Exercise in Smoking Cessation in Postmenopausal Women

说明(申请人提供)：30%的女性吸烟者是绝经后，这一比例预计会随着人口老龄化而增长。基于绝经后吸烟者的额外健康风险，以及我们在参与先前研究的女性中观察到的终生抑郁症诊断的高患病率和相当大的体重增加，我们选择检查运动作为绝经后女性吸烟治疗的辅助工具的潜在效用。这项研究的具体研究目标是：1.评估在标准的吸烟治疗方案中增加为绝经后妇女制定的中等阻力/有氧运动计划是否能改善短期和长期的吸烟结果；2.检查抑郁和锻炼对戒烟结果的主要和交互影响；3.使用交互式语音记录(IVR)技术来检查运动可以提高戒烟率的机制；4.检查在标准的戒烟治疗计划中增加适度运动计划是否可以改善健康结果，如体重增加、骨密度和生活质量测量。研究地点将包括康涅狄格大学健康中心和明尼苏达大学。受试者(N=364)将包括每天至少吸烟10支的绝经后妇女。受试者将接受吸烟治疗(行为咨询和varenicline)，并被随机分配到1)有监督的锻炼计划或2)有监督的放松控制条件。将利用交互式语音应答系统(IVR)来提高对这两种治疗条件的依从性。我们假设：1.被随机安排到锻炼条件下的绝经后女性的治疗结束禁烟率和年终禁烟率将高于那些被分配到注意力控制条件下的女性；2.有抑郁症病史的女性短期和长期禁烟率将会降低。B.运动对戒烟和抑郁的改善作用将存在，从而使有抑郁病史的妇女戒烟率与没有抑郁病史的妇女的戒烟率相当；3)运动将通过减少尼古丁的渴望、减少负面影响和提高戒烟自我效能来促进戒烟；4)与对照条件下的妇女相比，随机进入运动条件的妇女将有更高的骨密度，生活质量得到改善。在绝经后妇女戒烟的基础上再加上有效的锻炼计划，有可能解决这一高危人群中的许多健康问题，并显著提高生活质量。公共卫生相关性：30%的女性吸烟者是绝经后，这一比例预计会随着人口老龄化而增长。在绝经后妇女戒烟的基础上增加有效的锻炼计划，有可能提高戒烟率，解决这一高危人群的许多健康问题，并显著提高生活质量。

DESCRIPTION (provided by applicant): Thirty percent of female smokers are postmenopausal, and this proportion is expected to grow as the population ages. Based on the additional health risks in postmenopausal smokers, together with the high prevalence of a lifetime depression diagnosis and considerable weight gain we observed among women who have participated in our previous studies, we have chosen to examine the potential utility of exercise as an adjunct to smoking treatment in postmenopausal women. The specific research aims of this study are: 1. To evaluate whether adding an established moderate resistance/aerobic exercise program for postmenopausal women to a standard smoking treatment program improves short and long term smoking outcomes; 2. To examine the main and interactive effects of history of depression and exercise on smoking cessation outcomes; 3.To use interactive voice recording (IVR) technology to examine the mechanisms by which exercise may improve smoking cessation rates; 4. To examine whether adding a moderate exercise program to a standard smoking cessation treatment program improves health outcomes such as, weight gain, bone mineral density, and quality of life measurements. Study sites will include The University of Connecticut Health Center and the University of Minnesota. Subjects (N=364) will include postmenopausal women who smoke at least 10 cigarettes per day. Subjects will receive smoking treatment (behavioral counseling and varenicline) and will be randomly assigned to either 1) a supervised exercise program or 2) a supervised relaxation control condition. Interactive voice response system (IVR) will be utilized to increase adherence to both treatment conditions. We hypothesize that 1. Postmenopausal women randomized to the exercise condition will have greater end of treatment abstinence rates and end of year abstinence rates than will those women assigned to an attention control condition; 2. A. Women with a history of depression will have reduced short and long-term smoking abstinence rates. B. Ameliorative effects of exercise on smoking cessation and depression will exist such that women with a history of depression will abstain from smoking at a rate equivalent to those with no such history; 3) Exercise will improve smoking cessation by reducing nicotine craving, negative affect, and by increasing self- efficacy for smoking cessation; 4) Women randomized to the exercise condition will have increased bone mineral density, and improved quality of life compared to women in the control condition. An effective exercise program added to smoking cessation for postmenopausal women has the potential to address many health problems in this at-risk population, and markedly improve quality of life. PUBLIC HEALTH RELEVANCE: Thirty percent of female smokers are postmenopausal, and this proportion is expected to grow as the population ages. An effective exercise program added to smoking cessation for postmenopausal women has the potential to increase smoking cessation rates, address many health problems in this at-risk population, and markedly improve quality of life.