Acute Effects of Exercise in Smokers with Schizophrenia

描述(申请人提供)：精神分裂症患者的死亡风险是普通人群的两到三倍。这主要是由于他们吸烟率异常高，以及其他心血管风险因素，如缺乏运动、肥胖、高胆固醇和糖尿病。需要有效的吸烟治疗来降低这一人群的发病率和死亡率。十几项实验研究表明，散步和其他形式的运动可以显著减少非精神吸烟者的烟瘾、尼古丁戒断症状和吸烟行为。然而，在患有精神分裂症的吸烟者中，还没有研究过急性运动对吸烟措施的影响。这项NIH探索性/发展性(R21)研究资助申请的主要目的是调查与被动对照条件相比，运动对精神分裂症吸烟者主观和行为吸烟测量的急性影响。由于暴露在吸烟线索中的间歇性渴望与戒烟尝试期间的复发有关，第二个目的是调查暴露在吸烟线索中是否改变了锻炼减少吸烟渴望和其他吸烟措施的能力。第三个目的是调查已知对戒烟药物的温和反应的因素(性别、抗精神病药物类型、戒烟意图)是否缓和运动对吸烟措施的影响。本研究将采用受试者内重复测量设计，参与者将经历1个练习阶段，然后是4个实验阶段：(1)吸烟线索，然后是锻炼；(2)吸烟线索，然后是被动活动；(3)中性线索，然后是锻炼；(4)中性线索，然后是被动活动。结果指标包括吸烟渴望、尼古丁戒断症状、情绪和吸烟行为。如果这项研究的结果表明，步行可以显著减少患有精神分裂症的吸烟者的渴望和吸烟，那么这项研究的下一步将是测试戒烟干预的有效性，该干预将运动作为提高这一人群戒烟率的行为策略。 公共卫生相关性：精神分裂症患者的吸烟率异常高，与吸烟相关的发病率和死亡率也相应较高。该项目的目的是在实验室条件下检查运动是否减少了患有精神分裂症的吸烟者的吸烟欲望、尼古丁戒断症状和吸烟行为。如果是这样的话，这项研究的下一步将是检查戒烟干预的有效性，该干预将运动作为减少精神分裂症吸烟者吸烟欲望和吸烟的行为策略。

DESCRIPTION (provided by applicant): People with schizophrenia have two- to three-times the mortality risk of the general population. This is primarily due to their unusually high rates o cigarette smoking, as well as other cardiovascular risk factors such as physical inactivity, obesity, high blood cholesterol and diabetes. Effective smoking treatments are needed to reduce morbidity and mortality in this population. Over a dozen experimental studies indicate that walking and other forms of exercise acutely reduce cigarette craving, nicotine withdrawal symptoms and smoking behavior in non-psychiatric smokers. However, the effects of acute exercise on smoking measures have not been studied in smokers with schizophrenia. The primary aim of this NIH Exploratory/Developmental (R21) Research Grant application is to investigate the acute effects of exercise, compared to a passive control condition, on subjective and behavioral smoking measures in smokers with schizophrenia. As episodic craving following exposure to smoking cues is associated with relapse during quit attempts, the secondary aim is to investigate whether exposure to smoking cues alters the ability of exercise to reduce cigarette craving and other smoking measures. The tertiary aim is to investigate whether factors known to moderate responses to smoking cessation medications (gender, antipsychotic medication type, intention to quit smoking) moderate the effects of exercise on smoking measures. This study will use a within-subjects, repeated-measures design, in which participants will undergo 1 practice session followed by 4 experimental sessions: (1) smoking cues followed by exercise, (2) smoking cues followed by passive activity, (3) neutral cues followed by exercise, (4) neutral cues followed by passive activity. Outcome measures include cigarette craving, nicotine withdrawal symptoms, mood and smoking behavior. If the results of this study indicate that walking acutely reduces craving and smoking in smokers with schizophrenia, the next step in this research would be to test the effectiveness of a smoking cessation intervention that incorporates exercise bouts as a behavioral strategy for improving smoking cessation rates in this population. PUBLIC HEALTH RELEVANCE: There is an unusually high rate of cigarette smoking among people with schizophrenia and correspondingly high rates of smoking-related morbidity and mortality in these patients. The aim of this project is to examine, under laboratory conditions, whether exercise reduces cigarette craving, nicotine withdrawal symptoms and smoking behavior in smokers with schizophrenia. If so, the next step in this research would be to examine the effectiveness of a smoking cessation intervention that incorporates exercise bouts as a behavioral strategy for reducing cigarette craving and smoking in smokers with schizophrenia.