, Volume 222, Issue 1, pp 1–15 | Cite as

The acute effects of exercise on cigarette cravings, withdrawal symptoms, affect, and smoking behaviour: systematic review update and meta-analysis

  • Vaughan Roberts
  • Ralph Maddison
  • Caroline Simpson
  • Chris Bullen
  • Harry Prapavessis



Smoking cessation is associated with cigarette cravings and tobacco withdrawal symptoms (TWS), and exercise appears to ameliorate many of these negative effects. A number of studies have examined the relationships between exercise, cigarette cravings, and TWS.


The objectives of this study were (a) to review and update the literature examining the effects of short bouts of exercise on cigarette cravings, TWS, affect, and smoking behaviour and (b) to conduct meta-analyses of the effect of exercise on cigarette cravings.


A systematic review of all studies published between January 2006 and June 2011 was conducted.


Fifteen new studies were identified, 12 of which found a positive effect of exercise on cigarette cravings. The magnitude of statistically significant effect sizes for ‘desire to smoke’ and ‘strength of desire to smoke’ ranged from 0.4 to 1.98 in favour of exercise compared to passive control conditions, and peaked either during or soon after treatment. Effects were found up to 30 min post-exercise. Cigarette cravings were reduced following exercise with a wide range of intensities from isometric exercise and yoga to activity as high as 80–85 % heart rate reserve. Meta-analyses revealed weighted mean differences of −1.90 and −2.41 in ‘desire to smoke’ and ‘strength of desire to smoke’ outcomes, respectively. Measures of TWS and negative affect were reduced following light–moderate intensity exercise, but increased during vigorous exercise.


Exercise can have a positive effect on cigarette cravings and TWS. However, the most effective exercise intensity to reduce cravings and the underlying mechanisms associated with this effect remain unclear.


Nicotine Exercise Physical activity Smoking cessation Affect Smoking topography Tobacco withdrawal symptoms Cigarette cravings Behavioural intervention 



Mr. Roberts is supported by a University of Auckland Doctoral Scholarship.

Conflict of interest

The authors declare no conflict of interest.


