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Darabseh, M.Z.;  Selfe, J.;  Morse, C.I.;  Aburub, A.;  Degens, H. Aerobic Exercise Facilitate Vaping and Smoking Cessation. Encyclopedia. Available online: (accessed on 14 June 2024).
Darabseh MZ,  Selfe J,  Morse CI,  Aburub A,  Degens H. Aerobic Exercise Facilitate Vaping and Smoking Cessation. Encyclopedia. Available at: Accessed June 14, 2024.
Darabseh, Mohammad Z., James Selfe, Christopher I. Morse, Aseel Aburub, Hans Degens. "Aerobic Exercise Facilitate Vaping and Smoking Cessation" Encyclopedia, (accessed June 14, 2024).
Darabseh, M.Z.,  Selfe, J.,  Morse, C.I.,  Aburub, A., & Degens, H. (2022, November 09). Aerobic Exercise Facilitate Vaping and Smoking Cessation. In Encyclopedia.
Darabseh, Mohammad Z., et al. "Aerobic Exercise Facilitate Vaping and Smoking Cessation." Encyclopedia. Web. 09 November, 2022.
Aerobic Exercise Facilitate Vaping and Smoking Cessation

Cigarette smokers try to quit using several strategies including electronic cigarette use (vaping). An alternative, easy and cheap method is exercise. However, little is known about the efficacy of aerobic exercise (AE) to augment smoking and vaping cessation. One such potential alternative smoking cessation (SC) intervention is aerobic exercise. Exercise interventions are categorised as, e.g., aerobic, strengthening or relaxation exercises. Exercise is easy to access and cheap and therefore one may consider exercise as a viable intervention to facilitate SC, particularly via the reduction in nicotine withdrawal symptoms and cigarette craving

aerobic exercise rehabilitation smoking cessation vaping cessation exercise physiology systematic review meta-analysis

1. Introduction

Smoking is considered the main risk factor for the development of preventable diseases such as cancers, cardiovascular diseases and respiratory disorders, including chronic obstructive pulmonary disease (COPD), and globally seven million deaths per year are attributable to smoking [1]. Smoking cessation (SC) reduces the risk of hospitalization due to chronic conditions, such as COPD, and is associated with significant life extensions [2][3]. As the annual death rate attributable to smoking is expected to increase within the next decades, the World Health Organization started calling upon governments and health institutes to develop anti-smoking regulations and interventions to further promote SC [1].
Although approximately 40% of smokers make at least one quit attempt annually [4], only fewer than 5% succeed [5]. Electronic-cigarette use (vaping) is promoted as a harmless and safe alternative to cigarette smoking [6] and uptake of vaping has been reported to be associated with higher rates of SC [7][8]. Vaping may, however, not be as harmless as originally thought and has been reported to cause similar detrimental effects on lung and cardiovascular function as smoking [9][10]. Such harmful effects may well contribute to the reportedly 33% of vapers that are willing to visit a vaping cessation service if available in their neighbourhood [11].
Beside vaping, SC interventions vary from pharmacotherapies including nicotine replacement therapy and SC counselling [12] to meditation and yoga programmes [13]. However, the success of these interventions is influenced by many factors such as the dose, type and duration of medication, intervention or counselling, motivational skills of SC advisors, follow-up periods, smokers’ adherence, duration of smoking and number of cigarettes one used to smoke per day. Indeed, the long-term effectiveness of these interventions remains ambiguous [14][15][16][17] and it is essential to keep looking for other interventions and assess their effectiveness.
One such potential alternative SC intervention is aerobic exercise. Exercise interventions are categorised as, e.g., aerobic, strengthening or relaxation exercises. As vaping and smoking particularly affect the cardiovascular and respiratory systems researchers consider here the impact of aerobic exercise training on the success of vaping and smoking cessation. In addition, it has been shown that aerobic exercise improves mood, well-being, and alleviates anxiety and depression, thereby contributing to the often-reported improvement in the quality of life [18][19][20][21][22]. Perhaps even more important is that exercise is easy to access and cheap and therefore one may consider exercise as a viable intervention to facilitate SC, particularly via the reduction in nicotine withdrawal symptoms and cigarette craving [23][24].
The mechanism by which aerobic exercise may enhance SC is not fully clear, but a number of mechanisms have been postulated, including raised endorphins, distraction and increased self-efficacy. It is known for example, that aerobic exercise induces an increase in plasma β-endorphins [25] that is dependent on the intensity and duration of the exercise performed [26]. The exercise-induced rise in β-endorphin levels may be significant as it has been found that higher levels were associated with fewer smoking relapses after cessation [27]. Additional mechanisms whereby aerobic exercise may facilitate SC are (1) increased proprioceptive input due to larger and more frequent movements that could distract smokers from cigarette craving [28] and (2) improved image self-efficacy [29]. Despite these potential mechanisms, the long-term benefits of exercise for smoking- and vaping- cessation are not clear.

