title: Smoking cessation, depression, and exercise: empirical evidence, clinical needs, and mechanisms.
abstract: BACKGROUND
  Smoking is significantly more common among persons with major depressive disorders (MDDs). Furthermore, smokers with MDD report more difficulties when they quit smoking (greater withdrawal symptoms, higher probability of relapse). The aim of this narrative review is to describe research on exercise and depression and exercise and smoking cessation.
  
  
  METHODS
  We have critically reviewed various smoking cessation intervention programs for depressive smokers examining (a) the protective effect of exercise against relapse for smokers with MDD and (b) the benefits of exercise for treating withdrawal symptoms. We have also reviewed the current literature investigating the mechanisms between exercise-depression and exercise-smoking.
  
  
  RESULTS
  This review suggests that exercise may reduce depressive symptoms following cessation and provide a useful strategy for managing withdrawal symptoms in smokers with MDD. Various psychological, biological, and genetic hypotheses have been tested (e.g., distraction hypothesis, expectations hypothesis, cortisol hypothesis) and few have obtained significant results.
  
  
  CONCLUSIONS
  It might be beneficial for health professionals to recommend physical activity and promote supervised exercise sessions for smokers with MDD during smoking cessation. Future research needs to examine relationships between exercise, smoking, and depression with transdisciplinary and ecological momentary assessment.
authors.affiliation: Laboratory Epsylon EA 4556, Dynamics of Human Abilities and Health Behaviors, University of Montpellier, France;
authors.forename: Paquito
authors.initials: P
authors.lastname: Bernard
authors.forename: Gregory
authors.initials: G
authors.lastname: Ninot
authors.forename: Gregory
authors.initials: G
authors.lastname: Moullec
authors.forename: Sebastien
authors.initials: S
authors.lastname: Guillaume
authors.forename: Philippe
authors.initials: P
authors.lastname: Courtet
authors.forename: Xavier
authors.initials: X
authors.lastname: Quantin
mesh_terms: D003863:Depression / Q000503:physiopathology*; D015444:Exercise / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D016540:Smoking Cessation / Q000523:psychology*