Exercise and Nicotine Replacement for Female Smokers

女性吸烟者的运动和尼古丁替代品

• 批准号: 7274391
• 负责人: TARU KINNUNEN
• 金额: $ 2.78万
• 依托单位: HARVARD MEDICAL SCHOOL
• 依托单位国家: 美国
• 财政年份: 1999
• 资助国家: 美国
• 起止时间: 1999-04-15 至 2008-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7274391
• 关键词: aerobic exercise; clinical research; cognitive behavior therapy; combination therapy; female; human middle age (35-64); human subject; human therapy evaluation; menstrual cycle; nicotine; nicotine replacement; patient oriented research; radioimmunoassay; smoking; smoking cessation; therapy compliance; tobacco abuse; transdermal drug delivery; women' s health; young adult human (21-34)

DESCRIPTION (provided by applicant): Overcoming tobacco use and nicotine dependence, one of the main cardiovascular risk factors, appears to be more difficult for women than for men, mainly because 1) women may be more sensitive to the effects of nicotine than men; 2) negative affectivity that is associated with continued tobacco use is more common among women than men; and 3) women have more concerns about weight as a reason for continuing smoking and not attempting to quit. The combination of an exercise intervention with nicotine replacement therapy (NRT) should provide a particularly efficacious and cost-effective treatment for female smokers. In our ongoing study, we have found that aerobic exercise, held in a supervised hospital setting, and used as an adjunct to NRT, has produced higher quit rates than standard care with NRT. However, relapse was still very rapid and adherence to the exercise regimen was less than optimal. Exercise adherence was particularly poor among those who had higher body mass index, higher nicotine dependence, and depression prior to quitting, i.e., those with a high cardiovascular risk index. Increasing the adherence to the exercise might result in improved cessation rates, concurrently reducing cardiovascular risk factors and, in turn, female morbidity and mortality. The proposed study will investigate if cognitive-behavioral exercise adherence counseling (CBC) added to an exercise prescription (ERx), used effectively in many patient-populations, increases engagement in physical exercise among female smokers attempting to quit compared to an ERx alone condition. We will examine if increased exercise adherence results in higher cessation rates, and whether prescribed exercise that is home-based (HB), making implementation potentially easier and cost-effective, would result in the same cessation effects as an exercise program that is facility-based (FB). We are planning to include nicotine transdermal patch treatment as the pharmacological treatment and aerobic exercise as a behavioral adjunct. The proposed study will assess how to achieve the maximum effects of aerobic exercise on smoking cessation and the minimum conditions under which these effects can be achieved. Transdermal NRT will be given to 540 female smokers who are randomly assigned to exercise under one of four conditions: HB+ERx, FB+ERx, HB+ERx+CBC, or FB+ERx+CBC. Participants will engage in 3 sessions of aerobic exercise per week from 3 weeks precessation through 12 weeks postcessation, and will be followed for one year postcessation. In addition to assessing how best to implement aerobic exercise as a smoking cessation adjunct, the mechanisms by which exercise affects cessation, and cessation in turn affects cardiovascular risk factors (e.g., BMI, lipids, depression) will be examined.

描述（由申请人提供）： 克服烟草使用和尼古丁依赖（主要心血管危险因素之一）对女性来说似乎比男性更困难，主要是因为 1) 女性可能比男性对尼古丁的影响更敏感； 2) 与持续吸烟相关的负面情绪在女性中比男性更常见； 3) 女性更担心体重，这是她们继续吸烟而不尝试戒烟的原因。运动干预与尼古丁替代疗法（NRT）的结合应该为女性吸烟者提供特别有效且具有成本效益的治疗方法。在我们正在进行的研究中，我们发现在受监督的医院环境中进行有氧运动并用作 NRT 的辅助手段，其戒烟率高于 NRT 的标准护理。然而，复发仍然非常快，并且对运动方案的坚持也不是最佳的。对于那些体重指数较高、尼古丁依赖性较高、戒烟前患有​​抑郁症的人（即心血管风险指数较高的人），运动依从性尤其差。增加锻炼的坚持可能会提高戒烟率，同时减少心血管危险因素，进而降低女性发病率和死亡率。拟议的研究将调查与单独使用 ERx 相比，在运动处方 (ERx) 中添加认知行为运动依从咨询 (CBC) 是否能在许多患者群体中有效使用，从而增加试图戒烟的女性吸烟者的体育锻炼参与度。我们将研究增加运动坚持是否会导致更高的戒烟率，以及以家庭为基础的规定运动（HB）是否会导致与设施锻炼计划相同的戒烟效果，这使得实施可能更容易且具有成本效益。基于（FB）。我们计划将尼古丁透皮贴剂治疗作为药物治疗，将有氧运动作为行为辅助。拟议的研究将评估如何实现有氧运动对戒烟的最大效果以及实现这些效果的最低条件。将向 540 名女性吸烟者提供透皮 NRT 治疗，她们被随机分配在以下四种条件之一下进行锻炼：HB+ERx、FB+ERx、HB+ERx+CBC 或 FB+ERx+CBC。从戒烟前 3 周到戒烟后 12 周，参与者每周进行 3 次有氧运动，并在戒烟后跟踪一年。除了评估如何最好地将有氧运动作为戒烟辅助手段之外，还将研究运动影响戒烟的机制，以及戒烟反过来影响心血管危险因素（例如体重指数、血脂、抑郁）。