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A Randomized Controlled Trial

Bess H. Marcus, PhD; Anna E. Albrecht, RN, MS; Teresa K. King, PhD; Alfred F. Parisi, MD; Bernardine M. Pinto, PhD; Mary Roberts, MS; Raymond S. Niaura, PhD; David B. Abrams, PhD

Arch Intern Med. 1999;159:1229-1234.

Background  Smoking prevalence rates among women are declining at a slower rate than among men.

Objective  To determine if exercise, a healthful alternative to smoking, enhances the achievement and maintenance of smoking cessation.

Methods  Two hundred eighty-one healthy, sedentary female smokers were randomly assigned to either a cognitive-behavioral smoking cessation program with vigorous exercise (exercise) or to the same program with equal staff contact time (control). Subjects participated in a 12-session, group-based smoking cessation program. Additionally, exercise subjects were required to attend 3 supervised exercise sessions per week and control subjects were required to participate in 3 supervised health education lectures per week. Abstinence from smoking was based on self-report, was verified by saliva cotinine level, and was measured at 1 week after quit day (week 5), end of treatment (week 12), and 3 and 12 months later (20 and 60 weeks after quit day, respectively).

Results  Compared with control subjects (n=147), exercise subjects (n=134) achieved significantly higher levels of continuous abstinence at the end of treatment (19.4% vs 10.2%, P=.03) and 3 months (16.4% vs 8.2%, P=.03) and 12 months (11.9% vs 5.4%, P=.05) following treatment. Exercise subjects had significantly increased functional capacity (estimated O₂ peak, 25±6 to 28±6, P<.01) and had gained less weight by the end of treatment (3.05 vs 5.40 kg, P=.03).

Conclusions  Vigorous exercise facilitates short- and longer-term smoking cessation in women when combined with a cognitive-behavioral smoking cessation program. Vigorous exercise improves exercise capacity and delays weight gain following smoking cessation.

From the Center for Behavioral and Preventive Medicine (Drs Marcus, King, Pinto, Niaura, Abrams and Mss Albrecht and Roberts) and Division of Cardiology (Dr Parisi), The Miriam Hospital and Brown University School of Medicine, Providence, RI.

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