2. Design of the Exercise Studies and Verification of Smoking Cessation

Comparator groups received the same intervention as the exercise group, and consisted of face-to-face consultation [30][31][32][33][34][35][36][37][38][39][40], telephone counselling [33], behavioural treatment [39][41], nicotine gum [41][42], nicotine patch [39], inhalers [42], cognitive therapy [39], or combination of more than one treatment. In the trials included in the meta-analysis, smoking cessation was confirmed by measurement of the expired CO [31][32][33][34][35][37][38][39][40][41][42], saliva cotinine [32][36][37][38][39] or plasma thiocyanate [30] concentrations.

3. Exercise Interventions Do Not Enhance Smoking Cessation

When studying the benefits of exercise interventions for smoking cessation it is important to consider whether that is influenced by the frequency, intensity, time and type (FITT) of exercise [43][44][45].
Only two high quality trials reported that aerobic exercise intervention resulted in higher number of long-term successful quitters compared to other interventions [36][38]. These trials used 3 vigorous-intensity exercise sessions a week for 12–15 weeks. This is, however, an equivocal observation as three other high-quality trials with similar intensity, frequency and duration of exercise did not report a significant improvement in SC after aerobic exercise interventions [34][37][41]. As the effectiveness of exercise programs is highly dependent on adherence [46], it is possible that the benefits of exercise in two trials [36][38] and no benefits in another trial is related to the high adherence (68.7% and 88%, respectively), or low (55%) adherence [41] to the exercise interventions.

4. Exercise during Smoking Cessation Interventions Enhances VO2max and/or VO2peak

Even if exercise does not benefit SC, there are substantial other benefits of exercise, such as the negative association with the prevalence of lung carcinoma in smokers and quitters [47] and a significant reduction in the mortality of smokers [48]. In addition, exercise during smoking cessation interventions led to a significant improvement in VO2max and/or VO2peak [32][33][34][35][36][37][38][39]. Improvements in VO2max indicate improved aerobic exercise capacity and may also contribute to a reduction in the development of numerous clinical conditions and morbidities [49]. Besides these benefits for exercise capacity and diminishing the risk of future morbidity, there are also other physiological and psychological benefits to exercise as an adjunct to SC [50][51]. For example, exercise led to a reduction in withdrawal symptoms and improvement in psychological wellbeing, such as reduction in anxiety, depression and mood-swings [32][33][40]. Thus, even though exercise did not enhance the success rate of smoking cessation it nevertheless has significant beneficial effects for people seeking to stop smoking.


