Addition of Pedometer-based Physical Activity Intervention to Smoking Cessation Program May Increase Quit Rates in Teenagers, Particularly in Boys

DynaMed Weekly Update - Volume 6, Issue 40

Some counseling interventions have been shown to have moderate success in reducing smoking rates in teenagers (Cochrane Database Syst Rev 2010 Jan 20;(1):CD003289). A recent cluster randomized trial evaluated the efficacy of adding physical activity to counseling for teenagers trying to quit smoking. High schools in West Virginia were randomized to provide 1 of 3 smoking cessation programs to students aged 14-19 years who smoked on at least 1 day in the last 30 days: a brief intervention with a single 10-15 minute group meeting conducted by a trained facilitator; Not on Tobacco (N-O-T), a program from the American Lung Association that includes group counseling and advice on healthy behaviors, stress management and life skills, once weekly for 10 weeks; or a combination of N-O-T plus a pedometer-based physical activity intervention. Students in the combined group were given pedometers and logs to record steps and daily minutes of other physical activity, and they had additional time in group sessions devoted to encouragement and instruction.

A total of 233 teenagers from 19 schools participated in the trial (54% girls, 96% daily smokers, mean smoking rates 10.1-14.5 cigarettes/day). Follow-up rates were 75% at 3 months and 63% at 6 months, but all participants were included in intention-to-treat analyses. At 6-month follow-up, the combination group had the highest quit rate (31.3%), followed by the N-O-T group (21.1%, p = 0.066 vs. combination) and the brief intervention group (15.9%, p = 0.013 vs. combination) (level 2 [mid-level] evidence). In subgroup analyses by gender, the combination group had significantly increased quit rates compared to the N-O-T program alone in boys (36.8% vs. 18.4%, p = 0.033, NNT 6), but not in girls (26.2% vs. 21.1%). The pattern of results was similar at 3 months (Pediatrics 2011 Oct;128(4):e801).

For more information, see the Tobacco use disorder topic in DynaMed.