Teens who add physical exercise to a smoking cessation program have greater success in kicking the habit, a new report from Pediatrics suggests.
Studies in adult smokers have found that success is enhanced when physical exercise is added to a smoking cessation program. Physical exercise alleviates withdrawal symptoms, reduces cravings and prevents against weight gain.
Armed with this knowledge, researchers wanted to determine if adding physical exercise to Not on Tobacco (NOT) – the American Lung Association’s teen smoking intervention program – would improve smoking cessation rates in high school students†.
Study participants were recruited from 19 high schools in West Virginia in 2006 to 2009. This region was chosen because smoking rates in teens is high yet physical activity is low. Each of the schools was randomly assigned to one of three smoking cessation programs: Brief Intervention (BI), Not on Tobacco (NOT) or Not on Tobacco plus Physical Exercise (NOT+FIT).
The Brief Intervention program included a 10-15 minute advice session at the start of the study. The NOT program included the brief advice session plus core NOT sessions once a week for 10 weeks. Youths in the NOT+FIT also received a challenge log and pedometer to track their progress toward fitness goals plus an additional 5 minutes of encouragement each week.
A total of 233 teens participated in the study. The average age of participants was around 16 years with most starting smoking around age 11. The vast majority had tried quitting smoking previously. More than 60 percent reported that their parents smoked and virtually all of their friends smoked. While the smoking rate was lower on weekdays (8-13 cigarettes per day), it was higher on weekends (12–16 cigarettes per day).
As researchers had predicted, study results showed that when physical exercise was added to NOT the likelihood of quitting smoking was higher. Three months after the study started, the quit rates were higher in the NOT and NOT+FIT groups, 21% and 31% respectively compared with 16% in the Brief Intervention group.
The addition of physical exercise to the NOT program was very effective for boys. Just 8% of boys quit in the NOT group but this jumped threefold to 24% in the NOT+FIT group.
In girls, the physical component did not boost smoking cessation rates. In the NOT group, the 7-day quit rate was 14% but was just 5% in the NOT+FIT group. Despite this difference, girls in the NOT group still had higher quit rates than girls in the Brief Intervention group.
“Girls’ exercise levels plummet in the teen years, whereas boys are more likely to stay active to some degree”, noted lead researcher Kimberly Horn, of the West Virginia University School of Medicine. “It may be that the girls had greater fitness barriers to get around, Horn speculated.
The Bottom Line
I grew up in a family where my parents did not smoke. Despite this fact, when I was 13 my friends encouraged me to try smoking. While I never fully embraced the habit, I periodically smoked until I was 17. It was not until I was a senior in high school and started running that I realized smoking was a stupid habit. At that same time, I realized that the reason why I had started smoking in the first place was due to peer pressure. From that point forward, I never smoked again. As I found in my own experience and this study demonstrated, getting teenagers physically active can help them to quit smoking.
As we all know, it is so important for kids to never start this habit because once they start; it’s so difficult to stop. Beginning September 2012, FDA will require larger, more prominent cigarette health warnings on all cigarette packaging and advertisements in the United States. But, I doubt that these images will change teen behavior. Studies show that a better deterrent, especially in women, is demonstrating how smoking ages the skin and negatively effects beauty.
The good news is that recent government surveys demonstrate that fewer kids are smoking than in the past. But, everything we can do now to prevent them from starting is key. Especially, as we look toward November 17 when the American Cancer Society marks the 36th Great American Smokeout encouraging smokers to use the date to make a plan to quit, or to plan in advance and quit smoking that day.
†Not on Tobacco is the American Lung Association’s quit program geared specifically for high school students. It is available in public schools across the country. Since 1999, more than 150,000 teens in 48 states have participated in the NOT program. The voluntary program uses a total-health approach: offers advice on healthy behaviors, stress management, and life skills. Studies have found that the average quit rate for NOT participants is around 21%.
David H. Rahm, M.D. is the founder and medical director of The Wellness Center, a medical clinic located in Long Beach, CA. Dr. Rahm is also president and medical director of VitaMedica. Dr. Rahm is one of a select group of conventional medical doctors who have education and expertise in functional medicine and nutritional science. Over the past 20 years, Dr. Rahm has published articles in the plastic surgery literature and educated physicians about the importance of good peri-operative nutrition.