  1. Arbour-Nicitopoulos KP, Faulkner GE, Hsin A, Selby P (2011) A pilot study examining the acute effects of exercise on cigarette cravings and affect among individuals with serious mental illness. Ment Heal Phys Act 4:89–94CrossRefGoogle Scholar
  2. Avecado E, Ekkekakis P (2006) Psychobiology of physical activity. Human Kinetics, ChampaignGoogle Scholar
  3. Bock BC, Marcus BH, King TC, Borrelli B, Roberts MR (1999) Exercise effects on withdrawal and mood among women attempting smoking cessation. Addict Behav 24:399–410PubMedCrossRefGoogle Scholar
  4. Borrelli B, Spring B, Niaura R, Hitsman B, Papandonatos G (2001) Influences of gender and weight gain on short-term relapse to smoking in a cessation trial. J Consult Clin Psychol 69:511–515PubMedCrossRefGoogle Scholar
  5. Brandon TH (1994) Negative affect as motivation to smoke. Curr Dir Psychol Sci 3:33–37CrossRefGoogle Scholar
  6. Cohen J (1992) A power primer. Psychol Bull 112:155–159PubMedCrossRefGoogle Scholar
  7. Cox LS, Tiffany ST, Christen AG (2001) Evaluation of the brief questionnaire of smoking urges (QSU-brief) in laboratory and clinical settings. Nicotine Tob Res: Off J Soc Res Nicotine Tob 3:7–16CrossRefGoogle Scholar
  8. Curtin F, Altman DG, Elbourne D (2002) Meta-analysis combining parallel and cross-over clinical trials. I: continuous outcomes. Stat Med 21:2131–2144PubMedCrossRefGoogle Scholar
  9. Daniel J, Cropley M, Ussher M, West R (2004) Acute effects of a short bout of moderate versus light intensity exercise versus inactivity on tobacco withdrawal symptoms in sedentary smokers. Psychopharmacol 174:320–326Google Scholar
  10. Daniel JZ, Cropley M, Fife-Schaw C (2006) The effect of exercise in reducing desire to smoke and cigarette withdrawal symptoms is not caused by distraction. Addiction 101:1187–1192PubMedCrossRefGoogle Scholar
  11. Daniel JZ, Cropley M, Fife-Schaw C (2007) Acute exercise effects on smoking withdrawal symptoms and desire to smoke are not related to expectation. Psychopharmacol 195:125–129CrossRefGoogle Scholar
  12. Devilly GJ, Borkovec TD (2000) Psychometric properties of the credibility/expectancy questionnaire. J Behav Ther 31:73–86CrossRefGoogle Scholar
  13. Elbourne DR, Altman DG, Higgins JP, Curtin F, Worthington HV, Vail A (2002) Meta-analyses involving cross-over trials: methodological issues. Int J Epidemiol 31:140–149PubMedCrossRefGoogle Scholar
  14. Elibero A, Janse Van Rensburg K, Drobes DJ (2011) Acute effects of aerobic exercise and hatha yoga on craving to smoke. Nicotine Tob Res 13:1140–8PubMedCrossRefGoogle Scholar
  15. Everson ES, Daley AJ, Ussher M (2006) Does exercise have an acute effect on desire to smoke, mood and withdrawal symptoms in abstaining adolescent smokers? Addict Behav 31:1547–1558PubMedCrossRefGoogle Scholar
  16. Everson ES, Daley AJ, Ussher M (2008) The effects of moderate and vigorous exercise on desire to smoke, withdrawal symptoms and mood in abstaining young adult smokers. Ment Heal Phys Act 1:26–31CrossRefGoogle Scholar
  17. Faulkner GE, Arbour-Nicitopoulos KP, Hsin A (2010) Cutting down one puff at a time: the acute effects of exercise on smoking behaviour [online]. J Smok Cessat 5:130–135CrossRefGoogle Scholar
  18. Follmann D, Elliott P, Suh I, Cutler J (1992) Variance imputation for overviews of clinical-trials with continuous response. J Clin Epidemiol 45:769–773PubMedCrossRefGoogle Scholar
  19. Greenberg RP, Constantino MJ, Bruce N (2006) Are patient expectations still relevant for psychotherapy process and outcome? Clin Psychol Rev 26:657–678PubMedCrossRefGoogle Scholar
  20. Hardy CJ, Rejeski WJ (1989) Not what, but how one feels: the measurement of affect during exercise. J Sport Exerc Psychol 11:304–317Google Scholar
  21. Harper TM (2011) Mechanisms behind the success of exercise as an adjunct quit smoking aid. Electronic Thesis and Dissertation Repository. Paper 198. Accessed 27 September 2011
