DESCRIPTION (adapted from investigator's abstract): Lung cancer rates now
exceed breast cancer rates as the leading cause of death by cancer among
women. Furthermore, smoking prevalence rates among women are declining at a
slower rate than men and approximately 23% of women still smoke. One
important reason why women do not attempt and/or succeed at smoking
cessation may be fear of post-cessation weight gain. However, combined
smoking cessation and weight control treatments have not been successful at
decreasing post-cessation weight gain or enhancing achievement of smoking
cessation. Exercise offers a healthful alternative to smoking, which may
allay women's fear of weight gain. Exercise facilitates regulation of body
weight, moderates mood changes, aids in decreasing responses to stress, and
is incompatible with smoking.
The proposed study will test the hypothesis that moderate intensity exercise
enhances the achievement and maintenance of smoking cessation among healthy
adult female smokers. This is a randomized controlled clinical trial
comparing two conditions: (a) cognitive-behavioral smoking cessation plus
moderate exercise and (b) cognitive-behavioral smoking cessation with equal
contact time. The treatment is delivered over 12 weeks. A sample of 224
subjects will be recruited, treated for twelve weeks and followed for 12
months. This design permits separation of the effects of physical activity
from the effects of frequent contact with staff and other subjects. Smoking
cessation outcome (7 day point-prevalence) will be verified by saliva
cotinine. Exercise adherence will be validated by attendance at supervised
sessions, exercise monitors, and maximal exercise testing. Secondary
analyses of hypothesized mediators (weight and/or weight concerns, negative
affect, withdrawal symptoms, self-efficacy, motivation) of the effect of
moderate exercise on smoking cessation will also be examined.
Successful smoking cessation in women could significantly reduce chronic
disease mortality in this group. Although intensive, this kind of program
could have advantages over pharmacologic treatments and/or could be made
more disseminable and cost-effective, but only if the initial results of
this rigorous trial are promising.
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