Title: Exercise Interventions for Smoking cessation
Funder: Department of Health (England)

Abstract: BackgroundTaking regular exercise may help people give up smoking by moderating nicotine withdrawal and cravings and by helping to manage weight gain.ObjectivesTo determine whether exercise-based interventions alone or combined with a smoking cessation programme are more effective than a smoking cessation intervention alone.Search methodsWe searched the Cochrane Tobacco Addiction Group Specialized Register in April 2014 and searched MEDLINE EMBASE PsycINFO and CINAHL Plus in May 2014.Selection criteriaWe 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 analysisWe 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 atmeta-analysis. We assessed risk of selection and attrition bias using standard methodological procedures expected by The Cochrane Collaboration.Main resultsWe identified 20 trials with a total of 5870 participants. The largest study was an internet trial with 2318 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’ conclusionsOnly 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.


Research activity codes: 6.7 PHYSICAL
Health categories: RESPIRATORY;CANCER AND NEOPLASMS;CARDIOVASCULAR