Should I Quit Smoking Before I Start to Exercise?

[Thomas3.20.2010]

Q. I’d like to quit smoking and start exercising, but I know that both habits will be tough to stick to. Should I try to quit smoking first and start exercising later?

A. Some people get overwhelmed if they make too many drastic lifestyle changes all at once. But others thrive, especially if adopting one good habit reinforces another good habit. With smoking, you may find that exercising while you stop smoking will make kicking cigs easier. And that’s because they are fairly incompatible habits.

Let me explain.

When you exercise, especially if you do cardio activity such as running, cycling, dancing or Zumba, your body requires extra oxygen to move more. Immediate physiological changes occur:  Your breathing rate increases so you can suck more air — and oxygen — into your lungs, to be carried through your blood to the working muscles. Also, your blood vessels expand, increasing your circulation, and your heart beats faster to pump more of that super-oxygenated blood around.

Once you exercise regularly, your body adapts and sustained physiological changes occur: Your lungs can inflate more, taking in more air — and oxygen. Your lungs can deflate more, excreting some of the stale dead air that can linger and limit breathing capacity. Your heart gets stronger and this means that you pump more blood out to your body per beat, and your heart works less hard to push out the same amount of blood.

When you smoke, some opposing effects occur: Your lungs get clogged with toxins, impeding your ability to suck in optimal amounts of oxygen; your heart rate is higher, so the heart works harder at rest. This impairs the ability to pump the extra blood — and oxygen — needed during exercise.

Once you start exercising, regardless of whether you smoke, you’ll start to notice improvements in your cardiovascular stamina.  You’ll breathe more deeply and feel more energized, especially as you get fitter. That makes you extra-sensitive to cigarettes that stifle this response. Having a cigarette and then exercising can make the exercise feel tougher. And it just doesn’t feel so good to suck smoke in once you’re opening up those lungs to receiving and delivering more oxygen to your body.

A few research studies suggest that different types and intensities of exercise may be beneficial in kicking the habit. Several studies have shown that high-intensity exercise has positive effects on smoking cessation. A 2009 study published in the journal, Addiction, found that riding a stationary bike at a fairly light to moderately hard intensity for around 20 minutes helped reduced a subject's desire to smoke after the workout. This reduced desire was measured by a reduction in their attention to smoking-related clues that were presented to them in visual tests.

Researchers at Brown University wanted to see if moderate-intensity exercise would improve the ability to quit smoking. In a 2010 pilot study in the journal, Psychology of Addictive Behaviors, 59 adult women who had smoked at least five cigarettes per day for more than a year were given an eight-week smoking cessation treatment that included one counseling session and a nicotine patch. Half the participants were put in a "wellness" group where they watched 30-minute films about health and wellness three days a week (but were given no additional information on smoking, or information on exercise.) The other group was put on an exercise program where they walked on treadmills at a moderate intensity three times per week, accumulating about 120 minutes per week of exercise.

The smoking status of all the subjects was checked regularly — three times per week throughout the eight-week study and seven weeks and 11 weeks after the exercise or wellness group sessions ended. A device that measures carbon monoxide levels in breath was also used to determine whether participants had smoked. Nicotine withdrawal symptoms were also assessed every week.

Results showed that the exercisers were more likely to have not smoked in the past seven days when assessed for smoking status than those who participated in the wellness educational group. Although these results for not scientifically significant, researchers say they were a preliminary indication that sticking to a moderate-intensity exercise plan might enhance the efficacy of using a nicotine patch along with brief counseling to help quit the habit. The researchers noted that a larger trial to test this theory should be conducted.

Another study looked at the effects of weight-lifting on quitting smoking. The 2011 study published in Nicotine & Tobacco Researchput 25 smokers on a nicotine patch and gave them brief smoking-cessation counseling. Half of the group participated in a 12-week resistance training program twice a week working up to two sets of 10 repetitions of 10 exercises. At the end of the three months, twice the number of those who weight-trained exhibited prolonged abstinence from smoking compared to the group who did not exercise (16% versus 8%). And 15% still sustained this six months later.

Although there can be risks associated with exercising when you smoke (and I’ve written about those here), shifting from an unhealthy habit to a healthy one in order to improve your health and give up smoking appears to help people quit.