Yoga as a complementary treatment for smoking cessation: Rationale, study design and participant characteristics of the Quitting-in-Balance study

Centers for Behavioral and Preventive Medicine, Alpert School of Medicine at Brown University, The Miriam Hospital, Providence, RI 02903, USA.
BMC Complementary and Alternative Medicine (Impact Factor: 2.02). 04/2010; 10(1):14. DOI: 10.1186/1472-6882-10-14
Source: PubMed


Tobacco smoking remains the leading preventable cause of death among American women. Exercise has shown promise as an aid to smoking cessation because it reduces weight gain and weight concerns, improves affect, and reduces nicotine withdrawal symptoms and cigarette craving. Studies have shown that the practice of yoga improves weight control, and reduces perceived stress and negative affect. Yoga practice also includes regulation of breathing and focused attention, both of which may enhance stress reduction and improve mood and well-being and may improve cessation outcomes.
This pilot efficacy study is designed to examine the rates of cessation among women randomized to either a novel, 8-week Yoga plus Cognitive Behavioral Therapy (CBT) smoking cessation intervention versus a Wellness program plus the same CBT smoking cessation intervention. Outcome measures include 7-day point prevalence abstinence at end of treatment, 3 and 6 months follow up and potential mediating variables (e.g., confidence in quitting smoking, self-efficacy). Other assessments include measures of mindfulness, spirituality, depressive symptoms, anxiety and perceived health (SF-36).
Innovative treatments are needed that address barriers to successful smoking cessation among men and women. The design chosen for this study will allow us to explore potential mediators of intervention efficacy so that we may better understand the mechanism(s) by which yoga may act as an effective complementary treatment for smoking cessation. If shown to be effective, yoga can offer an alternative to traditional exercise for reducing negative symptoms that often accompany smoking cessation and predict relapse to smoking among recent quitters.
ClinicalTrials NCT00492310.

Download full-text


Available from: Beth C Bock,
39 Reads
  • Source
    • "In two studies, participants followed an audio guide which instructed participants to focus on their breathing by concentrating attention on the abdominal area which resulted in acute reductions in cravings and tobacco withdrawal symptoms (Cropley et al. 2007;Ussher et al. 2009). Indeed, yoga -a philosophical and cultural system of physical and mental practice that seeks to achieve a very high level of control -has been suggested as complementary treatment for smoking cessation (Bock et al. 2010). "
    [Show abstract] [Hide abstract]
    ABSTRACT: RATIONALE: Breathing exercises have been proposed as a way of combating cigarette cravings, potentially presenting a low-cost, easily scalable smoking cessation aid. OBJECTIVE: The aim of this study is to evaluate the acute impact of breathing exercises based on yogic pranayama on cravings in abstaining smokers. METHODS: Participants visited the laboratory on two occasions 24 h apart and were asked to abstain from smoking12 h prior to the first visit until the end of the second visit. Smokers (N = 96) were randomly allocated to a yogic breathing exercise (YBG) or video control (VCG) group. The former was instructed on breathing exercises, practised these for 10 min and asked to use these when experiencing cravings until the next visit. The latter was shown a breathing exercise video for 10 min and asked to concentrate on their breathing. Strength of urges to smoke, other craving measures and mood and physical symptoms associated with cigarette withdrawal were assessed at the beginning and end of the first visit, and again at the second visit. RESULTS: At immediate follow-up, in the laboratory, all craving measures were reduced in YBG compared with VCG (strength of urges: F(1, 96) = 16.1, p < 0.001; cigarette craving: F(1, 96) = 11.3, p = 0.001; desire to smoke: F(1, 96) = 6.6, p = 0.012). There was no effect on mood or physical symptoms. Adherence to the breathing exercise regimen in the following 24 h was low, and at 24 h follow-up, there was no evidence of reduced cravings in YBG compared with VCG. CONCLUSIONS: Simple yogic-style breathing exercises can reduce cigarette craving acutely in the laboratory. Further research is needed to determine how far this translates into field settings.
    Psychopharmacology 09/2012; 225(4). DOI:10.1007/s00213-012-2876-9 · 3.88 Impact Factor
  • Source
    • "We are not aware of any published studies that have reported on the acute effects of yoga on smoking-related measures. However, one prior study has shown that 5 weeks of yoga and breath awareness are associated with increased desire to quit smoking (McIver, O'Halloran, & McGartland, 2004), and another ongoing study is examining yoga in the context of smoking cessation treatment (Bock et al., 2010). Demonstrating that yoga has similar acute effects as CE on cravings to smoke would promote greater choice for individuals who may want to incorporate exercise into their cessation attempt. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Recent studies have examined the effects of physical activity on craving to smoke and smoking withdrawal. The current study was designed to compare and contrast the effects of 2 different forms of physical activity on general and cue-elicited craving to smoke. Following 1-hr nicotine abstinence, 76 daily smokers were randomly assigned to engage in a 30-min bout of cardiovascular exercise (CE; brisk walk on a treadmill), Hatha yoga (HY), or a nonactivity control condition. Participants completed measures of craving and mood, and a smoking cue reactivity assessment, before, immediately following, and approximately 20 min after the physical activity or control conditions. Compared with the control condition, participants in each of the physical activity groups reported a decrease in craving to smoke, an increase in positive affect, and a decrease in negative affect. In addition, craving in response to smoking cues was specifically reduced among those who engaged in CE, whereas those who engaged in HY reported a general decrease in cravings. This study provides further support for the use of exercise bouts for attenuating cigarette cravings during temporary nicotine abstinence. Results also suggest that CE can attenuate cravings in response to smoking cues. There are several areas for further research that may improve integration of exercise within smoking cessation treatment.
    Nicotine & Tobacco Research 08/2011; 13(11):1140-8. DOI:10.1093/ntr/ntr163 · 3.30 Impact Factor
    • "Other Indian research has also shown the efficacy of yoga in post traumatic stress symptoms.[48] Recent research has highlighted the effects of yoga in chronic pain,[49] low back pain,[5051] enhancing brain function,[52] resiliency to stress,[5354] and the overall well-being and optimism in healthy populations,[5556] improving sleep in the institutionalized elderly,[57] benefiting sexual drive,[58] and even smoking cessation.[59] Grover and Avasthi[60] have suggested including yoga in the Clinical Practice guidelines of the Indian Psychiatric Society. "
    [Show abstract] [Hide abstract]
    ABSTRACT: India and UK have had a long history together, since the times of the British Raj. Most of what Indian psychiatry is today, finds its roots in ancient Indian texts and medicine systems as much as it is influenced by the European system. Psychiatric research in India is growing. It is being influenced by research in the UK and Europe and is influencing them at the same time. In addition to the sharing of ideas and the know-how, there has also been a good amount of sharing of mental health professionals and research samples in the form of immigrants from India to the UK. The Indian mental health professionals based in UK have done a good amount of research with a focus on these Indian immigrants, giving an insight into cross-cultural aspects of some major psychiatric disorders. This article discusses the impact that research in these countries has had on each other and the contributions that have resulted from it.
    Indian Journal of Psychiatry 01/2010; 52(7):S56-S63. DOI:10.4103/0019-5545.69211
Show more