Abrantes Ana M, Browne Julia, Uebelacker Lisa A, Anderson Bradley J, Barter Sarah, Shah Zainab, Kunicki Zachary J, Caviness Celeste, Price Lawrence H, Desaulniers Julie, Brown Richard A
Behavioral Medicine and Addictions Research, Butler Hospital, Providence, RI, USA.
Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA.
Nicotine Tob Res. 2024 Apr 22;26(5):634-638. doi: 10.1093/ntr/ntad201.
Adults with depression have higher rates of cigarette smoking and are more likely to relapse than those without depression. Pharmacological, psychological, and combined interventions have largely yielded small improvements in smoking outcomes for adults with depression. Aerobic exercise (AE) may facilitate smoking cessation in this subpopulation.
This study was a 12-week two-arm randomized controlled trial that evaluated the effect of a moderate-intensity AE program compared to a health education contact (HEC) control on smoking cessation in adults with elevated depressive symptoms (mild to severe). Participants (n = 231) were randomized to AE or HEC and received smoking cessation treatment (telephone counseling and nicotine replacement therapy). Primary (biologically confirmed 7-day point prevalence abstinence) and secondary (depressive symptoms, objective and self-reported physical activity, and cardiorespiratory fitness) outcomes were assessed at baseline, 3, 6, and 12 months. Data were analyzed with mixed-effects generalized linear models controlling for age, gender, nicotine dependence, history of major depression disorder, and month of follow-up assessment.
There were no significant differences in primary or secondary outcomes between the AE and HEC groups.
The AE program was not superior to HEC in facilitating smoking cessation, increases in physical activity, or improved depressive symptoms. Given evidence for the positive acute effects of exercise on mood and smoking urges, future research should consider testing alternative exercise approaches for aiding smoking cessation beyond structured, AE programs.
This study found that an adjunctive aerobic exercise (AE) program was not superior to a health education contact control for adults with elevated depressive symptoms, all of whom also received standard smoking cessation treatment. This finding adds to the growing body of literature that structured AE programs for smoking cessation may have limited efficacy for cessation outcomes. Future research is needed to test alternative methods of integrating AE into smoking cessation treatment, such as strategically using exercise to manage cravings and low mood in the moment.
与无抑郁症的成年人相比，患有抑郁症的成年人吸烟率更高，且更易复发。药物治疗、心理治疗及联合干预在改善抑郁症成年人吸烟状况方面大多收效甚微。有氧运动（AE）可能有助于该亚人群戒烟。
本研究为一项为期12周的双臂随机对照试验，评估了中等强度AE项目相较于健康教育接触（HEC）对照对抑郁症状（轻度至重度）升高的成年人戒烟的效果。参与者（n = 231）被随机分为AE组或HEC组，并接受戒烟治疗（电话咨询和尼古丁替代疗法）。在基线、3个月、6个月和12个月时评估主要（生物学确认的7天点患病率戒断）和次要（抑郁症状、客观和自我报告的身体活动以及心肺适能）结局。使用混合效应广义线性模型分析数据，控制年龄、性别、尼古丁依赖、重度抑郁症病史和随访评估月份。
AE组和HEC组在主要或次要结局方面无显著差异。
AE项目在促进戒烟、增加身体活动或改善抑郁症状方面并不优于HEC。鉴于有证据表明运动对情绪和吸烟冲动有积极的急性影响，未来研究应考虑测试除结构化AE项目之外的其他运动方法以辅助戒烟。
本研究发现，对于抑郁症状升高的成年人，辅助有氧运动（AE）项目并不优于健康教育接触对照，所有参与者均接受了标准戒烟治疗。这一发现进一步丰富了相关文献资料，即结构化AE项目对戒烟结局的疗效可能有限。未来需要开展研究，测试将AE纳入戒烟治疗的替代方法，比如在当下策略性地利用运动来应对渴望和低落情绪。
