The acute effects of physical activity on cigarette cravings: Exploration of potential moderators, mediators and physical activity attributes using individual participant data (IPD) meta-analyses

Abstract

Rationale The effects of acute bouts of physical activity (PA) on Strength of Desire (SoD) and Desire to Smoke (DtS) using individual participant data (IPD) from 19 acute randomised controlled studies were quantified. However, there is a need to identify factors influencing this relationship. Objectives To understand who most benefits from PA, whether changes in affect mediate these effects, and whether any specific attributes of PA are associated with cigarette cravings. Methods IPD (N=930) contributed to one-stage IPD meta-analyses.Participants engaging in PA were compared against controls, using post-intervention DtS and SoD (when DtS not available) with baseline adjustments. The cravings scales were linearly rescaled to 0-100% (a mean difference between groups of -10 would indicate that postintervention cravings were 10% lower in the PA compared with the control group).Demographic, smoking and other characteristics were examined as predictors and potential moderators whereas change in affect was considered as a mediator. PA was categorised according to type, duration and intensity, to determine PA attributes associated with cravings reduction. Results None of the included covariates were shown to moderate or mediate the effects of PA. Intensity of PA was significantly associated with a reduction in cravings; moderate and vigorous intensity PA offered the most benefits. A one-stage IPD meta-analysis yielded effects size of -9.22 (-15.24; -3.20) for light, -34.57 (-42.64; -26.50) for moderate and -31.29 (-38.00; -24.57) for vigorous intensity in comparison with controls. Conclusions Moderate intensity PA could be recommended to all smokers regardless of demographic, smoking and other characteristics.

Effects of exercise on the desire to smoke and physiological responses to temporary smoking abstinence: a crossover trial

“…Despite this, the magnitude and duration of effects on cravings observed in this study were smaller than those reported in some previous studies (Everson et al 2008;Janse Van Rensburg et al 2012, 2009aScerbo et al 2010;Taylor et al 2005Ussher et al 2009Ussher et al , 2001. Moreover, the difference in craving seen between moderate and vigorous-intensity exercise contrasts a recent meta-analysis by Haasova et al (2014) which found similar reductions in cravings for moderate and vigorousintensity exercise. The reason for the difference between these conditions in the present study, relative to the Haasova et al (2014) meta-analysis, may be due to characteristics of the current sample, including a low mean baseline cravings level and a fitter sample than many previous studies.…”

“…Two recently published reviews support the view that acute episodes of moderate exercise significantly reduce the magnitude of urges to smoke compared with passive control conditions (Haasova et al 2012;Roberts et al 2012). However, the mechanisms underlying this relationship have not been systematically investigated (Haasova et al 2014). Exploring biomarkers to help understand the mechanisms by which acute exercise reduces cigarette cravings is paramount for confidence in treatment.…”

“…If acute exercise is to be accepted and recommended by health professionals as a legitimate strategy to reduce urges to smoke, then health professionals, and their clients (smokers), need to understand how exercise works. In their meta-analysis, Haasova et al (2014) examined a range of demographics, smoking outcomes, and physical activity characteristics, as potential predictors or moderators, and measures of affect were included as potential mediators. None of the included covariates moderated or mediated the effects of exercise on cigarette cravings.…”

“…One of the proposed mechanisms, not explored by Haasova et al (2014) that could explain why exercise could be helpful to quit smoking is that exercise acts via the same neurobiological pathway(s) as nicotine to relieve cigarette cravings and withdrawal symptoms that prompt relapse to smoking . Biomarkers influenced by both nicotine and exercise include cortisol, autonomic regulation (indexed by heart rate variability), noradrenaline, and adrenaline (Brunzell 2007).…”

mActive-Smoke: A Prospective Observational Study Using Mobile Health Tools to Assess the Association of Physical Activity With Smoking Urges (Preprint)

“…Previous interventional studies have suggested that acute exercise decreases smoking urges [9][10][11][12][13][14][15]. A systematic review and meta-analysis of individual-level data from 17 trials reported that physical activity acutely reduces cigarette craving [16].…”