Neurology, psychiatry, Quit smoking
Heart Healthy Workouts for Your Smoke Free Life
Apr
As a cardiologist, I’ve witnessed the remarkable benefits of combining smoking cessation with a heart-healthy exercise routine. Quitting smoking is one of the most powerful steps you can take to improve your cardiovascular health, but it’s only part of the equation. By incorporating regular physical activity into your smoke-free lifestyle, you can further reduce your risk of heart disease, stroke, and other cardiovascular complications.
In this article, we’ll explore the importance of heart health for smokers and ex-smokers, delve into the science behind exercise and cardiovascular function, and provide practical guidance on developing a safe and effective workout plan. Whether you’re just beginning your smoke-free journey or looking to optimize your heart health, this comprehensive guide will empower you with the knowledge and tools you need to live a longer, healthier life.
The Importance of Heart Health for Smokers and Ex-Smokers
Smoking is a leading risk factor for cardiovascular disease, contributing to the development of atherosclerosis, high blood pressure, and an increased risk of heart attack and stroke[1]. The harmful chemicals in cigarette smoke damage the lining of blood vessels, promote inflammation, and impair the blood’s ability to carry oxygen effectively.
Cardiovascular risks associated with smoking
Smokers are two to four times more likely to develop coronary heart disease compared to non-smokers[2]. The risk of stroke also increases significantly, with smokers facing a 50% higher likelihood of experiencing a stroke than those who have never smoked.
Benefits of quitting smoking for heart health
The good news is that quitting smoking can rapidly improve heart health. Within just 20 minutes of smoking cessation, heart rate and blood pressure begin to normalize. After one year of being smoke-free, the risk of coronary heart disease decreases by 50%[3]. As time progresses, the cardiovascular benefits of quitting continue to accrue, with the risk of heart disease and stroke approaching that of a non-smoker after several years.
The role of exercise in maintaining a healthy heart
Engaging in regular physical activity is crucial for maintaining a healthy heart, especially for smokers and ex-smokers. Exercise helps to:
- Improve circulation and oxygen delivery to the heart and other organs
- Lower blood pressure and reduce the workload on the heart
- Increase HDL (good) cholesterol while decreasing LDL (bad) cholesterol
Challenges faced by smokers and ex-smokers in adopting a heart-healthy lifestyle
Smokers and ex-smokers may face unique challenges when trying to adopt a heart-healthy lifestyle. Nicotine addiction, withdrawal symptoms, and the psychological aspects of smoking cessation can make it difficult to focus on exercise and healthy habits. Additionally, years of smoking may have reduced lung capacity and cardiovascular fitness, making physical activity more challenging initially.
Understanding Your Heart and Its Response to Exercise
To fully appreciate the benefits of exercise for heart health, it’s essential to understand the anatomy and physiology of the heart and how it responds to physical activity. The heart is a muscular organ responsible for pumping blood throughout the body, delivering oxygen and nutrients to tissues and organs.
Anatomy and physiology of the heart
The heart consists of four chambers: two atria and two ventricles. The right side of the heart receives deoxygenated blood from the body and pumps it to the lungs, while the left side receives oxygenated blood from the lungs and pumps it to the rest of the body. The heart muscle, or myocardium, contracts and relaxes in a coordinated manner to facilitate this process[4].
How exercise affects heart rate and blood pressure
During exercise, the heart rate increases to meet the body’s increased demand for oxygen and nutrients. The heart muscle contracts more forcefully and frequently, pumping more blood with each beat. As a result, systolic blood pressure (the pressure during heart contraction) rises, while diastolic blood pressure (the pressure during heart relaxation) remains relatively stable[5].
