Institute for Mental Health Research and Department of Psychology, The University of Texas at Austin, Austin, USA.
Department of Psychology, University of Houston, Houston, TX, USA.
Addiction. 2021 Nov;116(11):3188-3197. doi: 10.1111/add.15586. Epub 2021 Jun 13.
People with anxiety disorders are more likely to smoke and less likely to succeed when they try to quit. Anxiety sensitivity may underlie both phenomena, such that people with high anxiety sensitivity react to interoceptive distress by avoidance. This study aimed to test the efficacy of an exercise program that induced interoceptive distress and thereby created tolerance to this distress in a safe environment.
DESIGN, SETTING AND PARTICIPANTS: Randomized clinical trial at four YMCA branches in Austin, Texas, USA. Participants [n = 150; 130 (86.7%) white; 101 (67.3%) female; mean = 38.6, standard deviation (SD) = 10.4] were adult, daily smokers with high anxiety sensitivity motivated to quit smoking, who reported no regular moderate-intensity exercise.
Participants were assigned a YMCA personal trainer who guided them through a 15-week intervention aerobic exercise program. Participants assigned to the personalized intervention trained at 60-85% of their heart rate reserve (HRR), whereas participants assigned to the control intervention trained at 20-40% of their HRR. Participants in both groups received standard behavioral support and nicotine replacement therapy.
The primary outcome was biologically verified 7-day point prevalence abstinence (PPA) at 6-month follow-up.
Sixty-one per cent of participants were available at the 6-month follow-up. PPA at 6 months was higher in the personalized intervention than the control intervention [27.6 versus 14.8%; odds ratio (OR) = 2.20, 95% confidence interval (CI) = 1.28, 3.80, P = 0.005], assuming missing at random. Anxiety sensitivity declined in both groups with no evidence that this differed between groups.
An exercise program of high intensity increased abstinence from smoking in people with high anxiety sensitivity, but may not have done so by reducing anxiety sensitivity.
焦虑障碍患者更有可能吸烟，并且在尝试戒烟时成功率较低。焦虑敏感性可能是这两种现象的基础，即具有高焦虑敏感性的人通过回避来应对内脏性不适。本研究旨在测试一种运动方案的疗效，该方案在安全的环境中引起内脏性不适，从而使人们对这种不适产生耐受性。
设计、地点和参与者：在美国德克萨斯州奥斯汀的四个基督教青年会分会进行的随机临床试验。参与者[n=150；130（86.7%）为白人；101（67.3%）为女性；平均年龄=38.6，标准差（SD）=10.4]为成年、每日吸烟、焦虑敏感性高、有戒烟意愿、且无规律进行中等强度运动的吸烟者。
参与者被分配到基督教青年会的私人教练，由教练指导他们进行为期 15 周的干预性有氧运动方案。被分配到个性化干预组的参与者以 60-85%的心率储备（HRR）进行训练，而被分配到对照组的参与者以 20-40%的 HRR 进行训练。两组参与者均接受标准行为支持和尼古丁替代疗法。
主要结局是在 6 个月随访时通过生物验证的 7 天点流行率戒烟（PPA）。
61%的参与者在 6 个月随访时可获得数据。个性化干预组的 PPA 高于对照组[27.6%比 14.8%；比值比（OR）=2.20，95%置信区间（CI）=1.28，3.80，P=0.005]，假设随机缺失。两组的焦虑敏感性均下降，但没有证据表明两组之间存在差异。
高强度的运动方案增加了具有高焦虑敏感性的人的戒烟成功率，但这可能不是通过降低焦虑敏感性来实现的。
