title: The acute effects of exercise on cigarette cravings, withdrawal symptoms, affect, and smoking behaviour: systematic review update and meta-analysis.
abstract: BACKGROUND
  Smoking cessation is associated with cigarette cravings and tobacco withdrawal symptoms (TWS), and exercise appears to ameliorate many of these negative effects. A number of studies have examined the relationships between exercise, cigarette cravings, and TWS.
  
  
  OBJECTIVE
  The objectives of this study were (a) to review and update the literature examining the effects of short bouts of exercise on cigarette cravings, TWS, affect, and smoking behaviour and (b) to conduct meta-analyses of the effect of exercise on cigarette cravings.
  
  
  METHODS
  A systematic review of all studies published between January 2006 and June 2011 was conducted.
  
  
  RESULTS
  Fifteen new studies were identified, 12 of which found a positive effect of exercise on cigarette cravings. The magnitude of statistically significant effect sizes for 'desire to smoke' and 'strength of desire to smoke' ranged from 0.4 to 1.98 in favour of exercise compared to passive control conditions, and peaked either during or soon after treatment. Effects were found up to 30 min post-exercise. Cigarette cravings were reduced following exercise with a wide range of intensities from isometric exercise and yoga to activity as high as 80-85 % heart rate reserve. Meta-analyses revealed weighted mean differences of -1.90 and -2.41 in 'desire to smoke' and 'strength of desire to smoke' outcomes, respectively. Measures of TWS and negative affect were reduced following light-moderate intensity exercise, but increased during vigorous exercise.
  
  
  CONCLUSIONS
  Exercise can have a positive effect on cigarette cravings and TWS. However, the most effective exercise intensity to reduce cravings and the underlying mechanisms associated with this effect remain unclear.
authors.affiliation: National Institute for Health Innovation, University of Auckland, Private Bag 92019, Auckland 1142, New Zealand. v.roberts@nihi.auckland.ac.nz
authors.forename: Vaughan
authors.initials: V
authors.lastname: Roberts
authors.forename: Ralph
authors.initials: R
authors.lastname: Maddison
authors.forename: Caroline
authors.initials: C
authors.lastname: Simpson
authors.forename: Chris
authors.initials: C
authors.lastname: Bullen
authors.forename: Harry
authors.initials: H
authors.lastname: Prapavessis
mesh_terms: D000339:Affect; D015444:Exercise / Q000502:physiology*; D006339:Heart Rate; D006801:Humans; D012907:Smoking / Q000453:epidemiology / Q000523:psychology; D016540:Smoking Cessation / Q000379:methods*; D000074606:Smoking Prevention; D013375:Substance Withdrawal Syndrome / Q000503:physiopathology / Q000517:prevention & control; D013997:Time Factors; D014029:Tobacco Use Disorder / Q000534:rehabilitation