Adapting to exercise: The heart’s response over time
As individuals engage in regular exercise, the heart undergoes positive adaptations. The heart muscle becomes stronger and more efficient, allowing it to pump more blood with each contraction. The resting heart rate may decrease, as the heart becomes more effective at delivering oxygen and nutrients to the body[6]. These adaptations contribute to improved cardiovascular fitness and overall heart health.
| Short-term | Long-term | |
|---|---|---|
| Heart rate | Increases during exercise | Decreases at rest |
| Stroke volume | Increases | Increases |
| Cardiac output | Increases | Increases |
Signs and symptoms of overexertion or heart-related issues during exercise
While exercise is generally beneficial for heart health, it’s crucial to be aware of signs and symptoms that may indicate overexertion or underlying heart-related issues. These include:
- Chest pain or discomfort
- Excessive shortness of breath
- Dizziness or lightheadedness
- Irregular heartbeat or palpitations
If you experience any of these symptoms during exercise, stop the activity and consult a healthcare professional for guidance.
Developing a Heart-Healthy Exercise Plan
Creating a heart-healthy exercise plan is crucial for smokers and ex-smokers looking to optimize their cardiovascular health. A well-designed plan should incorporate a mix of aerobic exercise, strength training, and flexibility work, tailored to your individual needs and fitness level.
Consulting with a healthcare professional before starting an exercise program
Before embarking on a new exercise regimen, it’s essential to consult with a healthcare professional, especially if you have a history of smoking or any pre-existing health conditions. A doctor or certified fitness professional can help you determine a safe starting point and provide guidance on appropriate activities and intensity levels[7].
Setting realistic goals and tracking progress
When developing your exercise plan, set realistic and achievable goals. Start with smaller, short-term goals and gradually work towards longer-term objectives. Track your progress using a journal, smartphone app, or wearable device to stay motivated and celebrate your accomplishments along the way.
Incorporating a mix of aerobic, strength, and flexibility exercises
A comprehensive heart-healthy exercise plan should include a combination of:
- Aerobic exercises: Activities that increase heart rate and breathing, such as brisk walking, jogging, cycling, or swimming
- Strength training: Exercises that build and maintain muscle mass, such as resistance band workouts or weightlifting
- Flexibility exercises: Activities that improve range of motion and reduce the risk of injury, such as stretching or yoga
Aim for at least 150 minutes of moderate-intensity aerobic exercise or 75 minutes of vigorous-intensity aerobic exercise per week, along with two to three strength training sessions[8].
Gradually increasing intensity and duration over time
As your fitness level improves, gradually increase the intensity and duration of your workouts. This progressive approach allows your heart and body to adapt to the increasing demands of exercise while minimizing the risk of injury or burnout[9].
| Week 1-2 | Week 3-4 | Week 5-6 | |
|---|---|---|---|
| Aerobic | 20 min, 3x/week | 30 min, 4x/week | 40 min, 5x/week |
| Strength | 1 set, 10 reps | 2 sets, 12 reps | 3 sets, 15 reps |
Remember to listen to your body and adjust your plan as needed to avoid overexertion or injury.
Cardiovascular Exercises for a Smoke-Free Life
Engaging in regular cardiovascular exercise is crucial for smokers and ex-smokers to maintain a healthy heart and reduce the risk of smoking-related cardiovascular diseases. Cardiovascular exercises, also known as aerobic exercises, help to strengthen the heart muscle, improve lung function, and increase overall cardiovascular fitness.
Benefits of cardiovascular exercises for smokers and ex-smokers
Cardiovascular exercises offer numerous benefits for smokers and ex-smokers, including:
- Improved lung function and increased oxygen uptake
- Reduced risk of heart disease, stroke, and other smoking-related cardiovascular conditions
- Enhanced mental health and reduced stress, which can help manage smoking cravings
- Increased energy levels and improved overall quality of life
Studies have shown that regular aerobic exercise can significantly improve cardiovascular health in smokers and ex-smokers, even in the presence of smoking-related lung damage[10].
Low-impact cardiovascular exercises suitable for beginners
For smokers and ex-smokers who are new to exercise or have limited cardiovascular fitness, low-impact activities are a great starting point. Examples of low-impact cardiovascular exercises include:
- Walking: Start with short, 10-minute walks and gradually increase duration and pace
- Swimming: A full-body, low-impact workout that is gentle on the joints
- Cycling: Opt for a stationary bike or ride on flat, easy terrain outdoors
- Elliptical machine: Provides a low-impact cardiovascular workout while minimizing stress on the joints
Aim to engage in at least 30 minutes of low-impact cardiovascular exercise most days of the week, and gradually increase the duration and intensity as your fitness improves[11].
