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Smoke and Mirrors
Studies Suggest Getting Active Can Help Break Bad Habits and Form Good Ones

By Carol Krucoff
Special to the Washington Post
Tuesday, March 23, 1999; Page Z20

You don't see many top athletes smoking. And you're not likely to find much junk food on an Olympic training table. Even among recreational exercisers, being active is associated with other healthy behaviors such as eating a nutritious diet and avoiding smoking and substance abuse.

This well-documented relationship is sometimes called "the granola effect" of exercise, and it is considered to be an indirect benefit of a physically active lifestyle. But while numerous studies show a strong association between regular exercise and other healthy habits, little research has been done on whether exercise actually triggers other healthy behaviors.

When it comes to smoking, however, a growing body of evidence indicates that starting a program of vigorous activity may help people quit. One study of more than 4,000 male runners, published in the journal Preventive Medicine, reported that 70 percent of those who smoked at the time they took up running subsequently quit. The greater the number of miles run per week, the greater the likelihood of quitting. Researchers suggest that more serious runners kick the habit because smoking hinders performance.

New research reveals additional reasons why exercise may help smokers quit. "Many women are afraid to quit smoking because they fear gaining weight," notes Bess H. Marcus, an associate professor of psychiatry and human behavior at Brown University School of Medicine. "National data shows most people gain an average of 10 pounds when they quit smoking."

Since exercise minimizes that weight gain, it may increase the likelihood that women will quit smoking and stay quit, Marcus says. Her recent "Commit to Quit" study examined the effects of combining a smoking cessation program with an exercise program. The randomized trial divided 281 sedentary, middle-aged, overweight female smokers into two groups: a control group that attended a smoking cessation program plus a three-times-a-week wellness program, and a study group that attended the same smoking cessation program plus a supervised program of vigorous exercise three times a week.

"Approximately twice as many of the exercisers were able to attain and maintain cessation," says Marcus, who recently traveled to Australia to present her findings. Among those who adhered to treatment, 49 percent of the exercisers had quit smoking by the end of the 12-week program, compared with 29 percent of those in the control group. Three months later, 38 percent of the exercisers were still not smoking, compared with 19 percent of the control group.

"Among the people who quit, women who exercised gained an average of six pounds and those who didn't exercise gained an average of 12 pounds," Marcus notes. "The fact that exercise minimized weight gain may explain why exercising helped women stay quit."

In addition to buffering against weight gain, exercise also may have helped counter the "worsening mood commonly reported among those trying to kick the cigarette habit," she says. "Many people report increases in stress and anxiety when they try to give up smoking. Other studies show that exercise helps relieve depression and anxiety, which may be another mechanism by which exercise enhances smoking abstinence."

Exercise can give smokers an alternative way to handle stress, says Michael H. Sacks, professor of psychiatry at Cornell University's Weill Medical College in New York. "When people start exercising regularly, they realize how good it makes them feel," Sacks says. "They also begin to realize that they can take care of their stress without resorting to destructive things" such as smoking, overeating and substance abuse.

In addition, he says, "it's hard to get into exercise without beginning to think about all the things that can influence the way you exercise--such as diet, smoking, drinking."

Some recovering alcoholics report using the exercise "high" as a kind of alcohol replacement therapy. "Exercise reduces my level of anxiety and gives me a heightened sense of well-being I carry around for 24 hours," says David Hobler, a former trial lawyer and recovering alcoholic from Mill Valley, Calif. Hobler considers exercise so essential to his sobriety that, three years ago, he founded "Fit to Recover," a consulting firm that promotes exercise for people recovering from addictions.

Sports and exercise also may help keep kids from getting involved with drugs. "Some studies show that kids who are physically active are less likely to have negative health behaviors such as carrying weapons in school, getting involved in substance abuse, fights or early sexual activity," says Michael Pratt, acting chief of the physical activity and health branch of the U.S. Centers for Disease Control and Prevention in Atlanta.

Exercise may indeed be a "gateway" behavior that triggers other positive changes, says Karen Emmons, an associate professor of health and social behavior at the Harvard School of Public Health. Her recent study of more than 5,000 workers involved a variety of wellness programs and examined how certain health behaviors cluster together.

"We found that the people who were sedentary and became active had the greatest amount of positive behavior changes," she says. These included eating more fruits and vegetables, reducing the amount of fat calories and doubling the amount of fiber consumed.

"My belief is that many of these changes happen at a physiologic level," she says. "As people start to become active they seem to have more of a taste for fruits and vegetables and healthier foods."

On a psychological level, she says, "being successful in exercise may give someone confidence in their ability to change other behaviors, too. Belief in your ability to accomplish a goal is one of the greatest predictors of success."

© Copyright 1999 The Washington Post Company

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