Acute Effects of Exercise in Smokers with Schizophrenia

描述（由申请人提供）：精神分裂症患者的死亡风险是一般人群的两到三倍。这主要是由于他们的吸烟率异常高，以及其他心血管风险因素，如缺乏体育活动、肥胖、高血胆固醇和糖尿病。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能显著减少非精神病吸烟者对香烟的渴望、尼古丁戒断症状和吸烟行为。然而，急性运动对吸烟措施的影响尚未在患有精神分裂症的吸烟者中进行过研究。这项NIH探索性/发展性（R21）研究基金申请的主要目的是调查运动对精神分裂症吸烟者主观和行为吸烟措施的急性影响，与被动对照条件相比。由于暴露于吸烟暗示后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于吸烟暗示是否会改变运动减少吸烟渴望和其他吸烟措施的能力。第三个目的是调查是否已知的因素缓和对戒烟药物的反应（性别，抗精神病药物类型，戒烟意图）缓和运动对吸烟措施的影响。本研究将采用受试者内部重复测量设计，参与者将经历1个练习阶段，然后是4个实验阶段：(1)吸烟提示后运动，(2)吸烟提示后被动活动，(3)中性提示后运动，(4)中性提示后被动活动。结果测量包括香烟渴望、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，步行能显著减少精神分裂症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，该干预将运动作为一种行为策略，以提高这一人群的戒烟率。

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.