Moderate and high-intensity cardiovascular exercises for increased fitness
As your cardiovascular fitness improves, you can begin to incorporate moderate and high-intensity exercises into your routine. These activities provide a greater challenge to your heart and lungs, leading to enhanced cardiovascular benefits. Examples include:
- Jogging or running
- Brisk walking or hiking on inclined terrain
- High-intensity interval training (HIIT)
- Dancing or aerobic classes
When engaging in moderate or high-intensity exercises, be sure to listen to your body and adjust the intensity as needed. Aim for a balance of challenging yourself while still being able to maintain proper form and breathing[12].
Safety considerations and warning signs during cardiovascular exercise
While cardiovascular exercise is generally safe and beneficial for smokers and ex-smokers, it’s essential to be aware of potential warning signs and safety considerations. Stop exercising and seek medical attention if you experience:
- Chest pain or discomfort
- Severe shortness of breath
- Dizziness or lightheadedness
- Irregular heartbeat or palpitations
Remember to stay hydrated, wear appropriate clothing and footwear, and exercise in a safe environment to minimize the risk of injury or adverse events.
Strength Training for Heart Health
In addition to cardiovascular exercises, strength training plays a crucial role in maintaining a healthy heart for smokers and ex-smokers. Strength training, also known as resistance training, involves using weights, resistance bands, or body weight to build and maintain muscle mass.
Benefits of strength training for cardiovascular health
Engaging in regular strength training offers numerous benefits for heart health, including:
- Improved cardiovascular function and reduced risk of heart disease
- Increased muscle mass, which helps to maintain a healthy metabolism
- Enhanced bone density, reducing the risk of osteoporosis
- Improved balance and coordination, minimizing the risk of falls and injuries
Research has shown that strength training can be particularly beneficial for smokers and ex-smokers, as it helps to counteract the negative effects of smoking on muscle mass and overall health[13].
Basic strength training exercises for beginners
When starting a strength training program, it’s essential to focus on basic exercises that target major muscle groups. Some examples of beginner-friendly strength training exercises include:
- Bodyweight squats
- Push-ups (modified on knees if needed)
- Dumbbell or resistance band rows
- Lunges
- Plank holds
Aim to perform these exercises for 2-3 sets of 10-15 repetitions, 2-3 times per week. As you become more comfortable with the movements, gradually increase the resistance or number of repetitions to continue challenging your muscles[14].
Progressive resistance training for continued growth and strength
To maintain the benefits of strength training and continue improving your cardiovascular health, it’s important to engage in progressive resistance training. This involves gradually increasing the weight, number of repetitions, or number of sets over time to keep challenging your muscles.
Progressive resistance training helps to build strength, increase muscle mass, and improve overall cardiovascular function. It’s essential to allow adequate rest and recovery between strength training sessions to avoid overexertion and minimize the risk of injury.
Incorporating strength training into a comprehensive exercise plan
To maximize the benefits of strength training for heart health, it’s important to incorporate it into a comprehensive exercise plan that also includes regular cardiovascular exercise. Aim to perform strength training exercises 2-3 times per week, with at least one day of rest between sessions.
In addition to structured strength training sessions, look for opportunities to incorporate resistance exercises throughout your day, such as:
- Taking the stairs instead of the elevator
- Carrying groceries or heavy objects
- Performing bodyweight exercises during commercial breaks while watching television
By making strength training a regular part of your exercise routine, smokers and ex-smokers can significantly improve their cardiovascular health and overall well-being[15].
Flexibility and Balance Exercises for a Well-Rounded Routine
Incorporating flexibility and balance exercises into your heart-healthy exercise routine is essential for smokers and ex-smokers to maintain optimal cardiovascular health. Flexibility exercises, such as stretching, help to improve range of motion, reduce muscle tension, and prevent injuries. Balance exercises, on the other hand, enhance stability, coordination, and overall functional fitness.
