The Effect of Exercise on Acute Nicotine Withdrawal
Condition: Nicotine Dependence; Smoking; Sleep Disorders, Intrinsic
MeSH terms: Sleep Wake Disorders; Sleep Disorders, Intrinsic; Tobacco Use Disorder
Study type: Interventional

Summary: 
      The primary aim of this project is to test the effect of exercise on acute nicotine
      withdrawal. Acute nicotine withdrawal is characterized by a complex array of symptoms
      associated with increased risk of relapse among individuals attempting smoking cessation. The
      available remedies do not target all aspects of withdrawal. For example, pharmacologic
      treatments reduce withdrawal-based craving, but have no effect on cue-related craving,
      altered sleep, and mood disturbances during withdrawal. Therefore, non-pharmacologic
      behavioral techniques with the potential to attenuate persistent withdrawal symptoms are
      needed. We hypothesized that exercise can be a valid non-pharmacologic strategy to improve
      these domains.
    

Detailed description: 
      The goal of the proposed work is to test: 1) the effects of exercise on mood, objective
      measures of sleep, and cue reactivity; 2) the effects of exercise at a given intensity and
      duration, after a short (few hours) and more prolonged (24 to 72 hours) abstinence from
      smoking; and 3) the effects of exercising in the morning versus exercising in the evening on
      the proposed outcome domains. We plan to implement a within-subject design that will allow us
      to collect measures for each subject aged 18 to 45 in four different conditions: 1) ad
      libitum smoking; 2) evening exercise after 2 to 72 hours of abstinence; 3) morning exercise
      after 2 to 72 hours of abstinence; and 4) no exercise after 2 to 72 hours of abstinence.
      Exercise will be conducted at a fixed and monitored dose and duration. By collecting morning
      and evening measures of withdrawal symptoms and cue reactivity, we will also test whether the
      effects of exercise in reducing withdrawal symptoms and cue reactivity will show a prolonged
      effect beyond the minutes/hours immediately after the exercise bout. We also hypothesize that
      the timing of exercise may have differential effects on different aspect of withdrawal. The
      proposed work will allow us to examine the extent to which exercise, a promising
      nonpharmacologic behavioral treatment method, can attenuate key symptoms of withdrawal
      recognized to impede abstinence efforts. A better understanding of these effects will allow
      us to implement exercise at the time of day that may be more troublesome for the individual
      attempting to quit. The development of new behavioral methods for attenuating withdrawal
      symptoms will be directly transferable to smoking cessation treatments aimed at reducing
      withdrawal symptoms and aiding efforts to avoid relapse after quitting smoking.
    

Intervention name(s): Exercise
Intervention type(s): Behavioral
Intervention description(s): Each 3-day experimental period will include one of the following conditions:
Morning exercise - subject will exercise on each of the three mornings in the sleep laboratory, starting 30 minutes after their habitual rise-time;
Evening exercise - subject will start exercise 4 hours before their habitual bedtime on each of the three evenings;
No exercise - subject will watch television or read and they will be required to remain sedentary.
Allocation: Randomized
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Basic Science
Keywords: Insomnia; Smoking; Cue reactivity; Exercise timing; Acute nicotine withdrawal; Mood disturbances; Smoking abstinence; Exercise intensity; Altered sleep; Exercise duration; Nonpharmacologic behavioral treatment; Smoking cessation; Exercise Test; Polysomnography