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The efficacy of vigorous-intensity exercise as an aid to smoking cessation in adults with high anxiety sensitivity: a randomized controlled trial
Smits JAJ, Zvolensky MJ, Davis ML, Rosenfield D, Marcus BH, Church TS, Powers MB, Frierson GM, Otto MW, Hopkins LB, Brown RA, Baird SO
Psychosomatic Medicine 2016 Apr;78(3):354-364
clinical trial
5/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: No; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: No. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

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[1,171] = -2.33, p = 0.020; PA b -0.98, SE 0.346, t[132] = -2.84, p = 0.005), but not among those with low anxiety sensitivity (PPA b = -0.23, SE 0.218, t[1,171] = -1.06, p = 0.29; PA b -0.31, SE 0.306, t[132] = -1.01, p = 0.32). 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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