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Background: Smoking prevalence rates among women are declining at a slower rate than among men., Objective: To determine if exercise, a healthful alternative to smoking, enhances the achievement and maintenance of smoking cessation., Methods: Two hundred eighty-one healthy, sedentary female smokers were randomly assigned to either a cognitive-behavioral smoking cessation program with vigorous exercise (exercise) or to the same program with equal staff contact time (control). Subjects participated in a 12-session, group-based smoking cessation program. Additionally, exercise subjects were required to attend 3 supervised exercise sessions per week and control subjects were required to participate in 3 supervised health education lectures per week. Abstinence from smoking was based on self-report, was verified by saliva cotinine level, and was measured at 1 week after quit day (week 5), end of treatment (week 12), and 3 and 12 months later (20 and 60 weeks after quit day, respectively)., Results: Compared with control subjects (n = 147), exercise subjects (n = 134) achieved significantly higher levels of continuous abstinence at the end of treatment (19.4% vs 10.2%, P = .03) and 3 months (16.4% vs 8.2%, P=.03) and 12 months (11.9% vs 5.4%, P=.05) following treatment. Exercise subjects had significantly increased functional capacity (estimated VO2 peak, 25+/-6 to 28+/-6, P<.01) and had gained less weight by the end of treatment (3.05 vs 5.40 kg, P = .03)., Conclusions: Vigorous exercise facilitates short- and longer-term smoking cessation in women when combined with a cognitive-behavioral smoking cessation program. Vigorous exercise improves exercise capacity and delays weight gain following smoking cessation.

We examined the effects of physical exercise on smoking relapse. Twenty previously sedentary female smokers were randomly assigned to smoking cessation plus exercise or smoking cessation with frequency contact control. The smoking cessation program included 12 professionally led sessions over 12 weeks. Exercise treatment included three supervised exercise sessions per week for 15 weeks. Contact control included three women's health/wellness lectures per week for 15 weeks. Smoking abstinence was validated by carbon monoxide and saliva cotinine. Mean exercise attendance for exercise subjects was 88% with an increase in estimated VO2 of 25%. The percentage of subjects who quit for 24 hours was 80% for the exercise and 90% for the contact group. One subject in the contact group remained abstinent at the end of the 12-week treatment and at 1-, 3-, and 12-month follow-ups, whereas three subjects in the exercise group were abstinent at these time points. These results suggest that exercise training improves short-term quit rates and may prove a useful strategy for long-term maintenance of smoking cessation.

This study examined the application of constructs concerning stage of readiness to change and self-efficacy to exercise. We developed two scales to measure stages of change for exercise behavior. Prevalence information on a sample of 1,063 government employees and 429 hospital employees was then obtained. Next, the ability of a questionnaire measuring exercise self-efficacy to differentiate employees according to stage of readiness to change was tested. Results from both stages-of-change scales revealed that 34-39% of employees were regularly participating in physical activity. Scores on efficacy items significantly differentiated employees at most stages. Results indicated employees who had not yet begun to exercise, in contrast with those who exercised regularly, had little confidence in their ability to exercise. Continued work at understanding the stages of exercise behavior and exercise self-efficacy could yield important information for enhancing exercise adoption and adherence.

We applied the model of the stages and processes of change to exercise adoption and maintenance. This model has shown promise in advancing theory and treatment of the addictions and other negative health behaviors, but there have been few systematic attempts to apply the model to positive health behaviors, such as exercise adoption. Questionnaires dealing with the stages and processes of exercise change were developed and administered to a sample of 1,172 participants in a worksite health promotion project. The sample was split randomly into halves for (a) initial model development and testing and (b) confirmatory measurement model testing. Additional model confirmation was obtained by examining the hierarchical structure of the processes of change and by conducting Stage x Process analyses. Results suggest that the underlying constructs derived from smoking cessation and other addictive behaviors can be generalized to exercise behavior. Understanding the stages and processes of exercise behavior change may yield important information for enhancing exercise adoption, adherence, and relapse prevention at both individual and public health levels.