Michael Ussher

Effect of a short bout of exercise on tobacco withdrawal symptoms and desire to smoke

Abstract. Rationale: Previous research suggests that a long bout of vigorous intensity exercise may reduce tobacco withdrawal symptoms and desire to smoke during abstinence. Objective: In the present study, we investigated whether a short bout of moderate intensity exercise reduced desire to smoke and withdrawal symptoms in abstaining smokers. Methods: Seventy-eight smokers attended the laboratory in the afternoon having not smoked since the previous evening. They rated their desire to smoke and withdrawal symptoms immediately before, during and after 10xa0min of moderate intensity exercise on a stationary cycle (experimental condition), or after waiting passively (control condition 1) or watching a video (control condition 2). Results: Ratings of desire to smoke and withdrawal symptoms decreased more in the experimental group than in both control groups, which did not differ from each other. The effect was evident at all measurement points and was maintained for at least 10xa0min following exercise. Conclusion: A single bout of 10xa0min of moderate intensity exercise has a rapid and measurable effect on desire to smoke and tobacco withdrawal symptoms in abstaining smokers. Short bouts of exercise may be useful in helping to reduce desire to smoke and withdrawal symptoms during smoking cessation.

Acute effects of a short bout of moderate versus light intensity exercise versus inactivity on tobacco withdrawal symptoms in sedentary smokers.

RationaleA previous study found that a 10-min bout of moderate intensity exercise reduced cigarette withdrawal symptoms and desire to smoke in sedentary smokers but the effect may have been due to participants focusing attention on physical activity rather than the activity itself.ObjectivesThis study examined the effect of 5xa0min of moderate intensity exercise and 5xa0min of light intensity exercise on tobacco withdrawal symptoms amongst sedentary smokers.MethodsEighty-four smokers attended a laboratory session having abstained from smoking for between 11 and 14xa0h. Participants were randomly allocated to one of three conditions: (i) light intensity exercise [n=28; 10–20% of heart rate reserve (HRR)]; (ii) moderate intensity exercise (n=28; 40–60% HRR), (iii) a passive control condition (n=28). Both exercise conditions involved 5xa0min of stationary cycling and participants rated tobacco withdrawal symptoms and cravings immediately before exercise (baseline), during exercise at 2.5xa0min, immediately following exercise, then after 5 and 10xa0min of rest. Control participants made the same ratings across an equivalent time period.ResultsFor moderate intensity exercise compared to light intensity exercise and control there was a significant reduction in strength of desire to smoke, relative to baseline, both during exercise and up to 5xa0min post-exercise. Relative to baseline, there were also significant reductions in restlessness, stress, tension and poor concentration at 5 and 10xa0min post-exercise, for moderate intensity exercise compared to light intensity exercise and control.ConclusionsFive minutes of moderate intensity exercise is associated with a short-term reduction in desire to smoke and tobacco withdrawal symptoms. Very brief bouts of exercise may therefore be useful as an aid to smoking cessation.

Is the ten-item Questionnaire of Smoking Urges (QSU-brief) more sensitive to abstinence than shorter craving measures?

ObjectiveThe Questionnaire on Smoking Urges is now very widely used as a measure of craving but is considerably longer than alternatives in current use. Longer scales carry a significant cost in studies and clinical practice. This study compared the ten-item Questionnaire on Smoking Urges (QSU-brief) with six shorter measures of craving in terms of sensitivity to abstinence and reliability.MethodsSixty smokers were randomly assigned to continue smoking (Nu2009=u200930) or abstain completely for 24xa0h (nu2009=u200930), by which time the craving would be expected to have increased. Craving was measured at baseline and after 24xa0h. The craving measures tested were the QSU-brief, the Minnesota Nicotine Withdrawal Scale (MNWS), the Mood and Physical Symptoms Scale (MPSS), the Shiffman Scale (SS), the Wisconsin Smoking Withdrawal Scale and the Cigarette Withdrawal Scale and a simple rating of ‘craving’ (CR).ResultsAll measures showed significant increases in scores following smoking abstinence. The two-item MPSS measure was similar to the QSU-brief (eta-squared 0.41 versus 0.45, respectively), and the CR was only slightly lower (eta-squared 0.37). The MNWS showed the least sensitivity (eta-squared 0.22). Stability while still smoking was good with the exception of the SS which showed a significant reduction on retest.ConclusionsThe ten-item QSU-brief is not more sensitive to abstinence or reliable than the two-item MPSS or a single rating of craving.