  1. World Health Organization. WHO Report on the Global Tobacco Epidemic, 2017: Monitoring Tobacco Use and Prevention Policies; World Health Organization: Geneva, Switzerland, 2017.
  2. Tran, B.; Falster, M.O.; Douglas, K.; Blyth, F.; Jorm, L.R. Smoking and potentially preventable hospitalisation: The benefit of smoking cessation in older ages. Drug Alcohol Depend. 2015, 150, 85–91.
  3. Taylor, D.H., Jr.; Hasselblad, V.; Henley, S.J.; Thun, M.J.; Sloan, F.A. Benefits of smoking cessation for longevity. Am. J. Public Health 2002, 92, 990–996.
  4. CDC. Cigarette smoking among adults—United States, 2007. MMWR. Morb. Mortal. Wkly. Rep. 2008, 57, 1221–1226.
  5. Etter, J.-F.; Perneger, T.V.; Ronchi, A. Distributions of smokers by stage: International comparison and association with smoking prevalence. Prev. Med. 1997, 26, 580–585.
  6. Dutra, L.M.; Grana, R.; Glantz, S.A. Philip Morris research on precursors to the modern e-cigarette since 1990. Tob. Control 2017, 26, e97–e105.
  7. Tackett, A.P.; Lechner, W.V.; Meier, E.; Grant, D.M.; Driskill, L.M.; Tahirkheli, N.N.; Wagener, T.L. Biochemically verified smoking cessation and vaping beliefs among vape store customers. Addiction 2015, 110, 868–874.
  8. Rahman, M.A.; Hann, N.; Wilson, A.; Mnatzaganian, G.; Worrall-Carter, L. E-cigarettes and smoking cessation: Evidence from a systematic review and meta-analysis. PLoS ONE 2015, 10, e0122544.
  9. Darabseh, M.Z.; Selfe, J.; Morse, C.I.; Degens, H. Is vaping better than smoking for cardiorespiratory and muscle function? Multidiscip. Respir. Med. 2020, 15, 674.
  10. Darabseh, M.Z.; Selfe, J.; Morse, C.I.; Degens, H. Impact of vaping and smoking on maximum respiratory pressures and respiratory function. Int. J. Adolesc. Youth 2021, 26, 421–431.
  11. Etter, J.F. Are long-term vapers interested in vaping cessation support? Addiction 2019, 114, 1473–1477.
  12. Lemmens, V.; Oenema, A.; Knut, I.K.; Brug, J. Effectiveness of smoking cessation interventions among adults: A systematic review of reviews. Eur. J. Cancer Prev. 2008, 17, 535–544.
  13. Bock, B.C.; Fava, J.L.; Gaskins, R.; Morrow, K.M.; Williams, D.M.; Jennings, E.; Becker, B.M.; Tremont, G.; Marcus, B.H. Yoga as a complementary treatment for smoking cessation in women. J. Women’s Health 2012, 21, 240–248.
  14. Ahluwalia, J.S.; Harris, K.J.; Catley, D.; Okuyemi, K.S.; Mayo, M.S. Sustained-release bupropion for smoking cessation in African Americans: A randomized controlled trial. JAMA 2002, 288, 468–474.
  15. Aubin, H.-J.; Bobak, A.; Britton, J.R.; Oncken, C.; Billing, C.B.; Gong, J.; Williams, K.E.; Reeves, K.R. Varenicline versus transdermal nicotine patch for smoking cessation: Results from a randomised open-label trial. Thorax 2008, 63, 717–724.
  16. Cooper, T.V.; Klesges, R.C.; DeBon, M.W.; Zbikowski, S.M.; Johnson, K.C.; Clemens, L.H. A placebo controlled randomized trial of the effects of phenylpropanolamine and nicotine gum on cessation rates and postcessation weight gain in women. Addict. Behav. 2005, 30, 61–75.
  17. Gariti, P.; Lynch, K.; Alterman, A.; Kampman, K.; Xie, H.; Varillo, K. Comparing smoking treatment programs for lighter smokers with and without a history of heavier smoking. J. Subst. Abus. Treat. 2009, 37, 247–255.
  18. Dunn, A.L.; Trivedi, M.H.; Kampert, J.B.; Clark, C.G.; Chambliss, H.O. Exercise treatment for depression: Efficacy and dose response. Am. J. Prev. Med. 2005, 28, 1–8.
