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BMC Complementary Medicine and Therapies
Published in: BMC Complementary Medicine and Therapies 1/2010

Open Access 01-12-2010 | Study protocol

Yoga as a complementary treatment for smoking cessation: rationale, study design and participant characteristics of the Quitting-in-Balance study

Authors: Beth C Bock, Kathleen M Morrow, Bruce M Becker, David M Williams, Geoffrey Tremont, Ronnesia B Gaskins, Ernestine Jennings, Joseph Fava, Bess H Marcus

Published in: BMC Complementary Medicine and Therapies | Issue 1/2010

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Abstract

Background

Tobacco smoking remains the leading preventable cause of death among American women. Exercise has shown promise as an aid to smoking cessation because it reduces weight gain and weight concerns, improves affect, and reduces nicotine withdrawal symptoms and cigarette craving. Studies have shown that the practice of yoga improves weight control, and reduces perceived stress and negative affect. Yoga practice also includes regulation of breathing and focused attention, both of which may enhance stress reduction and improve mood and well-being and may improve cessation outcomes.

Methods/Design

This pilot efficacy study is designed to examine the rates of cessation among women randomized to either a novel, 8-week Yoga plus Cognitive Behavioral Therapy (CBT) smoking cessation intervention versus a Wellness program plus the same CBT smoking cessation intervention. Outcome measures include 7-day point prevalence abstinence at end of treatment, 3 and 6 months follow up and potential mediating variables (e.g., confidence in quitting smoking, self-efficacy). Other assessments include measures of mindfulness, spirituality, depressive symptoms, anxiety and perceived health (SF-36).

Discussion

Innovative treatments are needed that address barriers to successful smoking cessation among men and women. The design chosen for this study will allow us to explore potential mediators of intervention efficacy so that we may better understand the mechanism(s) by which yoga may act as an effective complementary treatment for smoking cessation. If shown to be effective, yoga can offer an alternative to traditional exercise for reducing negative symptoms that often accompany smoking cessation and predict relapse to smoking among recent quitters.