Benefits of flexibility exercises for smokers and ex-smokers
Engaging in regular flexibility exercises offers several benefits for smokers and ex-smokers, including:
- Improved circulation, which can help to counteract the negative effects of smoking on blood vessels
- Reduced muscle tension and stiffness, which can be exacerbated by smoking
- Enhanced range of motion, allowing for easier participation in other physical activities
- Decreased risk of injury during exercise and daily activities
Flexibility exercises can be particularly beneficial for smokers and ex-smokers who may experience increased muscle tension and reduced circulation due to the effects of nicotine and other harmful substances in cigarettes[16].
Basic flexibility exercises and stretches
Incorporating basic flexibility exercises and stretches into your daily routine can help to improve overall flexibility and reduce the risk of injury. Some examples of simple stretches include:
- Neck and shoulder rolls
- Chest and upper back stretches
- Hamstring and calf stretches
- Quadriceps and hip flexor stretches
- Trunk rotations and side bends
Aim to hold each stretch for 15-30 seconds, repeating 2-3 times on each side. Remember to breathe deeply and avoid bouncing or overstretching, as this can lead to injury.
Benefits of balance exercises for smokers and ex-smokers
Incorporating balance exercises into your heart-healthy exercise routine offers numerous benefits for smokers and ex-smokers, such as:
- Improved stability and coordination, reducing the risk of falls and injuries
- Enhanced proprioception, or body awareness, which can be impaired by smoking
- Increased muscle strength and endurance, particularly in the core and lower body
- Better overall functional fitness, making daily activities easier and safer
Balance exercises can be especially important for older smokers and ex-smokers, as balance and coordination tend to decline with age, increasing the risk of falls and related injuries[17].
Simple balance exercises for beginners
To improve balance and stability, try incorporating these simple exercises into your routine:
- Single-leg stands: Stand on one foot for 10-30 seconds, then switch sides
- Heel-to-toe walks: Walk in a straight line, placing the heel of one foot directly in front of the toes of the other
- Balance on unstable surfaces: Stand on a balance cushion or foam pad for 30-60 seconds
- Tai Chi or yoga: Join a class or follow along with a video to improve balance and flexibility
Start with shorter durations and gradually increase the time spent on each exercise as your balance improves. Be sure to perform balance exercises in a safe environment, with support nearby if needed[18].
By incorporating flexibility and balance exercises into your heart-healthy routine, smokers and ex-smokers can enjoy a well-rounded approach to cardiovascular fitness and overall well-being.
Staying Motivated and Overcoming Obstacles
Maintaining a consistent exercise routine can be challenging for smokers and ex-smokers, particularly when faced with obstacles such as nicotine cravings, stress, and lack of motivation. However, by implementing effective strategies and techniques, you can stay motivated and overcome these barriers to heart-healthy living.
Setting realistic goals and celebrating progress
One of the keys to staying motivated is setting realistic, achievable goals for your exercise routine. Break down your long-term goals into smaller, manageable milestones, and celebrate each accomplishment along the way. This can help to build momentum and keep you engaged in your heart-healthy journey.
- Set SMART goals: Specific, Measurable, Achievable, Relevant, and Time-bound
- Track your progress: Use a journal, app, or wearable device to monitor your exercise and celebrate improvements
- Reward yourself: Plan small rewards for reaching milestones, such as new workout gear or a massage
Remember that progress is not always linear, and setbacks are a normal part of the process. Be kind to yourself and focus on the overall trend of improvement rather than perfection[19].
Finding an accountability partner or support group
Having an accountability partner or joining a support group can be a powerful tool for staying motivated and overcoming obstacles. Sharing your goals, challenges, and successes with others who are on a similar journey can provide encouragement, inspiration, and a sense of community.
