title: A mixed-method study of the efficacy of physical activity consultation as an adjunct to standard smoking cessation treatment among male smokers in Malaysia.
abstract: BACKGROUND
  This study examined the effectiveness of using Physical Activity Consultation (PAC) as an addition to the standard smoking cessation treatment in Malaysia. We explored participants' experiences in terms of physical activity and smoking abstinence with the combined PAC and smoking cessation intervention.
  
  
  METHODS
  Walk-in smokers from a local smoking cessation clinic volunteered for the 8-week intervention program, while undergoing standard smoking cessation treatment. In Week 1, a facilitator conducted a face-to-face intervention to explore participants' involvement in physical activity and helped to set physical activity strategies and goals for participants to increase physical activity levels. Participants were provided with follow-up phone calls at Weeks 3 and 6. Participants answered questionnaires that measured smoking withdrawal (Shiffman-Jarvik Withdrawal Scale), cessation self-efficacy (Cessation Self-efficacy Questionnaire), physical activity involvement (International Physical Activity Questionnaire), and mood (Brunel Mood Scale) upon recruitment, at post-intervention and at follow-up 3 months after the intervention ended. Participants also responded to interviews about their experiences with the PAC and smoking cessation treatment at post-intervention and at 3-month follow-up.
  
  
  RESULTS
  Seven participants completed the program until follow-up. All were successfully abstinent. Only two participants increased physical activity levels, whereas others maintained their physical activity levels or showed slight decreases. Several themes were identified in this study, including participants' experiences with withdrawal symptoms, smoking cessation self-efficacy, triggers to smoking cessation, thoughts on standard smoking cessation treatment in Malaysia, physical activity involvement, mood, and thoughts and beliefs on combining smoking cessation and physical activity.
  
  
  CONCLUSIONS
  This study suggests PAC was helpful in maintaining or increasing the overall physical activity levels of participants and could assist with smoking abstinence. Findings showed that all participants who stayed in the program were successfully abstinent. In general, the findings in this study provided promising results for further research on PAC as an adjunct to smoking cessation treatments in Malaysia.Trial registrationThis intervention is registered with the Australian New Zealand Clinical Trials Registry (Trial registration number: ACTRN12616000269437).
authors.affiliation: Sports Centre, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Yuin Yi
authors.initials: YY
authors.lastname: Lee
authors.affiliation: Sports Centre, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Selina
authors.identifier: 0000-0002-3090-9309
authors.initials: S
authors.lastname: Khoo
authors.affiliation: Institute of Sport, Exercise and Active Living (ISEAL), College of Sport and Exercise Science, Victoria University, Melbourne, Australia.
authors.forename: Tony
authors.initials: T
authors.lastname: Morris
authors.affiliation: Institute of Sport, Exercise and Active Living (ISEAL), College of Sport and Exercise Science, Victoria University, Melbourne, Australia.
authors.forename: Clare
authors.initials: C
authors.lastname: Hanlon
authors.affiliation: Faculty of Health Sciences, National University of Malaysia, Kuala Lumpur, Malaysia.
authors.forename: Lei-Hum
authors.initials: LH
authors.lastname: Wee
authors.affiliation: Sports Centre, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Eng Wah
authors.initials: EW
authors.lastname: Teo
authors.affiliation: Sports Centre, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Yuhanis
authors.initials: Y
authors.lastname: Adnan
keywords: Behavioral treatment; Case study; Motivational interviewing; Smoking intervention; Tobacco use