Smoking Clinical Trial
Official title:
Using a YMCA Exercise Program to Enhance Nicotine Dependence Treatment for Women
Approximately 21% of women continue to smoke cigarettes despite the increased risk of cancer and cardiovascular disease associated with cigarette smoking. Exercise has been shown to be an efficacious treatment component in combating nicotine dependence, especially among women for whom concerns about weight gain during smoking cessation are an obstacle to successful quitting. In previous trials of women smokers, the investigators program of cognitive behavioral smoking cessation treatment (CBT) plus regular aerobic exercise was more efficacious than CBT plus equal contact time. Recognizing the program's successes, Commit to Quit (CTQ) was recently designated an Effective Program by the Substance Abuse and Mental Health Services Administration's (SAMHSA) National Registry of Effective Programs. Thus, the Commit to Quit program is well poised for a larger trial in a community setting where it has the potential to reach a large number of female smokers in a setting in which it can be sustained. In response to PA-03-126, Behavioral Therapies Development Program, the investigators propose a Stage III study in which they will conduct a trial to test the investigators CTQ smoking cessation program in the community setting of the local YMCAs. As stated in the PA, Stage III research is aimed at understanding if and how an efficacious therapy may be transported to the community. The investigators propose a randomized controlled clinical trial to take place in the YMCA setting and delivered by YMCA staff. The trial will compare CBT smoking cessation treatment plus a program of regular exercise to CBT smoking cessation treatment plus contact control. In order to promote transportability to the YMCA, the investigators will use the YMCA's existing Personal Fitness Program, which is similar to the investigators CTQ exercise program, in that it is guided by trained staff and requires participants to exercise 3 times per week. If the exercise condition is found to be more efficacious than contact control when delivered at the YMCA by YMCA staff, then the investigators will be well positioned to partner with the YMCA to pursue widespread, national dissemination of this program.
We propose a randomized controlled clinical trial to take place in the YMCA setting and to
be delivered by YMCA staff. The trial will compare CBT smoking cessation treatment plus a
program of regular exercise (CBT + EXERCISE) to CBT smoking cessation treatment plus an
equal staff contact control (CBT + CONTACT). In order to promote transportability to the
YMCA, the exercise program will be the YMCA's existing Personal Fitness Program, which like
our CTQ exercise program, is guided by trained staff and requires participants to exercise
at least 3 times per week.
If CBT + EXERCISE is found to be more efficacious than CBT + CONTACT when delivered at the
YMCA by YMCA staff, then we will be well positioned to partner with the YMCA's initiative of
Y Total Health to pursue widespread, national dissemination of this program. The proposed
testing of the efficacy of the CTQ program in the YMCA setting is a necessary intermediate
step in the eventual dissemination of the CTQ program.
Primary Aim. To determine the efficacy of CBT + EXERCISE compared with CBT + CONTACT when
delivered in the YMCAs by YMCA staff to enhance the achievement and maintenance (3, 6, and
12 months follow-up) of smoking cessation (continuous abstinence) among healthy adult female
smokers.
Hypothesis. Participants in the CBT + EXERCISE condition will have significantly greater
continuous abstinence rates than those in the CBT + CONTACT condition at end-of-treatment,
3, 6, and 12 months follow-up.
Additional Questions of Interest.
1. To perform process-to-outcome analyses on the intermediate variables which influence the
achievement and maintenance of smoking cessation among healthy female smokers. Specifically,
to determine if exercise affects weight and/or weight concerns, negative affect associated
with nicotine withdrawal, and/or self-efficacy and to determine if these hypothesized
mediators affect the achievement and maintenance of smoking cessation.
To explore potential moderators of the treatment, such as baseline demographic and
psychological characteristics (e.g., age, baseline mood) on smoking cessation outcomes.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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