Cited by 103Smoking Behavior and CessationPhysical Activity and HealthSubstance Abuse Treatment and Outcomes

The Efficacy of Vigorous-Intensity Exercise as an Aid to Smoking Cessation in Adults With High Anxiety Sensitivity: A Randomized Controlled Trial

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Smits, Jasper A. J., Zvolensky, Michael J., Davis, Michelle L., Rosenfield, David, Marcus, Bess H., Church, Timothy S., Powers, Mark B., Frierson, Georita M. +4 more·2016·Psychosomatic Medicine

Abstract

OBJECTIVES: High anxiety sensitivity predicts poor smoking cessation outcomes. Aerobic exercise reduces anxiety sensitivity and aspects of the risk conferred by anxiety sensitivity. In the current study, we examined whether exercise can aid smoking cessation in adults with high anxiety sensitivity. METHODS: Participants were sedentary and low-activity adult daily smokers (n = 136) with elevated prescreen anxiety sensitivity. Participants received 15 weeks of standard smoking cessation treatment (ST; cognitive behavioral therapy plus nicotine replacement therapy). In addition, participants were simultaneously randomized to 15 weeks of either an exercise intervention (ST + EX; n = 72) or a wellness education control condition (ST + CTRL; n = 64). Self-reported smoking abstinence was assessed weekly during the intervention, at the end of treatment (10 weeks after the target quit date), and at 4 and 6 months after the target quit date. Abstinence was verified by expired carbon monoxide readings and saliva cotinine. RESULTS: Results indicated that point prevalence abstinence (PPA) and prolonged abstinence (PA) rates were significantly higher for ST + EX than for ST + CTRL at each of the major end points among persons with high anxiety sensitivity (PPA: b = -0.91, standard error [SE] = 0.393, t(1171) = -2.33, p = .020; PA: b = -0.98, SE = 0.346, t(132) = -2.84, p = .005), but not among those with low anxiety sensitivity (PPA: b = -0.23, SE = 0.218, t(1171) = -1.06, p = .29; PA: b = -0.31, SE = 0.306, t(132) = -1.01, p = .32). CONCLUSIONS: The present results suggest that exercise facilitates the odds of quit success for smokers with high levels of anxiety sensitivity and therefore may be a useful therapeutic tactic for this high-risk segment of the smoking population. TRIAL REGISTRATION: ClinicalTrials.gov, NCT01065506.

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  • The findings expand on the main outcome paper by showing that the relation between attendance patterns and treatment success may be non-linear and may depend on the type of intervention.

    “The findings reported here expand on those reported in the main outcome paper (Smits et al., 2016) by showing that the relation between attendance patterns and treatment success may not be linear and, importantly, may depend on the type of intervention.”
  • The parent trial's core outcome analysis showed that high-AS participants randomized to exercise were more likely to remain abstinent after quit day, and session attendance had an overall positive association with abstinence.

    “The core outcome analysis showed that participants high in AS randomized to exercise were more likely to remain abstinent following quit day and session attendance showed an overall positive association with abstinence (Smits et al., 2016).”
  • In some cases, greater session attendance or treatment completion has been positively associated with outcomes, but this association is not ubiquitous, suggesting individual differences in dose-response.

    “In some cases, a greater number of sessions attended or treatment completion have shown positive associations with outcomes (Baker et al., 2006; Fiore, 2008; Smits et al., 2016; Whiteley et al., 2012), but this is not ubiquitous, suggesting individual differences in dose-response exist (Baldwin et al., 2009; Barkham et al., 2006; Owen et al., 2016; Reese et al., 2011).”

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Research works printed but not linked: 2

  1. [23]First MB Spitzer R Gibbon M Williams J Structured Clinical Interview for DSM-IV-TR Axis I Disorders, Research Version, Patient Edition (SCID-I/P) New York Biometrics Research, New York State Psychiatric Institute 2002
  2. [42]Cohen J Applied Multiple Regression/correlation Analysis for the Behavioral Sciences Taylor & Francis 1983 572

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Authors
Smits, J. A. J., Zvolensky, M. J., Davis, M. L., Rosenfield, D., Marcus, B. H., Church, T. S., Powers, M. B., Frierson, G. M., Otto, M. W., Hopkins, L. B., Brown, R. A., & Baird, S. O.
Affiliations
  • Boston University (US)
  • The University of Texas MD Anderson Cancer Center (US)
  • The University of Texas at Austin (US)
  • Southern Methodist University (US)
  • University of California San Diego (US)
  • Pennington Biomedical Research Center (US)
  • Howard University (US)
  • San Francisco VA Medical Center (US)
Corresponding author
Smits, Jasper A. J.
Venue
Psychosomatic Medicine
Published
2016-04
Volume
78
Issue
3
Pages
354-364
ISSN
0033-3174 (ISSN-L)
OpenAlex
W2337581563
Cited by
103
References
50
Citations by year
2026: 2 · 2025: 5 · 2024: 7 · 2023: 6 · 2022: 11 · 2021: 16 · 2020: 9 · 2019: 11 · 2018: 13 · 2017: 12 · 2016: 11
FWCI
8.84
Type
journal article
Language
en
Open access
Locations
  • Psychosomatic Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
  • Radboud Repository (Radboud University) (submittedVersion)
Funders
  • National Institutes of Health (5r01da027533-04)
  • National Institute on Drug Abuse (R01-DA027533)
Topics
  • Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
  • Health Sciences › Medicine › Physiology › Physical Activity and Health
  • Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
Keywords
anxiety sensitivity, smoking cessation, high-intensity exercise, aerobic exercise, smoking abstinence, nicotine replacement therapy, cognitive behavioral therapy, exercise intervention, long-term abstinence
MeSH terms
Adult, Anxiety, Breath Tests, Combined Modality Therapy, Exercise Therapy, Female, Follow-Up Studies, Humans, Male, Middle Aged, Cognitive Behavioral Therapy, Smoking Cessation, Outcome Assessment, Health Care, Sedentary Behavior, Tobacco Use Cessation Devices

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