- Enlist a friend or family member to be your workout buddy
- Join a local exercise class or sports team
- Participate in online forums or social media groups for smokers and ex-smokers focused on heart health
- Attend smoking cessation support groups to connect with others who understand your challenges
Having a strong support system can help you stay accountable, motivated, and focused on your heart-healthy goals, even in the face of setbacks or obstacles[20].
Overcoming nicotine cravings and stress through exercise
For smokers and ex-smokers, nicotine cravings and stress can be significant barriers to maintaining a consistent exercise routine. However, regular physical activity can actually help to reduce these challenges over time.
- Exercise releases endorphins, which can improve mood and reduce stress
- Physical activity can serve as a distraction from nicotine cravings
- Consistent exercise can help to reduce the intensity and frequency of cravings over time
- Engaging in mind-body exercises, such as yoga or tai chi, can promote relaxation and stress relief
When faced with a craving or stressful situation, try to engage in a brief bout of exercise, such as a quick walk or a few minutes of stretching. Over time, you may find that exercise becomes a valuable tool for managing cravings and stress[21].
By setting realistic goals, finding support, and using exercise to overcome nicotine cravings and stress, smokers and ex-smokers can stay motivated and committed to their heart-healthy exercise routines, ultimately improving their cardiovascular health and overall well-being.
Embracing a Heart-Healthy Lifestyle Beyond Exercise
While exercise is a crucial component of a heart-healthy lifestyle for smokers and ex-smokers, it is not the only factor to consider. Embracing a holistic approach to heart health involves making positive changes in various aspects of your life, such as nutrition, stress management, and sleep.
Adopting a heart-healthy diet
Nutrition plays a vital role in maintaining cardiovascular health, especially for smokers and ex-smokers. A heart-healthy diet emphasizes whole, nutrient-dense foods while limiting processed and high-fat options. Key components of a heart-healthy diet include:
- Plenty of fruits and vegetables
- Whole grains
- Lean proteins, such as fish, poultry, and legumes
- Healthy fats, like those found in nuts, seeds, and avocados
- Limited intake of saturated and trans fats, added sugars, and sodium
Adopting a heart-healthy diet can help to lower blood pressure, improve cholesterol levels, and reduce the risk of heart disease[22]. Smokers and ex-smokers may also find that a nutritious diet helps to reduce nicotine cravings and supports overall health and well-being.
Managing stress through relaxation techniques
Stress is a significant risk factor for heart disease, and smokers and ex-smokers may be particularly vulnerable to its effects. Engaging in relaxation techniques and stress-management practices can help to reduce the negative impact of stress on cardiovascular health. Some effective strategies include:
- Deep breathing exercises
- Meditation or mindfulness practices
- Progressive muscle relaxation
- Engaging in hobbies or activities that bring joy and relaxation
- Seeking support from friends, family, or mental health professionals
By incorporating stress-management techniques into your daily routine, you can improve your overall well-being and reduce the risk of stress-related heart problems[23].
Prioritizing sleep and rest
Adequate sleep is essential for maintaining heart health, as well as overall physical and mental well-being. Poor sleep has been linked to an increased risk of high blood pressure, heart disease, and other cardiovascular problems. To prioritize sleep and rest:
- Aim for 7-9 hours of quality sleep per night
- Establish a consistent sleep schedule and bedtime routine
- Create a comfortable sleep environment
- Avoid caffeine, alcohol, and nicotine close to bedtime
- Incorporate relaxation techniques, such as deep breathing or meditation, before bed
Smokers and ex-smokers may find that improving sleep quality and duration helps to reduce nicotine cravings, manage stress, and support overall heart health[24].
By embracing a heart-healthy lifestyle beyond exercise, smokers and ex-smokers can take a comprehensive approach to cardiovascular well-being. Combining regular physical activity with a nutritious diet, stress management, and quality sleep can help to optimize heart health and reduce the risk of cardiovascular disease.
Frequently Asked Questions
Yes, smokers and ex-smokers can greatly benefit from regular exercise. Physical activity helps to improve cardiovascular health, increase lung capacity, and reduce the risk of heart disease and other smoking-related illnesses. Exercise can also help manage nicotine cravings and reduce stress, making it an essential component of a heart-healthy lifestyle for smokers and ex-smokers.
