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Intermittent exercise in response to nicotine cravings in the context of an internet-based smoking cessation program


Background: Interventions using sustained aerobic exercise programs to aid smoking cessation have resulted in modest, short-term cessation rates comparable to conventional cessation methods. No smoking cessation trial to date has prescribed intermittent bouts of exercise in response to nicotine cravings. Objectives: This randomized controlled trial examined the feasibility and efficacy of an Internet -based smoking cessation program alone (CON) vs. the same Internet-based program + exercise (EX). Study Population: Participants were generally healthy, inactive adult smokers (N = 38; mean age = 43.6 [SD = 11.5]; 60.5% women) who desired to quit. Study Design: This pilot study added unique strategies to the methods employed in prior studies utilizing exercise as a smoking cessation strategy. Results: Although retained participants (n = 23; 60.5%) achieved a higher cessation rate (26.1%) than all enrolled participants (15.8%), adjusted intent-to-treat and per- protocol binary logistic regression analyses revealed no significant cessation rate differences between EX and CON groups. A repeated measures general linear model (GLM) analysis examining between group and within subjects changes in smoking rate from baseline to post-intervention among all participants revealed a significant within subjects effect over time, F(1, 35) = 11.45, p = .002. However, neither the between group, F(1, 35) = 1.08, p = .31, nor the interaction, F(1, 35) = 0.86, p = .36, effect was statistically significant. Linear regression results indicated that additional days of self-reported exercise on the study website during the intervention phase predicted significantly higher reduction rates among EX group participants, F(2, 18) = 31.08, p < .001. Conclusions: Outcomes from this pilot study were comparable to more resource- and time-consuming smoking cessation programs, suggesting that future iterations of this program may be promising. Results were mixed with regard to the incremental benefit of exercise in the presence of the apparently valuable Internet-based smoking cessation program. The results support findings from related research and underscore the need for additional investigation into both the mechanisms underlying the effect of exercise on cigarette cravings and the challenges of poor adherence in the context of exercise- based smoking cessation interventions

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