Trial Registration

ClinicalTrials NCT00492310
Appendix
Available only for authorised users
Literature
1.
CDC: State-Specific Prevalence and Trends in Adult Cigarette Smoking --- United States, 1998--2007. 2009, MMWR, 58 (09): 221-226.
2.
CDC Smoking-Attributable Mortality, Years of Potential Life Lost, and Productivity Losses --- United States, 2000--2004. 2008, MMWR, 57 (45): 1226-28.
3.
Gilbert DG, McClernon FJ, Rabinovich NE, Plath LC, Masson CL, Anderson AE: Mood disturbance fails to resolve across 31 days of cigarette abstinence in women. J Consult Clin Psychol. 2002, 70 (1): 142-52. 10.1037/0022-006X.70.1.142.CrossRefPubMed
4.
Kassel JD, Stroud LR, Paronis CA: Smoking, stress, and negative affect: correlation, causation, and context across stages of smoking. Psychol Bull. 2003, 129 (2): 270-304. 10.1037/0033-2909.129.2.270.CrossRefPubMed
5.
Kenford SL, Smith SS, Wetter DW, Jorenby DE, Fiore MC, Baker TB: Predicting relapse back to smoking: contrasting affective and physical models of dependence. J Consult Clin Psychol. 2002, 70 (1): 216-27. 10.1037/0022-006X.70.1.216.CrossRefPubMed
6.
Shiffman S, Waters AJ: Negative affect and smoking lapses: a prospective analysis. J Consult Clin Psychol. 2004, 72 (2): 192-201. 10.1037/0022-006X.72.2.192.CrossRefPubMed
7.
al'Absi M, Amunrud T, Wittmers LE: Psychophysiological effects of nicotine abstinence and behavioral challenges in habitual smokers. Pharmacol, Biochem Behav. 2004, 72 (3): 707-16. 10.1016/S0091-3057(02)00739-6.CrossRef
8.
Clark MM, Hurt RD, Croghan IT, Patten CA, Novotny P, Sloan JA: The prevalence of weight concerns in a smoking abstinence clinical trial. Addict Behav. 2006, 31 (7): 1144-52. 10.1016/j.addbeh.2005.08.011.CrossRefPubMed
9.
Galanti MR, Ivarsson BH, Helgason AR, Gilljam H: Smoking cessation: Gender on the agenda. Drugs. 2002, 9 (1): 71-84.
10.
Perkins KA: Smoking cessation in women. Special considerations. CNS Drugs. 2001, 15 (5): 391-411. 10.2165/00023210-200115050-00005.CrossRefPubMed
11.
Pomerleau CS, Zucker AN, Stewart AJ: Characterizing concerns about post-cessation weight gain: results from a national survey of women smokers. Nicotine Tob Res. 2001, 3 (1): 51-60. 10.1080/14622200020032105.CrossRefPubMed
12.
Marcus BH, Albrecht AE, King TK, Parisi AF, Pinto BM, Roberts M: The efficacy of exercise as an aid for smoking cessation in women. Arch Intern Med. 1999, 159: 1229-34. 10.1001/archinte.159.11.1229.CrossRefPubMed
13.
Pinto BM, Borrelli B, King TK, Bock BC, Clark MM, Roberts M, Marcus BH: Weight control smoking among sedentary women. Addict Behav. 1999, 24 (1): 75-86. 10.1016/S0306-4603(98)00034-3.CrossRefPubMed
14.
Annesi J: Relations of self-motivation, perceived physical condition, and exercise-induced changes in revitalization and exhaustion with attendance in women initiating a moderate cardiovascular exercise regimen. Women's Health. 2005, 42 (3): 77-93.CrossRef
15.
Annesi JJ: Changes in depressed mood associated with 10 weeks of moderate cardiovascular exercise in formerly sedentary adults. Psychol Rep. 2005, 96 (3 Pt 1): 855-62. 10.2466/PR0.96.3.855-862.CrossRefPubMed
16.
Dunn AL, Trivedi MH, Kampert JB, Clark CG, Chambliss HO: Exercise treatment for depression: efficacy and dose response. Am J Prev Med. 2005, 28 (1): 1-8. 10.1016/j.amepre.2004.09.003.CrossRefPubMed
17.
Dunn AL, Trivedi MH, O'Neal HA: Physical activity dose-response effects on outcomes of depression and anxiety. Med Sci Sports Exerc. 2001, 33 (6 Suppl): S587-97.CrossRefPubMed
18.
Knubben K, Reischies FM, Adli M, Schlattmann P, Bauer M, Dimeo F: A randomised, controlled study on the effects of a short-term endurance training programme in patients with major depression. Br J Sports Med. 2007, 41 (1): 29-33. 10.1136/bjsm.2006.030130.CrossRefPubMedPubMedCentral
19.
Matsouka O, Kabitsis C, Harahousou Y, Trigonis I: Mood alterations following an indoor and outdoor exercise program in healthy elderly women. Percept Mot Skills. 2005, 100: 707-15. 10.2466/PMS.100.3.707-715.CrossRefPubMed