Acute effects of self-paced walking on urges to smoke during temporary smoking abstinence

RationaleRecent research highlights the need to extend our understanding of how exercise may aid smoking cessation, through exploration of different modes, intensity and duration of exercise.ObjectivesThe purpose of the study was to examine the effects of a 1-mile self-paced walk on different measures of urges to smoke following temporary smoking abstinence.MethodsIn a within-subject counterbalanced design, following 15xa0h of smoking abstinence, participants (N=15) exercised or sat passively on separate days. A single-item measure of strength of desire to smoke (West and Russell in Psychopharmacology 87:407–415, 1985) was administered during, immediately post, and at 10 and 20xa0min post-treatment. The two-factor Questionnaire for Smoking Urges (QSU; Tiffany and Drobes in Br J Addict 86:467–1476, 1991), involving intention and desire to engage in smoking behaviour which is anticipated as pleasant, enjoyable and satisfying (desire–behave), and anticipation of relief from negative affect through smoking (desire–affect relief), was administered before and 20xa0min post-treatment.ResultsA two-way repeated-measures MANOVA revealed a significant overall interaction effect for time by condition for strength of desire to smoke, and the two QSU scales. Two-way repeated-measures univariate ANOVAs revealed significant interaction effects for time by condition for each of the three urges to smoke measures. Planned contrasts revealed that exercise reduced cigarette cravings for up to 20xa0min after exercise, in comparison with the control condition. ANCOVAs revealed mixed support for independent effects of exercise on all measures of urges to smoke.ConclusionA self-paced walk, at a low intensity, lasting 15–20xa0min can have a rapid and measurable positive effect on both single and multi-item measures of urges to smoke, lasting at least 20xa0min, during temporary smoking abstinence.

A survey of pregnant smokers’ interest in different types of smoking cessation support

The aim of this study was to survey pregnant smokers interest in different types of smoking cessation support. Interest in cessation support was assessed via telephone interviews with women identified as smokers at their first antenatal visit. Of 206 pregnant smokers interviewed, 87% (179/206) reported wanting to stop smoking, of whom 69% (124/179) expressed an interest in receiving help with stopping. Interest was highest for behavioural support (82%, 102/124) and self-help materials (77%, 95/124). There was a significant preference for individual versus group appointments, for buddying among those not in professional/managerial occupations versus those in professional/managerial occupations, and for behavioural support among non-Caucasians versus Caucasians. These findings highlight the high level of interest expressed in support with stopping smoking among pregnant smokers. Smoking cessation services may benefit through offering a range of interventions for pregnant smokers, through considering ethnic and occupational status, and through routinely offering individual appointments.

The Role of Schema Processes in the Eating Disorders

This study tested a new schema-based cognitive-behavioural model of eating disorders. The model is predicated on the assumption that important differences between bulimic and restrictive psychopathology exist at the level of schema processing. To test this model, 134 females with eating disorders and 345 non-eating disordered females were recruited. Factor analyses validated the measures used. Three factors emerged for primary avoidance of affect (strategies to avoid the activation of emotion), and two for secondary avoidance of affect (strategies to reduce the experience of emotion once it has been triggered). As predicted, primary and secondary avoidance of affect were found in anorexia, where anorexics of the binge/purge subtype displayed the highest levels. In contrast, secondary avoidance of affect was found to characterise bulimia nervosa, and this avoidance was confined to the behavioural/somatic domain. These findings cannot be explained by existing models of eating disorders, but offer some support for the proposed schema-based model. Treatment implications are discussed, and it is suggested that cognitive-behavioural treatments might be extended to address schema processes in order to help those who suffer from eating-disorders to change their behaviours.

