Efficacy of Resistance Training as an Aid To Smoking Cessation Treatment

描述(由申请人提供)：为了减少吸烟造成的广泛死亡和疾病，流行率必须加速下降。帮助戒烟的处方药可能是有效的，但高达80%试图戒烟的吸烟者在没有医疗帮助的情况下戒烟。美国卫生与公众服务部提倡将锻炼作为戒烟的辅助手段，然而，我们对锻炼是如何帮助戒烟的理解存在很大差距。到目前为止，有氧运动一直是唯一被调查的运动类型；对其作用机制的了解很差；文献中对男性吸烟者的代表性不足。这项试验旨在产生新的数据，以弥补每一项差距。我们的初步研究[R03 CA132475]的积极结果表明，阻力训练(即举重训练)可以为吸烟者提供一种独特的戒烟行为策略。与对照组相比，接受抵抗训练的参与者更有可能实现戒烟，在试验结束时体重和体脂较低。这是一个关键的好处，因为在戒烟期间和戒烟后通常发生的体重/脂肪增加抵消了戒烟的好处，同时2型糖尿病、高血压和高血压的风险显著增加。 肺功能下降。本研究的目的是在第一个全面的随机对照试验中检验阻力训练作为戒烟辅助的有效性。总共206名男性和女性吸烟者将接受简短的戒烟咨询会议，然后被随机分为12周的抵抗训练或接触控制组。在为期12周的计划期间，两个小组将每周举行两次现场会议，后续评估将在12周(3个月)结束时以及6个月和12个月的时间点进行。参与者在随访期间不会接受任何额外的戒烟治疗；然而，抵抗训练组将获得一家健身中心为期9个月的会员资格，以鼓励继续进行抵抗训练，以此作为维持戒烟的一种方式，并将跟踪参加该中心的人数。接触控制组的参与者在12个月的随访后还将获得9个月的健身中心会员资格。主要结果是在3个月的评估以及6个月和12个月的随访中，唾液可替宁验证的7天点流行戒断(PPA)。次要结果将包括检查(A)在12周干预期间评估的潜在作用机制(例如皮质醇、情绪、渴求、戒烟自我效能、睡眠的急性变化)；(B)在每次随访时对疾病风险的生物标记物(例如肺功能、HbA1c、血脂、身体成分、骨量、血压)、身体健康和运动行为的治疗差异；以及(C)这些变量中的每个变量与吸烟结果之间的关联。最后，我们将探索性别是否缓和了治疗对吸烟结果的影响，或者对任何其他依赖变量的影响(例如，作用机制、生物标记物、健康状况、锻炼行为)。

DESCRIPTION (provided by applicant): To reduce the widespread death and disease that results from cigarette smoking, declines in prevalence must accelerate. Prescription medications to aid quitting can be effective, but up to 80% of smokers who attempt to quit do so without medical assistance. The U.S. Department of Health and Human Services promotes exercise as an aid for quitting, however, there are significant gaps in our understanding of how exercise is helpful. To date, aerobic exercise has been the only type of exercise investigated; there is a poor understanding of the mechanisms of action; and there is an under-representation of male smokers in the literature. This trial is designed to produce new data that will address each of these gaps. Positive results from our pilot study [R03 CA132475] suggest that resistance training (i.e., weight training) can offer smokers a unique behavioral strategy for quitting. When compared to a control, resistance trained participants were more likely to achieve smoking abstinence and have lower body weight and body fat at the end of the trial. This is a key benefit, as the body weight/fat gain that typically occurs during and after quitting offsets th benefit of cessation with significant increases in the risks for type 2 diabetes, hypertension, and a decline in lung function. The purpose of this study is to test of the efficacy of resistance training as an aid to smoking cessation in the first full scale randomized controlled trial. A tota of 206 male and female smokers will receive a brief smoking cessation counseling session prior to being randomized into a 12-week Resistance Training or Contact Control group. Both groups will meet on-site twice per week during the 12-week program, and follow-up assessments will occur at the end of the 12-weeks (3-month) and at a 6-month and 12-month time point. Participants will not receive any additional smoking cessation treatment during follow-up; however, the Resistance Training group will receive a 9-month membership to a fitness center to encourage continued resistance training as a way to maintain cessation, and attendance to the center will be tracked. Participants in the Contact Control group will also receive a 9-month fitness center membership after their 12-month follow-up. The primary outcome is salivary cotinine verified 7-Day Point Prevalence Abstinence (PPA) at the 3-month assessment, and at the 6 and 12-month follow-ups. Secondary outcomes will include an examination of (a) the potential mechanisms of action (e.g., acute changes in cortisol, mood, cravings, abstinence self-efficacy, sleep) assessed during the 12-week intervention; (b) treatment differences on biological markers of disease risk (e.g., lung function, HbA1c, blood lipids, body composition, bone mass, blood pressure), physical fitness, and exercise behavior at each follow-up; and (c) the association between each of these variables and smoking outcomes. Finally, we will explore whether gender moderates the effect of treatment on smoking outcome, or on any of the other dependent variables (e.g., mechanisms of action, biological markers, fitness, exercise behavior).