When we smoke cigarettes, nicotine reaches the brain in 10 to 20 seconds, resulting in the release of neurotransmitters that reinforce the behavior. Upon quitting, the reward system triggers strong cravings for cigarettes, accompanied by withdrawal symptoms such as sleep disturbances, difficulty concentrating, increased appetite, weight gain, restlessness, or negative affect (e.g., depression, irritability).
Our research and experience indicate that combining medication and behavioral therapy is the most effective approach to achieve and maintain abstinence from smoking. On the behavioral side, we encourage patients to develop personalized strategies to help them maintain tobacco abstinence since everyone's journey is different, and what works for one person may not necessarily work for another.
Evidence suggests that exercise can assist smokers in achieving sustained tobacco abstinence. Short bouts of activity have been shown to reduce cravings and withdrawal symptoms. However, some people associate exercise with running long distances or spending extended periods on a treadmill.
Yet, research also shows that as little as 5 minutes of activity, such as stationary cycling, can effectively reduce withdrawal symptoms. But what if a stationary cycle is not available? And is exercising outside our normal living environment more beneficial than doing it indoors?
Schöttl et al. (Acute effects of outdoor and indoor walking on cigarette cravings, withdrawal symptoms, and affective response during temporary smoking abstinence. Psychopharmacology (2023). https://doi.org/10.1007/s00213-023-06506-4) evaluated the relative effect of outdoor and indoor walking on cigarette craving and withdrawal symptoms in individuals temporarily abstinent from cigarette smoking.
Participants who smoked ≥ 10 cigarettes per day were asked to abstain from cigarette smoking for 10 hours, then randomized to three conditions: 1) Indoor walking on a treadmill for 10 minutes; 2) outdoor walking on a flat gravel path in an urban green space for 10 minutes; or 3) sitting quietly without reading or using a smartphone.
Compared to sitting quietly, both outdoor and indoor walking significantly reduced cigarette cravings and improved mood. Outdoor walking resulted in significantly lower cigarette cravings than indoor walking.
This data is compelling and clearly demonstrates that this simple intervention can reduce cigarette cravings. Outdoor walking may have the additive effect of taking us out of our normal environment and further reducing cigarette cravings. And all of this for the price of a pair of walking shoes…
