Abstract

BackgroundRates of cigarette smoking are decreasing because of public health initiatives, pharmacological aids, and clinician focus on smoking cessation. However, a sedentary lifestyle increases cardiovascular risk, and therefore, inactive smokers have a particularly enhanced risk of cardiovascular disease.ObjectiveIn this secondary analysis of mActive-Smoke, a 12-week observational study, we investigated adherence to guideline-recommended moderate-to-vigorous physical activity (MVPA) in smokers and its association with the urge to smoke.MethodsWe enrolled 60 active smokers (≥3 cigarettes per day) and recorded continuous step counts with the Fitbit Charge HR. MVPA was defined as a cadence of greater than or equal to 100 steps per minute. Participants were prompted to report instantaneous smoking urges via text message 3 times a day on a Likert scale from 1 to 9. We used a mixed effects linear model for repeated measures, controlling for demographics and baseline activity level, to investigate the association between MVPA and urge.ResultsA total of 53 participants (mean age 40 [SD 12] years, 57% [30/53] women, 49% [26/53] nonwhite, and 38% [20/53] obese) recorded 6 to 12 weeks of data. Data from 3633 person-days were analyzed, with a mean of 69 days per participant. Among all participants, median daily MVPA was 6 min (IQR 2-13), which differed by sex (12 min [IQR 3-20] for men vs 3.5 min [IQR 1-9] for women; P=.004) and BMI (2.5 min [IQR 1-8.3] for obese vs 10 min [IQR 3-15] for nonobese; P=.04). The median total MVPA minutes per week was 80 (IQR 31-162). Only 10% (5/51; 95% CI 4% to 22%) of participants met national guidelines of 150 min per week of MVPA on at least 50% of weeks. Adjusted models showed no association between the number of MVPA minutes per day and mean daily smoking urge (P=.72).ConclusionsThe prevalence of MVPA was low in adult smokers who rarely met national guidelines for MVPA. Given the poor physical activity attainment in smokers, more work is required to enhance physical activity in this population.

Highlights

  • BackgroundSmoking cessation and physical activity both lead to significant improvements in health [1]

  • The prevalence of moderate-to-vigorous physical activity (MVPA) was low in adult smokers who rarely met national guidelines for MVPA

  • The prevalence of meeting these activity guidelines in the general adult population is unsatisfactory, with half of the US adults attaining fewer than 150 min of moderate-to-vigorous physical activity (MVPA) during leisure time per week, by self-report [4]

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Summary

Introduction

BackgroundSmoking cessation and physical activity both lead to significant improvements in health [1]. Because a sedentary lifestyle increases cardiovascular risk [3], inactive smokers have a enhanced risk of cardiovascular disease. The prevalence of meeting these activity guidelines in the general adult population is unsatisfactory, with half of the US adults attaining fewer than 150 min of moderate-to-vigorous physical activity (MVPA) during leisure time per week, by self-report [4]. 2 studies in young adults [5] and youth aged 14 to 18 years [6] found that self-reported attainment of physical activity guidelines was positively associated with noncigarette forms of tobacco use (eg, electronic cigarettes) but inversely associated with cigarette smoking, suggesting that physical inactivity and cigarette smoking may be compounding risk factors. A sedentary lifestyle increases cardiovascular risk, and inactive smokers have a enhanced risk of cardiovascular disease

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