title: An Exploratory Analysis of the Smoking and Physical Activity Outcomes From a Pilot Randomized Controlled Trial of an Exercise Assisted Reduction to Stop Smoking Intervention in Disadvantaged Groups.
abstract: BACKGROUND
  Economically disadvantaged smokers not intending to stop may benefit from interventions aimed at reducing their smoking. This study assessed the effects of a behavioral intervention promoting an increase in physical activity versus usual care in a pilot randomized controlled trial.
  
  
  METHODS
  Disadvantaged smokers who wanted to reduce but not quit were randomized to either a counseling intervention of up to 12 weeks to support smoking reduction and increased physical activity (n = 49) or usual care (n = 50). Data at 16 weeks were collected for various smoking and physical activity outcomes. Primary analyses consisted of an intention to treat analysis based on complete case data. Secondary analyses explored the impact of handling missing data.
  
  
  RESULTS
  Compared with controls, intervention smokers were more likely to initiate a quit attempt (36 vs. 10%; odds ratio 5.05, [95% CI: 1.10; 23.15]), and a greater proportion achieved at least 50% reduction in cigarettes smoked (63 vs. 32%; 4.21 [1.32; 13.39]). Postquit abstinence measured by exhaled carbon monoxide at 4-week follow-up showed promising differences between groups (23% vs. 6%; 4.91 [0.80; 30.24]). No benefit of intervention on physical activity was found. Secondary analyses suggested that the standard missing data assumption of "missing" being equivalent to "smoking" may be conservative resulting in a reduced intervention effect.
  
  
  CONCLUSIONS
  A smoking reduction intervention for economically disadvantaged smokers which involved personal support to increase physical activity appears to be more effective than usual care in achieving reduction and may promote cessation. The effect does not appear to be influenced by an increase in physical activity.
authors.affiliation: Centre for Clinical Trials and Population Studies, Plymouth University Peninsula School of Medicine and Dentistry, Plymouth, United Kingdom; tom.thompson@plymouth.ac.uk.
authors.forename: Tom Paul
authors.initials: TP
authors.lastname: Thompson
authors.affiliation: University of Exeter Medical School, Exeter, United Kingdom;
authors.forename: Colin J
authors.initials: CJ
authors.lastname: Greaves
authors.affiliation: Centre for Clinical Trials and Population Studies, Plymouth University Peninsula School of Medicine and Dentistry, Plymouth, United Kingdom;
authors.forename: Richard
authors.initials: R
authors.lastname: Ayres
authors.affiliation: Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom;
authors.forename: Paul
authors.initials: P
authors.lastname: Aveyard
authors.affiliation: University of Exeter Medical School, Exeter, United Kingdom;
authors.forename: Fiona C
authors.initials: FC
authors.lastname: Warren
authors.affiliation: Centre for Clinical Trials and Population Studies, Plymouth University Peninsula School of Medicine and Dentistry, Plymouth, United Kingdom;
authors.forename: Richard
authors.initials: R
authors.lastname: Byng
authors.affiliation: University of Exeter Medical School, Exeter, United Kingdom;
authors.forename: Rod S
authors.initials: RS
authors.lastname: Taylor
authors.affiliation: University of Exeter Medical School, Exeter, United Kingdom;
authors.forename: John L
authors.initials: JL
authors.lastname: Campbell
authors.affiliation: Population Health Research Institute, St George's University of London, London, United Kingdom;
authors.forename: Michael
authors.initials: M
authors.lastname: Ussher
authors.affiliation: University of Exeter Medical School, Exeter, United Kingdom;
authors.forename: Colin
authors.initials: C
authors.lastname: Green
authors.affiliation: Research Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom;
authors.forename: Susan
authors.initials: S
authors.lastname: Michie
authors.affiliation: Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, London, United Kingdom.
authors.forename: Robert
authors.initials: R
authors.lastname: West
authors.affiliation: Centre for Clinical Trials and Population Studies, Plymouth University Peninsula School of Medicine and Dentistry, Plymouth, United Kingdom;
authors.forename: Adrian
authors.initials: A
authors.lastname: Taylor
mesh_terms: D000328:Adult; D001521:Behavior Therapy / Q000379:methods; D003376:Counseling / Q000379:methods; D015444:Exercise / Q000502:physiology / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009043:Motor Activity / Q000502:physiology*; D010865:Pilot Projects; D012907:Smoking / Q000453:epidemiology / Q000523:psychology / Q000628:therapy*; D016540:Smoking Cessation / Q000379:methods* / Q000523:psychology; D016896:Treatment Outcome; D035862:Vulnerable Populations / Q000523:psychology