Handgrip and isometric exercise intervention for smoking cessation: a feasibility and pilot randomized trial

Abstract

Background and Objectives: Isometric exercises reduce craving, negative affect, and withdrawal symptoms during smoking cessation. This pilot randomized trial was the first to test if a simple intervention using a handgrip and isometric exercises was efficacious and feasible. Methods: Participants were smokers who consumed 10 or more cigarettes a day and were seeking cessation services in community-based cessation clinics. The exercise group watched a 5-minute video on exercises to relieve craving, received a free handgrip, and installed a smartphone app providing exercise reminders. The healthy-diet group (control) received a similar dosage of intervention on diet (low salt, oil, and sugar). The primary outcome was self-reported abstinence in the previous 4 weeks at 6-month follow-up. Post-intervention satisfaction and exercise adherence were also assessed. Results: The exercise group (n = 108) showed significantly higher ratings on interest, understanding, perception that the exercise helps quitting, confidence, and plan to adhere to the intervention (do the exercises, in general and when craving) than the healthy-diet group (n = 100). No significant difference in quit rate (primary outcome) was found between groups (34% vs. 39%, OR = 0.80, p = 0.40). A posteriori analysis showed that self-reported adherence to doing the exercises when craving (49% vs. 26%, OR = 2.69, 1.18–-6.15, p = 0.02) and total adherence (including doing the exercises when craving, once a day, and for 2 weeks) (53% vs. 23%, OR = 3.70, 1.15–-11.92, p = 0.03) were significantly associated with greater abstinence. Conclusions: Simple handgrip and isometric exercises were feasible, but showed low adherence. Preliminary evidence of efficacy was observed when these exercises were done when craving.