; positive and negative affect [11,14]; cognitive to somatic thoughts [15]; and cortisol [16,17], catecholamines and heart rate variability [16]. These mechanisms are different to those of NRT and, through extension, suggest that exercise can provide further craving and withdrawal relief during a quit attempt involving NRT [18,19]. Exercise also has been shown to have a positive effect on other factors that may protect against smoking relapse, including coping with stress [19,20], depression [21] and general fatigue and sleep disturbances [22][23][24].…”