  19. Legrand, F.; Heuze, J.P. Antidepressant effects associated with different exercise conditions in participants with depression: A pilot study. J. Sport Exerc. Psychol. 2007, 29, 348–364.
  20. Senkfor, A.; Williams, J.M. The moderating effects of aerobic fitness and mental training on stress reactivity. J. Sport Behav. 1995, 18, 130.
  21. Steptoe, A.; Cox, S. Acute effects of aerobic exercise on mood. Health Psychol. 1988, 7, 329.
  22. Norris, R.; Carroll, D.; Cochrane, R. The effects of aerobic and anaerobic training on fitness, blood pressure, and psychological stress and well-being. J. Psychosom. Res. 1990, 34, 367–375.
  23. Taylor, A.H.; Ussher, M.H.; Faulkner, G. The acute effects of exercise on cigarette cravings, withdrawal symptoms, affect and smoking behaviour: A systematic review. Addiction 2007, 102, 534–543.
  24. Roberts, V.; Maddison, R.; Simpson, C.; Bullen, C.; Prapavessis, H. The acute effects of exercise on cigarette cravings, withdrawal symptoms, affect, and smoking behaviour: Systematic review update and meta-analysis. Psychopharmacology 2012, 222, 1–15.
  25. De Meirleir, K.; Naaktgeboren, N.; Van Steirteghem, A.; Gorus, F.; Olbrecht, J.; Block, P. Beta-endorphin and ACTH levels in peripheral blood during and after aerobic and anaerobic exercise. Eur. J. Appl. Physiol. Occup. Physiol. 1986, 55, 5–8.
  26. Goldfarb, A.H.; Hatfield, B.; Armstrong, D.; Potts, J. Plasma beta-endorphin concentration: Response to intensity and duration of exercise. Med. Sci. Sport. Exerc. 1990, 22, 241–244.
  27. Shaw, D.; al’Absi, M. Attenuated beta endorphin response to acute stress is associated with smoking relapse. Pharmacol. Biochem. Behav. 2008, 90, 357–362.
  28. Wai, E.K.; Rodriguez-Elizalde, S.; Dagenais, S.; Hall, H. Physical Activity, Smoking Cessation, and Weight Loss. Evid.-Based Manag. Low Back Pain 2011, 39–54.
  29. Loprinzi, P.D.; Wolfe, C.D.; Walker, J.F. Exercise facilitates smoking cessation indirectly via improvements in smoking-specific self-efficacy: Prospective cohort study among a national sample of young smokers. Prev. Med. 2015, 81, 63–66.
  30. Taylor, C.B.; Houston-Miller, N.; Haskell, W.L.; de Busk, R.F. Smoking cessation after acute myocardial infarction: The effects of exercise training. Addict. Behav. 1988, 13, 331–335.
  31. Prapavessis, H.; De Jesus, S.; Fitzgeorge, L.; Faulkner, G.; Maddison, R.; Batten, S. Exercise to Enhance Smoking Cessation: The Getting Physical on Cigarette Randomized Control Trial. Ann. Behav. Med. A Publ. Soc. Behav. Med. 2016, 50, 358–369.
  32. Marcus, B.H.; Lewis, B.A.; Hogan, J.; King, T.K.; Albrecht, A.E.; Bock, B.; Parisi, A.F.; Niaura, R.; Abrams, D.B. The efficacy of moderate-intensity exercise as an aid for smoking cessation in women: A randomized controlled trial. Nicotine Tob. Res. 2005, 7, 871–880.
  33. Abrantes, A.M.; Bloom, E.L.; Strong, D.R.; Riebe, D.; Marcus, B.H.; Desaulniers, J.; Fokas, K.; Brown, R.A. A preliminary randomized controlled trial of a behavioral exercise intervention for smoking cessation. Nicotine Tob. Res. Off. J. Soc. Res. Nicotine Tob. 2014, 16, 1094–1103.
  34. Hill, J.S. Effect of a program of aerobic exercise on the smoking behaviour of a group of adult volunteers. Can. J. Public Health 1985, 76, 183–186.