20.
Scully D, Kremer J, Meade MM, Graham R, Dudgeon K: Physical exercise and psychological well being: a critical review. Br J Sports Med. 1998, 32 (2): 111-20. 10.1136/bjsm.32.2.111.CrossRefPubMedPubMedCentral
21.
Bock BC, Marcus BH, King T, Borrelli B: Exercise effects on withdrawal symptoms and mood among women attempting smoking cessation. Addict Behav. 1999, 24: 399-410. 10.1016/S0306-4603(98)00088-4.CrossRefPubMed
22.
Marcus BH, Lewis BA, Hogan J, King TK, Albrecht AE, Bock B: The efficacy of moderate-intensity exercise as an aid for smoking cessation in women: a randomized controlled trial. Nicotine Tob Res. 2005, 7 (6): 871-80. 10.1080/14622200500266056.CrossRefPubMed
23.
Mishra RS: Fundamentals of Yoga: A Handbook of Theory, Practice and Applications. 1987, New York: Harmony Books
24.
Piasecki TM, Fiore MC, McCarthy DE, Baker TB: Have we lost our way? The need for dynamic formulations of smoking relapse proneness. Addiction. 2002, 97 (9): 1093-108. 10.1046/j.1360-0443.2002.00216.x.CrossRefPubMed
25.
Emery CF, Blumenthal JA: Perceived change among participants in an exercise program for older adults. Gerontologist. 1990, 30 (4): 516-21.CrossRefPubMed
26.
Schmidt T, Wijga A, Von Zur Muhlen A, Brabant G, Wagner TO: Changes in cardiovascular risk factors and hormones during a comprehensive residential three month kriva yoga training and vegetarian nutrition. Acta Physiology Scandinavica Suppl. 1997, 640: 158-62.
27.
Bera TK, Rajapurkar MV: Body composition, cardiovascular endurance and anaerobic power of yogic practitioner. Indian J Physiol Pharmacol. 1993, 37: 225-8.PubMed
28.
Mahajan AS, Reddy KS, Sachdeva U: Lipid profile of coronary risk subjects following yogic lifestyle intervention. Indian Heart J. 1999, 51 (1): 37-40.PubMed
29.
Carlson LE, Culos-Reed N, Daroux LM: The effects of therapeutic yoga on salivary cortisol, stress symptoms, quality of life and mood states in cancer outpatients: A randomized controlled study. Presented at the annual meeting of the American Psychosomatic Society. 2005, March ; Vancouver, BC
30.
Khumar SS, Kaur P, Kaur S: Effectiveness of shavasana on depression among university students. Indian J Clin Psychol. 1993, 20: 82-7.
31.
Malathi A, Damodaran A, Shah N, Patil N, Maratha S: Effect of yoga practices on subjective well being. Indian J Physiol Pharmacol. 2000, 44 (2): 202-6.PubMed
32.
Woolery A, Myers H, Sternlieb B: A yoga intervention for young adults with elevated symptoms of depression. Altern Ther Health Med. 2004, 10 (1): 60-3.PubMed
33.
Thomas S, Reading J, Shephard RJ: Revision of the Physical Activity Readiness Questionnaire (PAR-Q). Can J Sport Sci. 1992, 17 (4): 338-45.PubMed
34.
Heatherton TF, Kozlowski LT, Frecker RC, Fagerstrom KO: The Fagerstrom Test for Nicotine Dependence: a revision of the Fagerstrom Tolerance Questionnaire. Br J Addict. 1991, 86 (9): 1119-27. 10.1111/j.1360-0443.1991.tb01879.x.CrossRefPubMed
35.
Velicer WF, DiClemente CC, Rossi JS, Prochaska JO: Relapse situations and self-efficacy: an integrative model. Addict Behav. 1990, 15 (3): 271-83. 10.1016/0306-4603(90)90070-E.CrossRefPubMed
36.
Prochaska JO, DiClemente CC, Norcross JC: In search of how people change. Am Psychol. 1992, 47 (9): 1102-14. 10.1037/0003-066X.47.9.1102.CrossRefPubMed
37.
Hughes JR, Hatsukami D: Signs and symptoms of tobacco withdrawal. Arch Gen Psychiatry. 1986, 43: 289-94.CrossRefPubMed
38.
Walach H, Bucheld N, Buttenmuller V, Kleinknecht N, Schmidt S: Measuring mindfulness--the Freiburg Mindfulness Inventory (FMI). Pers Individ Dif. 2006, 40: 1543-55. 10.1016/j.paid.2005.11.025.CrossRef
39.
Seidlitz L, Abernethy AD, Duberstein PR, Evinger JS, Chang TH, Lewis BL: Development of the Spiritual Transcendence Index. J Sci Study Relig. 2002, 41 (3): 439-53. 10.1111/1468-5906.00129.CrossRef
40.
Spielberger CD, Gorsuch RL, Lushene R, Vagg PR, Jacobs GA: Manual for the State-trait Anxiety Inventory (Form Y Self-evaluation Questionnaire). 1983, Consulting Psychologists Press: Palo Alto, CA