  22. Higgins JPT, Altman DG (2008) Chapter 8: assessing risk of bias in included studies. In: Higgins J, Green S (eds) Cochrane handbook for systematic reviews of interventions. Wiley, ChichesterCrossRefGoogle Scholar
  23. Higgins JPT, Deeks J, Altman DG (2008) Chapter 16: special topic in statistics. In: Higgins J, Green S (eds) Cochrane handbook for systematic reviews of interventions. Wiley, ChichesterCrossRefGoogle Scholar
  24. Ho J (2009) Effects of resistance exercise on the HPA axis and cardiovascular responses to psychological stress during short-term smoking abstinence in men. Ph.D. dissertation 3367360, University of ConnecticutGoogle Scholar
  25. Hughes JR (2007) Effects of abstinence from tobacco: valid symptoms and time course. Nicotine Tob Res 9:315–27PubMedCrossRefGoogle Scholar
  26. Janse Van Rensburg K, Taylor AH (2008) The effects of acute exercise on cognitive functioning and cigarette cravings during temporary abstinence from smoking. Hum Psychopharmacol: Clin Exp 23:193–9CrossRefGoogle Scholar
  27. Janse Van Rensburg K, Taylor A, Hodgson T (2009a) The effects of acute exercise on attentional bias towards smoking-related stimuli during temporary abstinence from smoking. Addiction 104:1910–17CrossRefGoogle Scholar
  28. Janse Van Rensburg K, Taylor A, HODGSON T, Benattayallah A (2009b) Acute exercise modulates cigarette cravings and brain activation in response to smoking-related images: an fMRI study. Psychopharmacol 203:589–98CrossRefGoogle Scholar
  29. Janse Van Rensburg K, Taylor AH, Hodgson T, Benattayallah A (2012) The effects of exercise on cigarette cravings and brain activation in response to smoking-related images. Psychopharmacology. doi: 10.1007/s00213-011-2610-z
  30. Katomeri M (2009) Acute effects of self-paced walking on smoking withdrawal and cravings. PhD dissertation, University of Plymouth, UKGoogle Scholar
  31. Laustiola KE, Kotamaki M, Lassila R, Kallioniemi OP, Manninen V (1991) Cigarette smoking alters sympathoadrenal regulation by decreasing the density of beta 2-adrenoceptors. A study of monitored smoking cessation. J Cardiovasc Pharmacol 17:923–8PubMedCrossRefGoogle Scholar
  32. Lerman C, Tyndale RF, Patterson F, Wileyto EP, Shields PG, Pinto A, Benowitz N (2006) Nicotine metabolic ratio predicts efficacy of transdermal nicotine for smoking cessation. Clin Pharmacol Ther 79:600–8PubMedCrossRefGoogle Scholar
  33. Lucini D, Bertocchi F, Malliani A, Pagani M (1996) A controlled study of the autonomic changes produced by habitual cigarette smoking in healthy subjects. Cardiovasc Res 31:633–639PubMedGoogle Scholar
  34. Niedermaier ON, Smith ML, Beightol LA, Zukowskagrojec Z, Goldstein DS, Eckberg DL (1993) Influence of cigarette-smoking on human autonomic function. Circulation 88:562–571PubMedGoogle Scholar
  35. Reed J, Ones DS (2006) The effect of acute aerobic exercise on positive activated affect: a meta-analysis. Psychol Sport Exerc 7:477–514CrossRefGoogle Scholar
  36. Reeser KA (1983) The effects of repeated aerobic and non-aerobic exercise on cigarette smoking. Unpublished Master's thesis. University of Alberta, CanadaGoogle Scholar
  37. Richter EA, Sutton JR (1994) Hormonal adaptation to physical activity. In: Bouchard C, Shephard RJ, Stephens T (eds) Physical activity and health: International Proceedings and Consensus Statement. Human Kinetics, ChampaignGoogle Scholar
  38. Scerbo F, Faulkner G, Taylor A, Thomas S (2010) Effects of exercise on cravings to smoke: the role of exercise intensity and cortisol. J Sports Sci 28:11–9PubMedCrossRefGoogle Scholar
  39. Schnoll RA, Patterson F, Wileyto EP, Tyndale RF, Benowitz N, Lerman C (2009) Nicotine metabolic rate predicts successful smoking cessation with transdermal nicotine: a validation study. Pharmacol Biochem Behav 92:6–11PubMedCrossRefGoogle Scholar
  40. Shiffman S (2005) Dynamic influences on smoking relapse process. J Pers 73:1715–1748PubMedCrossRefGoogle Scholar
  41. Shiffman SM, Jarvik ME (1976) Smoking withdrawal symptoms in two weeks of abstinence. Psychopharmacol 50:35–39CrossRefGoogle Scholar