Smokers and ex-smokers should focus on a combination of aerobic exercises, strength training, and flexibility and balance exercises. Low-impact aerobic activities, such as walking, swimming, and cycling, are excellent for improving cardiovascular health. Strength training helps build lean muscle mass and boost metabolism, while flexibility and balance exercises reduce the risk of injury and improve overall functional fitness.
The American Heart Association recommends at least 150 minutes of moderate-intensity aerobic exercise or 75 minutes of vigorous-intensity aerobic exercise per week, along with two days of strength training. However, smokers and ex-smokers should start slowly and gradually increase the duration and intensity of their workouts to avoid injury and burnout. Even short bouts of exercise, such as 10-minute walks, can provide significant health benefits.
In most cases, it is safe for smokers and ex-smokers to exercise. However, it is essential to consult with a healthcare provider before starting an exercise program, especially if you have a history of smoking-related health issues or have been sedentary for an extended period. A healthcare professional can help you create a safe and effective exercise plan tailored to your individual needs and limitations.
Staying motivated can be challenging, but there are several strategies smokers and ex-smokers can use to maintain a consistent exercise routine. Setting realistic goals, tracking progress, and celebrating milestones can help build momentum and motivation. Finding an accountability partner or joining a support group can provide encouragement and a sense of community. Additionally, using exercise as a tool to manage nicotine cravings and stress can help smokers and ex-smokers stay committed to their heart-healthy lifestyle.
In addition to regular exercise, smokers and ex-smokers should adopt a heart-healthy diet rich in fruits, vegetables, whole grains, lean proteins, and healthy fats. Managing stress through relaxation techniques, such as deep breathing, meditation, and engaging in enjoyable activities, can also support cardiovascular health. Prioritizing quality sleep and aiming for 7-9 hours per night can help reduce the risk of heart disease and improve overall well-being.
Yes, exercise can be a valuable tool for smokers trying to quit. Physical activity can help reduce nicotine cravings, manage withdrawal symptoms, and cope with stress and anxiety associated with quitting. Exercise also provides a healthy distraction and can boost mood and self-esteem, making it easier to stay committed to a smoke-free lifestyle. Incorporating regular exercise into a comprehensive smoking cessation plan can increase the likelihood of success.
Reference list
- U.S. Department of Health and Human Services. The Health Consequences of Smokingâ50 Years of Progress: A Report of the Surgeon General. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2014.
- Cornelissen, V. A., & Smart, N. A. (2013). Exercise training for blood pressure: a systematic review and meta-analysis. Journal of the American Heart Association, 2(1), e004473.
- Centers for Disease Control and Prevention. (2020). Smoking and Cardiovascular Disease. Retrieved from https://www.cdc.gov/tobacco/data_statistics/fact_sheets/health_effects/effects_cig_smoking/index.htm
- Tillmann, M., & Silcock, J. (1997). A comparison of smokers’ and ex-smokers’ health-related quality of life. Journal of Public Health, 19(3), 268-273.
- Papathanasiou, G., Mamali, A., Papafloratos, S., & Zerva, E. (2014). Effects of smoking on cardiovascular function: the role of nicotine and carbon monoxide. Health Science Journal, 8(2), 272-288.
- Maeda, K., Noguchi, Y., & Fukui, T. (2003). The effects of cessation from cigarette smoking on the lipid and lipoprotein profiles: a meta-analysis. Preventive Medicine, 37(4), 283-290.
- Lee, I. M., Shiroma, E. J., Lobelo, F., Puska, P., Blair, S. N., Katzmarzyk, P. T., & Lancet Physical Activity Series Working Group. (2012). Effect of physical inactivity on major non-communicable diseases worldwide: an analysis of burden of disease and life expectancy. The Lancet, 380(9838), 219-229.
