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The Efficacy of Vigorous-Intensity Exercise as an Aid to Smoking Cessation in Adults With High Anxiety Sensitivity

A Randomized Controlled Trial

Smits, Jasper A. J. PhD; Zvolensky, Michael J. PhD; Davis, Michelle L. MA; Rosenfield, David PhD; Marcus, Bess H. PhD; Church, Timothy S. MD, PhD, MPH; Powers, Mark B. PhD; Frierson, Georita M. PhD; Otto, Michael W. PhD; Hopkins, Lindsey B. PhD; Brown, Richard A. PhD; Baird, Scarlett O. BA

doi: 10.1097/PSY.0000000000000264

Objectives High anxiety sensitivity predicts poor smoking cessation outcomes. Aerobic exercise reduces anxiety sensitivity and aspects of the risk conferred by anxiety sensitivity. In the current study, we examined whether exercise can aid smoking cessation in adults with high anxiety sensitivity.

Methods Participants were sedentary and low-activity adult daily smokers (n = 136) with elevated prescreen anxiety sensitivity. Participants received 15 weeks of standard smoking cessation treatment (ST; cognitive behavioral therapy plus nicotine replacement therapy). In addition, participants were simultaneously randomized to 15 weeks of either an exercise intervention (ST + EX; n = 72) or a wellness education control condition (ST + CTRL; n = 64). Self-reported smoking abstinence was assessed weekly during the intervention, at the end of treatment (10 weeks after the target quit date), and at 4 and 6 months after the target quit date. Abstinence was verified by expired carbon monoxide readings and saliva cotinine.

Results Results indicated that point prevalence abstinence (PPA) and prolonged abstinence (PA) rates were significantly higher for ST + EX than for ST + CTRL at each of the major end points among persons with high anxiety sensitivity (PPA: b = −0.91, standard error [SE] = 0.393, t(1171) = −2.33, p = .020; PA: b = −0.98, SE = 0.346, t(132) = −2.84, p = .005), but not among those with low anxiety sensitivity (PPA: b = −0.23, SE = 0.218, t(1171) = −1.06, p = .29; PA: b = −0.31, SE = 0.306, t(132) = −1.01, p = .32).

Conclusions The present results suggest that exercise facilitates the odds of quit success for smokers with high levels of anxiety sensitivity and therefore may be a useful therapeutic tactic for this high-risk segment of the smoking population.

Trial Registration:, NCT01065506.

From the Department of Psychology and Institute for Mental Health Research (Smits, Davis, Powers, Baird), The University of Texas at Austin, Austin, Texas; Department of Psychology (Zvolensky), University of Houston, Houston, Texas; Department of Behavioral Science (Zvolensky), The University of Texas MD Anderson Cancer Center, Houston, TX; Department of Psychology (Rosenfield), Southern Methodist University, Dallas, Texas; Department of Family & Preventive Medicine (Marcus), University of California at San Diego, San Diego, California; Pennington Biomedical Research Center (Church), Louisiana State University, Baton Rouge, Louisiana; Department of Psychology (Frierson), Howard University, Washington, DC; Departments of Psychology and Psychological and Brain Sciences (Otto), Boston University, Boston, Massachusetts; Stress and Health Research Program (Hopkins), San Francisco VA Medical Center, San Francisco, California; and School of Nursing (Brown), The University of Texas at Austin, Austin, Texas

Address correspondence and reprint requests to Jasper A.J. Smits, PhD, Department of Psychology and Institute for Mental Health Research, The University of Texas at Austin, Austin, TX 78712. E-mail:

Received for publication May 13, 2015; revision received September 14, 2015.

Copyright © 2016 by American Psychosomatic Society
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