  42. Shiffman S, Shadel WG, Niaura R, Khayrallah MA, Jorenby DE, Ryan CF, Ferguson CL (2003) Efficacy of acute administration of nicotine gum in relief of cue‐provoked cigarette craving. Psychopharmacology 166(4):343–350Google Scholar
  43. Stein PK, Rottman JN, Kleiger RS (1996) Effect of 21 mg transdermal nicotine patches and smoking cessation on heart rate variability. Am J Cardiol 77:701–705PubMedCrossRefGoogle Scholar
  44. Stroop JR (1935) Interference in serial verbal reaction. J Exp Psychol 18:643–661CrossRefGoogle Scholar
  45. Svebak S, Murgatroyd S (1985) Metamotivational dominance: a multimethod validation of reversal theory constructs. J Percept Soc Psychol 48:107–116CrossRefGoogle Scholar
  46. Taylor A, Katomeri M (2007) Walking reduces cue-elicited cigarette cravings and withdrawal symptoms, and delays ad libitum smoking. Nicotine Tob Res 9:1183–1190PubMedCrossRefGoogle Scholar
  47. Taylor A, Katomeri M, Ussher M (2005) Acute effects of self-paced walking on urges to smoke during temporary smoking abstinence. Psychopharmacol 181:1–7CrossRefGoogle Scholar
  48. Taylor A, Katomeri M, Ussher M (2006) Effects of walking on cigarette cravings and affect in the context of Nesbitt's paradox and the circumplex model. J Sport Exerc Psychol 28:18–31Google Scholar
  49. Taylor AH, Ussher MH, Faulkner G (2007) The acute effects of exercise on cigarette cravings, withdrawal symptoms, affect and smoking behaviour: a systematic review. Addiction 102(4):534–43PubMedCrossRefGoogle Scholar
  50. Thayer RE (1989) The biopsychology of mood and arousal. Oxford University Press, New YorkGoogle Scholar
  51. Thayer RE, Peters DP, Takahashi PJ, Birkhead-Flight AM (1993) Mood and behavior (smoking and sugar snacking) following moderate exercise: a partial test of self-regulation theory. Personal Individ Differ 14:97–104CrossRefGoogle Scholar
  52. Tiffany ST, Drobes DJ (1991) The development and initial validation of a questionnaire on smoking urges. Br J Addict 86:1467–76PubMedCrossRefGoogle Scholar
  53. Ussher M, Nunziata P, Cropley M, West R (2001) Effects of a short bout of exercise on tobacco withdrawal symptoms and desire to smoke. Psychopharmacol 158:66–72CrossRefGoogle Scholar
  54. Ussher M, West R, Doshi R, Sampuran AK (2006) Acute effect of isometric exercise on desire to smoke and tobacco withdrawal symptoms. Hum Psychopharmacol: Clin Exp 21:39–46CrossRefGoogle Scholar
  55. Ussher M, Cropley M, Playle S, Mohidin R, West R (2009) Effect of isometric exercise and body scanning on cigarette cravings and withdrawal symptoms. Addiction 104:1251–7PubMedCrossRefGoogle Scholar
  56. Ussher MH, Taylor A, Faulkner G (2012) Exercise interventions for smoking cessation. Cochrane Database Syst Rev 1:CD002295, OnlinePubMedGoogle Scholar
  57. Ward KD, Garvey AJ, Bliss RE, Sparrow D, Young JB, Landsberg L (1991) Changes in urinary catecholamine excretion after smoking cessation. Pharmacol Biochem Behav 40:937–40PubMedCrossRefGoogle Scholar
  58. West R, Hajek P (2004) Evaluation of the mood and physical symptoms scale (MPSS) to assess cigarette withdrawal. Psychopharmacol 177:195–9CrossRefGoogle Scholar
  59. West R, Hajek P, Belcher M (1989) Severity of withdrawal symptoms as a predictor of outcome of an attempt to quit smoking. Psychol Med 19:981–85PubMedCrossRefGoogle Scholar
  60. Williams DM, Dunsiger S, Whiteley JA, Ussher MH, Ciccolo JT, Jennings EG (2011) Acute effects of moderate intensity aerobic exercise on affective withdrawal symptoms and cravings among women smokers. Addict Behav 36:894–897PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • Vaughan Roberts
    • 1
  • Ralph Maddison
    • 1
  • Caroline Simpson
    • 1
  • Chris Bullen
    • 1
  • Harry Prapavessis
    • 2
  1. 1.National Institute for Health InnovationUniversity of AucklandAucklandNew Zealand
  2. 2.School of KinesiologyUniversity of Western OntarioLondonCanada

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