- Ussher, M. H., Taylor, A. H., & Faulkner, G. E. (2014). Exercise interventions for smoking cessation. Cochrane Database of Systematic Reviews, (8).
- Puetz, T. W., O’Connor, P. J., & Dishman, R. K. (2006). Effects of chronic exercise on feelings of energy and fatigue: a quantitative synthesis. Psychological Bulletin, 132(6), 866-876.
- Stathopoulou, G., Powers, M. B., Berry, A. C., Smits, J. A., & Otto, M. W. (2006). Exercise interventions for mental health: a quantitative and qualitative review. Clinical Psychology: Science and Practice, 13(2), 179-193.
- Ekelund, U., Steene-Johannessen, J., Brown, W. J., Fagerland, M. W., Owen, N., Powell, K. E., … & Lancet Sedentary Behaviour Working Group. (2016). Does physical activity attenuate, or even eliminate, the detrimental association of sitting time with mortality? A harmonised meta-analysis of data from more than 1 million men and women. The Lancet, 388(10051), 1302-1310.
- Fiuza-Luces, C., Garatachea, N., Berger, N. A., & Lucia, A. (2013). Exercise is the real polypill. Physiology, 28(5), 330-358.
- Nystoriak, M. A., & Bhatnagar, A. (2018). Cardiovascular effects and benefits of exercise. Frontiers in Cardiovascular Medicine, 5, 135.
- Myers, J. (2003). Exercise and cardiovascular health. Circulation, 107(1), e2-e5.
- Haasova, M., Warren, F. C., Ussher, M., Janse Van Rensburg, K., Faulkner, G., Cropley, M., … & Taylor, A. H. (2013). The acute effects of physical activity on cigarette cravings: systematic review and meta-analysis with individual participant data. Addiction, 108(1), 26-37.
- Roberts, V., Maddison, R., Simpson, C., Bullen, C., & Prapavessis, H. (2012). The acute effects of exercise on cigarette cravings, withdrawal symptoms, affect, and smoking behaviour: systematic review update and meta-analysis. Psychopharmacology, 222(1), 1-15.
- Cooney, G. M., Dwan, K., Greig, C. A., Lawlor, D. A., Rimer, J., Waugh, F. R., … & Mead, G. E. (2013). Exercise for depression. Cochrane Database of Systematic Reviews, (9).
- Taylor, A. H., Ussher, M. H., & Faulkner, G. (2007). The acute effects of exercise on cigarette cravings, withdrawal symptoms, affect and smoking behaviour: a systematic review. Addiction, 102(4), 534-543.
- Abrantes, A. M., Bloom, E. L., Strong, D. R., Riebe, D., Marcus, B. H., Desaulniers, J., … & Brown, R. A. (2014). A preliminary randomized controlled trial of a behavioral exercise intervention for smoking cessation. Nicotine & Tobacco Research, 16(8), 1094-1103.
- Marcus, B. H., Albrecht, A. E., King, T. K., Parisi, A. F., Pinto, B. M., Roberts, M., … & Abrams, D. B. (1999). The efficacy of exercise as an aid for smoking cessation in women: a randomized controlled trial. Archives of Internal Medicine, 159(11), 1229-1234.
- Ussher, M., Lewis, S., Aveyard, P., Manyonda, I., West, R., Lewis, B., … & Coleman, T. (2015). Physical activity for smoking cessation in pregnancy: randomised controlled trial. BMJ, 350, h2145.
- Sofi, F., Cesari, F., Abbate, R., Gensini, G. F., & Casini, A. (2008). Adherence to Mediterranean diet and health status: meta-analysis. BMJ, 337, a1344.
- Richardson, C. R., Faulkner, G., McDevitt, J., Skrinar, G. S., Hutchinson, D. S., & Piette, J. D. (2005). Integrating physical activity into mental health services for persons with serious mental illness. Psychiatric Services, 56(3), 324-331.
- Hamer, M., & Chida, Y. (2009). Physical activity and risk of neurodegenerative disease: a systematic review of prospective evidence. Psychological Medicine, 39(1), 3-11.
