INCREASING PHYSICAL ACTIVITY TO AID SMOKING CESSATION

描述（申请人提供）：吸烟仍然是美国发病率和死亡率的头号可预防原因（CDC，1997 b; McGinnis & Foege，1993）。此外，尽管实施了一些有效且具有成本效益的戒烟计划，但吸烟的流行率在过去几年中并未下降（CDC，1999 b）。改善戒烟结果的一种有希望的方法是增加试图戒烟的吸烟者的身体活动水平。经常锻炼的吸烟者报告说，他们比久坐不动的吸烟者更有信心戒烟（King等人，1996年）。随机对照试验的证据表明，在戒烟计划中加入锻炼可以增加戒烟率，并有助于减少戒烟后的体重增加（Marcus et al.，1999; Ussher等人，2000年）。然而，以前的试验完全依赖于高度结构化的、有监督的高强度活动，并且一直受到招募参与者困难和长期坚持运动方案的困扰。此外，这些试验通常具有较低的长期戒烟率，这可能至少部分是由于不包括药物干预（例如，尼古丁替代品）。如果体力活动在戒烟中发挥作用，似乎需要更好地适应以提高其可接受性，并将其整合到最先进的行为/药理学戒烟计划中。（1）招募400名久坐或最少活动的吸烟者，并将他们随机分配到两个治疗组中的一个：一个是经过验证的低成本戒烟计划，另一个是相同的戒烟计划与体力活动干预;以及（2）确定这两种干预措施的相对有效性，直至12个月的随访。试验的主要终点是戒烟，次要终点包括体力活动水平、体重指数、体脂百分比和腰围。

DESCRIPTION (provided by applicant): Smoking remains the number one preventable cause of morbidity and mortality in this nation (CDC, 1997b; McGinnis & Foege, 1993). Moreover, the prevalence of smoking has not declined in the past few years (CDC, 1999b), despite a number of effective and cost-effective smoking cessation programs. One promising method of improving cessation outcomes is to increase physical activity levels in smokers who are trying to quit. Smokers who engage in regular exercise report more confidence in their ability to quit than sedentary smokers (King et al., 1996). There is evidence from randomized controlled trials that adding exercise to cessation programs increases quit rates and helps to reduce post-cessation weight gain (Marcus et al., 1999; Ussher et al., 2000). Previous trials, however, have relied entirely on highly structured, supervised vigorous intensity activity, and have been plagued by difficulty recruiting participants and poor long-term adherence to exercise regimens. Furthermore, these trials generally have had low long-term quit rates, which likely is due at least partly to not including pharmacological intervention (e.g., nicotine replacement). If physical activity is to have a role in smoking cessation, it appears that it will need to be better adapted to increase its acceptability and be integrated into state-of-the-art, combined behavioral/pharmacological cessation programs. With that introduction, we propose the following specific aims: (1) To recruit a cohort of 400 sedentary or minimally active cigarette smokers and randomize them to one of two treatment arms: either a validated, low cost smoking cessation program, or the same smoking cessation program with a physical activity intervention; and (2) To determine the relative efficacy of these two interventions out to a 12-month follow-up. The primary endpoint of the trial is smoking cessation, and secondary endpoints include physical activity level, body mass index, percent body fat, and waist circumference.