41.
Bieling PJ, Antony MM, Swinson RP: The State-Trait Anxiety Inventory, Trait version: structure and content re-examined. Behav Res Ther. 1998, 36 (7-8): 777-88. 10.1016/S0005-7967(98)00023-0.CrossRefPubMed
42.
Andresen EM, Malmgren JA, Carter WB, Patrick DL: Screening for depression in well older adults: evaluation of a short form of the CES-D. Am J Prev Med. 1994, 10: 77-84.PubMed
43.
Blair SN, Haskell WL, Ho P, Paffenbarger RS, Vranizan KM, Farquhar JW, Wood PD: Assessment of habitual physical activity by a seven-day recall in a community survey and controlled experiments. Am J Epidemiol. 1985, 122 (5): 794-804.PubMed
44.
Sallis JF, Haskell WL, Wood PD, Fortmann SP, Rogers T, Blair SN: Physical activity assessment methodology in the Five-City Project. Am J Epidemiol. 1985, 121 (1): 91-106.PubMed
45.
Fox KR, Corbin CB: The Physical Self-Perception Profile: development and preliminary validation. J Sport Exer Psych. 1989, 11: 408-30.
46.
Ware JJ, Sherbourne CD: The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care. 1992, 30: 473-83. 10.1097/00005650-199206000-00002.CrossRefPubMed
47.
Weekley CK, Klesges RC, Reylea G: Smoking as a weight-control strategy and its relationship to smoking status. Addict Behav. 1992, 17 (3): 259-71. 10.1016/0306-4603(92)90031-P.CrossRefPubMed
48.
Watson D, Clark LA, Tellegen A: Development and validation of brief measures of positive and negative affect: The PANAS scales. J Pers Soc Psychol. 1988, 54: 1063-70. 10.1037/0022-3514.54.6.1063.CrossRefPubMed
49.
Society for Research on Nicotine and Tobacco: Biochemical verification of tobacco use and cessation. Nicotine Tob Res. 2002, 4: 149-59. 10.1080/14622200210123581.CrossRef
50.
Fiore MC, Jaén CR, Baker TB: Treating Tobacco Use and Dependence:2008 Update. Clinical Practice Guideline. 2008, Rockville, MD: U.S. Department of Health and Human Services. Public Health Service
51.
Zeger , Liang : Feedback Models for Discrete and Continuous Time Series. Statistica Sinica. 1991, 1: 51-64.
52.
Baron RM, Kenny DA: The moderator-mediator variable distinction in social psychological research: Conceptual, strategic and statistical considerations. J Pers Soc Psychol. 1986, 51: 1173-82. 10.1037/0022-3514.51.6.1173.CrossRefPubMed
53.
Little RJ, Rubin D: Statistical Analysis with Missing Data. 1987, New York: Wiley & Sons
54.
Al'absi M, Hatsukami D, Davis GL, Wittmers LE: Prospective examination of effects of smoking abstinence on cortisol and withdrawal symptoms as predictors of early smoking relapse. Drug Alcohol Depend. 2004, 73 (3): 267-78. 10.1016/j.drugalcdep.2003.10.014.CrossRefPubMed
55.
Manning BK, Catley D, Haris KJ, Mayo MS, Ahluwalia JS: Stress and quitting among African American smokers. J Behav Med. 2005, 28: 1-9. 10.1007/s10865-005-9004-9.CrossRef
56.
Swan GE, Ward MM, Jack LM: Abstinence effects as predictors of 28-day relapse in smokers. Addict Behav. 1996, 21 (4): 481-90. 10.1016/0306-4603(95)00070-4.CrossRefPubMed
57.
Shadel W, Mermelstein RJ: Cigarette smoking under stress: the role of coping expectancies among smokers in a clinic-based smoking cessation program. Health Psychol. 1993, 12 (6): 443-50. 10.1037/0278-6133.12.6.443.CrossRefPubMed
58.
Marcus BH, King TK, Albrecht AE, Parisi AF, Abrams DB: Rationale, design, and baseline data for commit to quit: An exercise efficacy trial for smoking cessation among women. Prev Med. 1997, 26: 586-97. 10.1006/pmed.1997.0180.CrossRefPubMed
Metadata
Title
Yoga as a complementary treatment for smoking cessation: rationale, study design and participant characteristics of the Quitting-in-Balance study
Authors
Beth C Bock
Kathleen M Morrow
Bruce M Becker
David M Williams
Geoffrey Tremont
Ronnesia B Gaskins
Ernestine Jennings
Joseph Fava
Bess H Marcus
Publication date
01-12-2010
Publisher
BioMed Central
Published in
BMC Complementary Medicine and Therapies / Issue 1/2010
Electronic ISSN: 2662-7671
DOI
https://doi.org/10.1186/1472-6882-10-14

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