BACKGROUND: Vigorous-intensity exercise has been shown to aid in smoking cessation, especially among women. In a previous trial, cognitive behavioral therapy (CBT) for smoking cessation plus regular vigorous aerobic exercise enhanced cessation rates, improved exercise capacity, and reduced weight gain compared to CBT plus equal contact time. PURPOSE: This study examined the effectiveness of this program adapted for and implemented in the YMCAs. DESIGN: An RCT comparing CBT+exercise (exercise) to CBT+contact control (control). SETTING/PARTICIPANTS: Apparently healthy female smokers were recruited to four local YMCAs. INTERVENTION: YMCA staff members were trained to lead the manualized CBT smoking-cessation intervention and a standardized YMCA exercise program. MAIN OUTCOME MEASURES: Seven-day point prevalence and continuous abstinence. RESULTS: Participants (330 women, mean age 44 years) were randomized to the exercise (n = 166) or control (n = 164) group. Results revealed no differences in 7-day point prevalence (29.5% versus 29.9%) nor continuous abstinence (13.9% versus 14.0%) between the exercise and control groups, respectively, at end of treatment or at the 3-, 6-, and 12-month follow-up. An examination of the relationship between exercise dose and quit status at end of treatment revealed that over 12 weeks, the odds of being quit (7-day point prevalence) grew by 4.5% for each additional aerobic exercise session (OR 1.05, 95% CI 1.01 to 1.08) and by 7.7% for each additional resistance training session (OR 1.08, 95% CI 1.02 to 1.14). Analyses were conducted between August 19, 2010, and December 16, 2011. CONCLUSIONS: No differences were seen between groups in smoking outcomes. The association between greater exercise participation and higher odds of quitting within the exercise condition suggests that the lack of between-group differences might be a result of poor compliance with the exercise program. TRIAL REGISTRATION: This study is registered at ClinicalTrials.gov NCT01615380.

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