The study, published in the Journal of Sport and Health Science, looked at 59 randomized controlled trials involving 9,083 participants. The researchers separated two types of interventions: long-term exercise training, which was examined in 43 studies, and one-time, short-term exercise, which was examined in 16 studies. All of the studies involved cigarette smokers, and no studies were found that directly examined quitting e-cigarettes.
The most striking finding concerned moments of intense cravings to smoke. A single bout of physical activity, lasting between 5 and 30 minutes, reduced nicotine cravings immediately after it ended. The effect was also observed after 10 minutes, 20 minutes, and even 30 minutes. The researchers found that the effect was stronger the more intense the activity: high-intensity activity reduced cravings the most, moderate-intensity activity was also effective, while light activity showed a smaller and not always significant effect.
The possible explanation for this has to do with mechanisms in the brain and nervous system. Exercise affects reward, mood, and stress systems, including through changes in dopamine, serotonin, endorphins, and cortisol. These are the same systems that are also involved in nicotine addiction and the temporary feeling of relief that smokers attribute to a cigarette. Simply put, exercise may provide the brain with an alternative stimulus that temporarily reduces the need for nicotine.
As for long-term abstinence, the picture is encouraging but more moderate. Long-term physical activity training increased the likelihood of continuous abstinence from smoking by 15% compared to control groups, and the likelihood of abstinence for seven days by 21%. Meanwhile, the studies that examined the number of cigarettes smoked per day found an average decrease of just over two cigarettes per day among those who combined physical activity.
However, researchers are wary of presenting exercise as a stand-alone solution to quitting. The quality of evidence for reducing the number of cigarettes smoked and reducing cravings was rated as moderate, but the evidence for sustained cessation was rated as lower, mainly due to large variability between studies, differences in types of exercise, duration of intervention, measurement methods, and some methodological limitations. Some studies relied on self-reporting by participants and not always on biochemical validation, such as breath carbon monoxide or cotinine testing.
The implication for smokers is not to replace proven treatments with a walk in the park. Pharmacological treatments such as nicotine replacement, varenicline or bupropion, along with behavioral counseling, remain the main tools for quitting smoking. But physical activity may join them as a daily aid, especially when the urge erupts suddenly: after coffee, following stress, while driving, after a meal or during a break at work.
The great advantage of physical activity is its availability. It does not require a prescription, does not require a doctor's appointment, and can be done almost anywhere. Even those who are not in shape can start with small steps: a quick walk around the building, climbing the stairs, a short bike ride, a short workout in front of a video, or a few minutes of simple strength exercises. According to the research findings, it is not necessary to start with a long workout. In fact, the short response to the moment of crisis is one of the most practical findings.
The researchers note that a key gap remains in the world of vaping. Despite the rise in e-cigarette use, none of the studies included in the review examined whether exercise helps with quitting vaping or dual use of both regular cigarettes and e-cigarettes. This is a significant gap, especially given the increasing use of nicotine products among young people and adults.
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