title: Promoting pre-quit physical activity to reduce cue reactivity among low-income sedentary smokers: A randomized proof of concept study.
abstract: BACKGROUND
  Smoking and lack of physical activity (PA) contribute to disproportionate rates of disease among low-income adults. Interventions that simultaneously address both risk behaviors have strong potential to reduce health disparities. Existing smoking-PA studies indicate promising results but have limited generalizability to low-income populations. The goal of this study is to assess the effects of an integrated behavioral counseling approach to promote low-to-moderate intensity PA (LMPA) and reduce short-term smoking cue reactivity among low-income sedentary smokers.
  
  
  METHODS
  This study uses a randomized, 2-group design with 4 measurement time points: baseline, quit day (week 4), 1-week and 1-month follow-up. Participants (sedentary, smoke>6 cigs/day) receive 4 weeks of either (a) standard smoking cessation counseling (SCC control) or (b) our Step-Up to Quit (SUTQ) intervention that integrates advice for LMPA with SCC. SUTQ counseling focuses on increasing daily steps (walking) to reach 7500-10,000/day by week 4 (quit day) and explicitly links short bouts of LMPA with smoking urge management. Potential for SUTQ to facilitate urge management will be assessed by comparing between-group differences in the reduction (extinction) of quit day cue reactivity. We will explore group differences in quit rates at 1-week and 1-month follow-up.
  
  
  CONCLUSIONS
  This novel approach overcomes gaps in the PA-smoking intervention literature by promoting a more realistic PA approach for sedentary populations, using an ecologically valid strategy, integrating LMPA with evidence-based SCC during a 4-week pre-quit period, and testing the SUTQ counseling model in a high-risk sample. Results will guide future efficacy and dissemination studies.
authors: College of Public Health, Temple University, Philadelphia, United States. Electronic address: uma.nair@temple.edu.
authors: Uma S
authors: US
authors: Nair
authors: College of Public Health, Temple University, Philadelphia, United States; Department of Pediatrics, School of Medicine, Temple University, Philadelphia, United States.
authors: Bradley N
authors: BN
authors: Collins
authors: College of Public Health, Temple University, Philadelphia, United States; Department of Kinesiology, College of Public Health, Temple University, Philadelphia, United States.
authors: Freda
authors: F
authors: Patterson
authors: Urban Public Health and Nutrition, School of Nursing and Health Sciences, La Salle University, Philadelphia, United States.
authors: Daniel
authors: D
authors: Rodriguez
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American; D003376:Counseling; D015444:Exercise; D005260:Female; D015438:Health Behavior; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation; D011203:Poverty; D012107:Research Design; D012309:Risk-Taking; D057185:Sedentary Behavior; D020377:Self Efficacy; D016540:Smoking Cessation / Q000208:ethnology* / Q000379:methods*; D016138:Walking; D055815:Young Adult
keywords: Cue reactivity; Health disparities; Multiple health behavior change; Physical activity; Smoking; Study protocol