  35. Kinnunen, T.; Leeman, R.F.; Korhonen, T.; Quiles, Z.N.; Terwal, D.M.; Garvey, A.J.; Hartley, H.L. Exercise as an adjunct to nicotine gum in treating tobacco dependence among women. Nicotine Tob. Res. Off. J. Soc. Res. Nicotine Tob. 2008, 10, 689–703.
  36. Marcus, B.H.; Albrecht, A.E.; Niaura, R.S.; Abrams, D.B.; Thompson, P.D. Usefulness of physical exercise for maintaining smoking cessation in women. Am. J. Cardiol. 1991, 68, 406–407.
  37. Marcus, B.H.; Albrecht, A.E.; Niaura, R.S.; Taylor, E.R.; Simkin, L.R.; Feder, S.I.; Abrams, D.B.; Thompson, P.D. Exercise enhances the maintenance of smoking cessation in women. Addict. Behav. 1995, 20, 87–92.
  38. Marcus, B.H.; Albrecht, A.E.; King, T.K.; Parisi, A.F.; Pinto, B.M.; Roberts, M.; Niaura, R.S.; Abrams, D.B. The efficacy of exercise as an aid for smoking cessation in women: A randomized controlled trial. Arch. Intern. Med. 1999, 159, 1229–1234.
  39. Prapavessis, H.; Cameron, L.; Baldi, J.C.; Robinson, S.; Borrie, K.; Harper, T.; Grove, R.J. The effects of exercise and nicotine replacement therapy on smoking rates in women. Addict. Behav. 2007, 32, 1416–1432.
  40. Russell, P.O.; Epstein, L.H.; Johnston, J.J.; Block, D.R.; Blair, E. The effects of physical activity as maintenance for smoking cessation. Addict. Behav. 1988, 13, 215–218.
  41. Hill, R.D.; Rigdon, M.; Johnson, S. Behavioral smoking cessation treatment for older chronic smokers. Behav. Ther. 1993, 24, 321–329.
  42. Bize, R.; Willi, C.; Chiolero, A.; Stoianov, R.; Payot, S.; Locatelli, I.; Cornuz, J. Participation in a population-based physical activity programme as an aid for smoking cessation: A randomised trial . Tobacco Control 2010, 19, 488–494.
  43. Franklin, B.A.; Swain, D.P.; Shephard, R.J. New insights in the prescription of exercise for coronary patients. J. Cardiovasc. Nurs. 2003, 18, 116–123.
  44. Brown, R.S.; Ramirez, D.E.; Taub, J.M. The prescription of exercise for depression. Physician Sportsmed. 1978, 6, 34–45.
  45. Sasso, J.P.; Eves, N.D.; Christensen, J.F.; Koelwyn, G.J.; Scott, J.; Jones, L.W. A framework for prescription in exercise-oncology research. J. Cachexia Sarcopenia Muscle 2015, 6, 115–124.
  46. Dishman, R.K. Advances in Exercise Adherence; Human Kinetics Publishers: Champaign, IL, USA, 1994.
  47. Leitzmann, M.F.; Koebnick, C.; Abnet, C.C.; Freedman, N.D.; Park, Y.; Hollenbeck, A.; Ballard-Barbash, R.; Schatzkin, A. Prospective study of physical activity and lung cancer by histologic type in current, former, and never smokers. Am. J. Epidemiol. 2009, 169, 542–553.
  48. Siahpush, M.; Levan, T.D.; Nguyen, M.N.; Grimm, B.L.; Ramos, A.K.; Michaud, T.L.; Johansson, P.L. The Association of Physical Activity and Mortality Risk Reduction Among Smokers: Results From 1998–2009 National Health Interview Surveys–National Death Index Linkage. J. Phys. Act. Health 2019, 16, 865–871.
  49. American College of Sports Medicine. ACSM’s Guidelines for Exercise Testing and Prescription; Lippincott Williams & Wilkins: Philadelphia, PA, USA, 2013.
  50. Daley, A. Exercise and depression: A review of reviews. J. Clin. Psychol. Med. Settings 2008, 15, 140.
  51. Penedo, F.J.; Dahn, J.R. Exercise and well-being: A review of mental and physical health benefits associated with physical activity. Curr. Opin. Psychiatry 2005, 18, 189–193.
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