Exercise and Nicotine Replacement for Female Smokers

女性吸烟者的运动和尼古丁替代品

• 批准号: 7453995
• 负责人: TARU KINNUNEN
• 金额: $ 0.99万
• 依托单位: HARVARD MEDICAL SCHOOL
• 依托单位国家: 美国
• 财政年份: 1999
• 资助国家: 美国
• 起止时间: 1999-04-15 至 2008-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7453995
• 关键词: Abstinence; Acute; Adherence; Adoption; Aerobic Exercise; Affect; Behavior Therapy; Behavioral; Blood Pressure; Body Composition; Body Weight; Body mass index; Bupropion; Cardiac; Cardiovascular Diseases; Cardiovascular system; Caring; Cessation of life; Cholesterol; Cigarette; Clinical; Cognitive; Cognitive Therapy; Condition; Coronary heart disease; Counseling; Etiology; Event; Exercise; Female; Frequencies; Glucose; Guidelines; Hand; Health; Home environment; Hospitals; Individual; Insulin; Intervention; Lead; Life; Lipids; Maintenance; Medical; Mental Depression; Metabolic syndrome; Morbidity - disease rate; Nicotine; Nicotine Dependence; Numbers; Outcome; Outcome Measure; Participant; Patients; Pharmacological Treatment; Physical activity; Physiological; Population; Predisposing Factor; Protocols documentation; Randomized; Rate; Relapse; Reporting; Research; Research Design; Research Personnel; Risk; Risk Factors; Smoker; Smoking; Standards of Weights and Measures; Stress; Sum; Supervision; Syndrome; Time; Tobacco; Tobacco use; Treatment Protocols; United States; Week; Weight; Withholding Treatment; Woman; base; cardiovascular risk factor; cost; depressive symptoms; follow-up; glucose tolerance; improved; indexing; men; mortality; nicotine replacement; positive mood; prescription document; prescription procedure; programs; smoking cessation; tool

Overcoming tobacco use and nicotine dependence, one of the main cardiovascular risk factors, appears to be more ifficult for women than for men, mainly because 1) women may be more sensitive to the effects of nicotine than men; 2) negative affectivity that is associated with continued tobacco use is more common among women than men; and 3) women have more concerns about weight as a reason for continuing smoking and not attempting to quit. The combination of an exercise intervention with nicotine replacement therapy (NRT) should provide a particularly efficacious and cost-effective treatment for female smokers. In our ongoing study, we have found that aerobic exercise, held in a supervised hospital setting, and used as an adjunct to NRT, has produced higher quit rates than standard care with NRT. However, relapse was still very rapid and adherence to the exercise regimen was less than optimal. Exercise adherence was particularly poor among those who had higher body mass index, higher nicotine dependence, and depression prior to quitting, i.e., those with a high cardiovascular risk index. Increasing the adherence to the exercise might result in improved cessation rates, concurrently reducing cardiovascular risk factors and, in turn, female morbidity and mortality. The proposed study will investigate if cognitive-behavioral exercise adherence counseling (CBC) added to an exercise prescription (ERx), used effectively in many patient-populations, increases engagement in physical exercise among female smokers attempting to quit compared to an ERx alone condition. We will examine if increased exercise adherence results in higher cessation rates, and whether prescribed exercise that is home-based (HB), making implementation potentially easier and cost-effective, would result in the same cessation effects as an exercise program that is facility-based (FB). We are planning to include nicotine transdermal patch treatment as the pharmacological treatment and aerobic exercise as a behavioral adjunct. The proposed study will assess how to achieve the maximum effects of aerobic exercise on smoking cessation and the minimum conditions under which these effects can be achieved. Transdermal NRT will be given to 540 female smokers who are randomly assigned to exercise under one of four conditions: HB+ERx, FB+ERx, HB+ERx+CBC, or FB+ERx+CBC. Participants will engage in 3 sessions of aerobic exercise per week from 3 weeks xecessation through 12 weeks postcessation, and will be followed for one year postcessation. In addition to assessing how best to implement aerobic exercise as a smoking cessation adjunct, the mechanisms by which exercise affects cessation, and cessation in turn affects cardiovascular risk factors (e.g., BMI, lipids, depression) will be examined.

克服吸烟和尼古丁依赖，这是主要的心血管风险因素之一，似乎更重要 女性比男性更难，主要是因为1)女性可能比男性对尼古丁的影响更敏感； 与持续吸烟有关的负面情感在女性中比男性更常见；以及3)女性 更担心体重是继续吸烟而不是尝试戒烟的原因。一种新技术的组合 尼古丁替代疗法(NRT)的运动干预应该提供一种特别有效和经济的 女性吸烟者的治疗。在我们正在进行的研究中，我们发现在有监督的医院环境中进行的有氧运动， 并作为NRT的辅助使用，比NRT的标准护理产生了更高的戒烟率。 然而，复发仍然非常迅速，坚持锻炼方案并不是最理想的。坚持锻炼 在那些有较高体重指数、较高尼古丁依赖和抑郁症的人中， 戒烟，即那些心血管风险指数较高的人。增加对锻炼的坚持可能会带来更好的效果 戒毒率，同时降低心血管危险因素，进而降低女性发病率和死亡率。建议数 这项研究将调查认知行为运动依从性咨询(CBC)是否添加到运动处方(ERX)中， 在许多患者中有效使用，增加女性吸烟者对体育锻炼的参与度 戒烟与单独使用eRx的情况相比。我们将研究是否更多的锻炼坚持会导致更高的戒烟率， 以及规定的家庭锻炼(HB)是否会使实施起来更容易、更具成本效益 产生与以设施为基础的锻炼计划相同的戒烟效果(FB)。 我们计划将尼古丁透皮贴片治疗作为药物治疗和有氧运动。 作为行为的附属品。建议的研究将评估如何达到有氧运动的最大效果 戒烟和达到这些效果的最低条件。将给予经皮NRT 540名女性吸烟者被随机分配到以下四种情况之一进行锻炼：Hb+ERx，Fb+ERx， Hb+eRx+Cbc或Fb+eRx+Cbc。参与者将从3周开始每周进行3次有氧运动 停药后12周复查，停药后复查一年。除了评估如何 最好将有氧运动作为戒烟的辅助手段，运动影响戒烟的机制，以及 戒烟反过来影响心血管危险因素(例如，体重指数、血脂、抑郁)将被检查。