Increase in common cold symptoms and mouth ulcers following smoking cessation

Objective: To examine changes in reports of common cold symptoms and mouth ulcers following smoking cessation. It was hypothesised that reports of these symptoms would increase on stopping smoking. Design: Smokers were assessed one week before stopping smoking (baseline), then after one, two, and six weeks of smoking abstinence. Participants: 174 smokers attending a seven week smoking cessation programme combining behavioural support with nicotine patches. Main outcome measures: Self reports of cold symptoms, mouth ulcers, and smoking abstinence (validated using expired carbon monoxide) were recorded on each measurement occasion. Results: Following one, two, and six weeks of smoking abstinence 73.0% (127/174), 57.5% (100/174), and 44.8% (78/174) of the participants, respectively, maintained continuous abstinence and provided reports of cold symptoms and mouth ulcers. For those abstinent from smoking for six weeks, relative to baseline, a significant increase in reports of the number of cold symptoms was observed following one and two weeks of smoking abstinence (p = 0.009 and p = 0.038, respectively) and an increase in reports of mouth ulcers after one and two weeks of abstinence (p = 0.004 and p = 0.008, respectively). Following one week of abstinence significant increases in reports of sore throat, coughing, deafness, and sneezing were observed (p = 0.049, p < 0.001, p< 0.039, and p < 0.003, respectively). Conclusions: This is the first study to systematically document significant increases in cold symptoms and mouth ulcers following smoking cessation. Smokers should be informed that they have an increased chance of experiencing these symptoms on stopping smoking. Being psychologically prepared for these effects may reduce their impact on the attempt to stop smoking.

Moderate Intensity Exercise as an Adjunct to Standard Smoking Cessation Treatment for Women: A Pilot Study

Previous randomized controlled trials have not supported moderate intensity exercise as an efficacious adjunct to smoking cessation treatments for women; however, compliance with exercise programs in these studies has been poor. The purpose of this pilot study was to estimate the effects of moderate intensity exercise on smoking cessation outcomes under optimal conditions for exercise program compliance. Sixty previously sedentary, healthy, female smokers were randomized to an 8-week program consisting of brief baseline smoking cessation counseling and the nicotine patch plus either 150 min/week of moderate intensity exercise or contact control. Participants attended a median of 86.4% and 95.5% of prescribed exercise/control sessions, respectively. There was a moderate, though statistically nonsignificant, effect of exercise at post-treatment for objectively verified 7-day point prevalence abstinence (48.3% vs. 23.3%; OR = 3.07, 95% CI: 0.89-11.07) and prolonged abstinence (34.5% vs. 20.0%; OR = 2.11, 95% CI: 0.56-8.32). Effects were attenuated when controlling for potential confounders, and after a 1-month, no-treatment period. The findings provide a preliminary indication that, given adequate compliance, moderate intensity exercise may enhance short-term smoking cessation outcomes for women; however, a larger trial is warranted.

Acute effects of moderate intensity aerobic exercise on affective withdrawal symptoms and cravings among women smokers

A growing number of laboratory studies have shown that acute bouts of aerobic exercise favorably impact affect and cravings among smokers. However, randomized trials have generally shown exercise to have no favorable effect on smoking cessation or withdrawal symptoms during quit attempts. The purpose of the present study was to explore this apparent contradiction by assessing acute changes in affect and cravings immediately prior to and following each exercise and contact control session during an eight-week smoking cessation trial. Sixty previously low-active, healthy, female smokers were randomized to an eight-week program consisting of brief baseline smoking cessation counseling and the nicotine patch plus either three sessions/week of moderate intensity aerobic exercise or contact control. Findings revealed a favorable impact of exercise on acute changes in positive activated affect (i.e., energy), negative deactivated affect (i.e., tiredness), and cigarette cravings relative to contact control. However, effects dissipated from session to session. Results suggest that aerobic exercise has potential as a smoking cessation treatment, but that it must be engaged in frequently and consistently over time in order to derive benefits. Thus, it is not surprising that previous randomized controlled trials-in which adherence to exercise programs has generally been poor-have been unsuccessful in showing effects of aerobic exercise on smoking cessation outcomes.

Interest in nicotine replacement therapy among pregnant smokers

In the UK nicotine replacement therapy (NRT) may now be considered for those pregnant women who cannot otherwise stop smoking.1 However, very little research has been carried out with NRT during pregnancy and the level of interest in using NRT is not known.2 This letter reports the results of a survey to assess the level of interest in using NRT among pregnant smokers.nnAcross a seven month period pregnant smokers were identified using the patient administration system of a large district general hospital in south west London. Ethical approval was obtained and participants gave verbal consent via the telephone. Women identified as smokers at their first antenatal booking visit were telephoned within one week of this visit and invited to take part in the survey. The interview took place during the initial telephone call or during a …