Exercise has been proposed as a potential treatment to help people quit smoking and, more recently, to treat addictions to alcohol and other drugs of abuse. This entry discusses the rationale and empirical support for the use of exercise as a treatment for addiction.
Exercise has been proposed as a stand-alone or supplementary treatment for addiction. The focus has been on exercise as a potential treatment to assist with successful quitting and prevention of relapse among those who are initially motivated to discontinue use of the addictive substance, rather than to produce intentions to quit among those who are not initially motivated. The rationale for exercise as a potential treatment for addictive substances is predicated on a number of potential mechanisms, including potential effects of exercise on (a) affective states, (b) cravings or urges to use the addictive substance, and (c) reduced concerns about post cessation weight gain.
Withdrawal from addictive substances typically results in chronic negative shifts in affective valence (i.e., negative mood states). It has been proposed that exercise might help to prevent relapse by attenuating chronic negative mood states or providing a substitute means for producing an acute positive shift in affective valence. This proposed pathway was predicated on early research findings supporting the general notion that “exercise feels good.” More recent research has shown that the effect of exercise on affective states (e.g., emotion, mood, pleasure or displeasure) is more complex. It now appears that affective response during exercise varies greatly based on a number of variables, including personal factors, such as exercise history, fitness, health status; exercise setting and mode; and, perhaps most importantly, exercise intensity. Nonetheless, across populations, settings, and exercise modes and intensities, people generally tend to have a positive shift in affective valence (feel more pleasure or less displeasure) immediately after an acute session of exercise. Additionally, there is accumulating evidence that engaging in a program of regular exercise for at least 8 weeks results in reduced depressive symptoms among clinically depressed adults. Thus, given these caveats, there is reason to believe that exercise might serve as a treatment for addictive substances through its influence on affective states.
A second potential pathway through which exercise may serve as a treatment for addictive substances involves the effects of exercise on acute cravings or urges for the addictive substance. It has been posited that acute exercise may serve as a substitute or distraction for use of the addictive substance during a craving or urge, particularly to the extent that it is difficult—if not impossible—to use the addictive substance while exercising.
Concerns About Weight Gain
Another potential pathway through which exercise might serve as a treatment for smoking cessation is through its effects on concerns about post cessation weight gain—a common barrier to smoking cessation, especially among women. Indeed, women who are concerned about post cessation weight gain are less likely to attempt smoking cessation, less likely to successfully quit smoking, more likely to relapse postpartum, and more likely to drop out of smoking cessation programs. Exercise plays a major role in preventing weight gain, as a moderate increase in one’s level of exercise can minimize weight gain in women who have quit smoking. The ability for exercise to combat weight gain in the general population and particularly during smoking cessation is likely to make it especially attractive for women smokers who are concerned about gaining weight during their smoking cessation attempt.
Exercise as a Smoking Cessation Treatment
Numerous research studies have shown that a single exercise session has favorable effects on immediate changes in affective states and cigarette cravings. However, the optimal mode, intensity, and duration of the exercise stimulus remain unclear. Moreover, the duration of the effects of a single session of exercise on affect and cravings remains uncertain.
While outcomes of studies examining a single session of exercise on affect and cravings have been generally positive, results from the first 14 randomized controlled trials conducted have been equivocal, with only a single study showing positive effects of exercise on rates of successful smoking cessation at the end of the trial. Some problems with these studies are (a) a lack of adherence to the exercise treatments; (b) an inability to objectively verify adherence to the exercise program; (c) lack of data on who continues to exercise during the study follow-up period, following the initial exercise treatment (usually about three months); (d) high drop-out among study participants; and (e) lack of data on the potential mechanisms of treatment (see above). Thus, more research is needed to determine whether exercise is an effective treatment for smoking cessation, and if so, the optimal dose.
Exercise as a Treatment for Addiction to Alcohol and Other Drugs of Abuse
Research on exercise as a treatment for alcohol and other drugs has thus far been limited to studies conducted on animals and a few small-scale studies among humans. While the existing research shows promise, no large-scale clinical trials have been conducted in humans. Thus, it remains unclear as to whether exercise will serve as an effective treatment for addiction to alcohol and other drugs.
There is a strong rationale for exercise as treatment for addiction to various substances. Findings from research on animals and small-scale studies with humans are supportive of the rationale. However, outcomes of randomized control trials have been equivocal for smoking cessation and are yet to be conducted for alcohol and other drugs of abuse.
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