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The acute effects of aerobic exercise on cigarette smoking 1983

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THE ACUTE EFFECTS OF AEROBIC EXERCISE ON CIGARETTE SMOKING by CARMEN MIKHAIL B . S c , The U n i v e r s i t y of L e t h b r i d g e , 1979 A THESIS SUBMITTED IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF MASTER OF ARTS i n THE FACULTY OF GRADUATE STUDIES Psychology Department We accept t h i s t h e s i s as conforming ' to the r e q u i r e d standard THE UNIVERSITY OF BRITISH COLUMBIA August 19 8 3 © Carmen M i k h a i l , 1983 e 6 In p r e s e n t i n g t h i s t h e s i s i n p a r t i a l f u l f i l m e n t o f the requirements f o r an advanced degree a t the U n i v e r s i t y o f B r i t i s h Columbia, I agree t h a t the L i b r a r y s h a l l make i t f r e e l y a v a i l a b l e f o r r e f e r e n c e and study. I f u r t h e r agree t h a t p e r m i s s i o n f o r e x t e n s i v e copying o f t h i s t h e s i s f o r s c h o l a r l y purposes may be granted by the head o f my department o r by h i s or her r e p r e s e n t a t i v e s . I t i s understood t h a t copying o r p u b l i c a t i o n o f t h i s t h e s i s f o r f i n a n c i a l g a i n s h a l l not be allowed without my w r i t t e n p e r m i s s i o n . Department o f 7^S -V c^...c /o JAJ The U n i v e r s i t y o f B r i t i s h Columbia 1956 Main Mall Vancouver, Canada V6T 1Y3 Date DE-6 (3/81) i ABSTRACT The e f f e c t s of two i n t e n s i t i e s of e x e r c i s e and a no- e x e r c i s e c o n t r o l c o n d i t i o n on c i g a r e t t e smoking were i n v e s - t i g a t e d i n 18 men, aged 20 to 30 y e a r s . Each s u b j e c t , who was b l i n d to the purpose of the study, came to the l a b o r a t o r y a t the same time on three c o n s e c u t i v e days t o pedal a s t a - t i o n a r y b i c y c l e a t a work-load s u f f i c i e n t t o maintain a he a r t r a t e between 130-135 b.p.m. or 160-165 b.p.m. or to be monitored w h i l e seated i n a c h a i r , f o r 10 minutes. Each s u b j e c t was then ushered i n t o a w a i t i n g room where he r e - mained f o r one hour while i n d i c e s of smoking behavior i n - c l u d i n g number and weight of c i g a r e t t e s consumed, c i g a r e t t e d u r a t i o n (time e l a p s e d from the i n s t a n c e the c i g a r e t t e was l i t t o the i n s t a n c e i t was extingui s h e d ) and number of p u f f s taken f o r the f i r s t cigar.ette p o s t - e x e r c i s e were s u r r e p t i t i o u s l y observed by a conf e d e r a t e . Subjects a l s o s e l f - m o n i t o r e d c i g a r e t t e i n t a k e d u r i n g the three days of the study. Urine samples were c o l l e c t e d p r e - and 15 and 64 minutes f o l l o w i n g e x e r c i s e . The only smoking measure found t o be s i g n i f i c a n t l y a f f e c t e d by e x e r c i s e was c i g a r e t t e d u r a t i o n , which was i n - v e r s e l y r e l a t e d t o e x e r c i s e i n t e n s i t y . A d d i t i o n a l analyses r e v e a l e d t h a t h i g h - i n t e n s i t y e x e r c i s e s i g n i f i c a n t l y a c i d i f i e d t h e u r i n e , and t h a t a s i g n i f i c a n t i n v e r s e c o r r e l a t i o n e x i s t e d i i between u r i n a r y pH change and c i g a r e t t e d u r a t i o n f o r t h i s c o n d i t i o n . The i m p l i c a t i o n s of t h i s f i n d i n g are d i s c u s s e d i n regard to Schachter's hypothesis of n i c o t i n e a d d i c t i o n . i i i TABLE OF CONTENTS Page ABSTRACT i LIST OF TABLES i v LIST OF APPENDICES v INTRODUCTION 1 L i t e r a t u r e Review on A e r o b i c E x e r c i s e and Smoking 5 A n e c d o t a l Reports and C o r r e l a t i o n a l S t u d i e s 5 E xperimental S t u d i e s on E x e r c i s e and Smoking 7 P h y s i o l o g i c a l I n c o m p a t i b i l i t y between A e r o b i c E x e r c i s e and Smoking 11 P s y c h o l o g i c a l F a c t o r s R e l a t e d to E x e r c i s e and Smoking 15 Summary of Research on E x e r c i s e and Smoking 19 Schachter's Model of Smoking: I m p l i c a t i o n s f o r E x e r c i s e 20 Statement of Purpose and Experimental' Hypotheses 24 METHOD 25 Subj e c t s 25 Apparatus . . . . 26 Procedure 26 Dependent V a r i a b l e s 33 RESULTS 34 Data Analyses . . . . . 34 M a n i p u l a t i o n Checks 35 R e l i a b i l i t y Checks 38 Dependent V a r i a b l e s 39 C o r r e l a t i o n a l S t a t i s t i c s 40 DISCUSSION 47 REFERENCES 54 i v LIST OF TABLES Page Table 1. Summary ANOVA Table f o r U r i n a r y pH measures 36 Table 2. Means and Standard D e v i a t i o n s of Smoking Measures 41 Table 3. C o r r e l a t i o n M a t r i x f o r Smoking Measures f o l l o w i n g No-Exercise C o n d i t i o n 43 Table 4. C o r r e l a t i o n M a t r i x f o r Smoking Measures f o l l o w i n g Low-Intensity E x e r c i s e 44 Table 5. C o r r e l a t i o n M a t r i x f o r Smoking Measures f o l l o w i n g H i g h - I n t e n s i t y E x e r c i s e 45 LIST OF APPENDICES Page Appendix A. Information f o r Phone Contact 66 Appendix B. P h y s i c a l A c t i v i t y Readiness Q u e s t i o n n a i r e (PAR-Q) 6 7 Appendix C. P h y s i o l o g i c a l Responses t o E x e r c i s e Among Smokers: O u t l i n e of Study 69 Appendix D. Consent Form 70 Appendix E. S u b j e c t i v e Ratings of B r e a t h l e s s n e s s Form 72 Appendix F. Experimental S c r i p t : Waiting Room 73 Appendix G. E x e r c i s e and Smoking Q u e s t i o n n a i r e 75 Appendix H. Post-Study Q u e s t i o n n a i r e 7 8 v i AC KNOWLEDGEMENT S The a u t h o r w i s h e s t o a c k n o w l e d g e t h e h e l p o f h e r t h e s i s a d v i s o r , D r . D a v i d L a w s o n a n d members o f h e r t h e s i s c o m m i t t e e , D r . R o b e r t McMahon a n d D r . J i m J o h n s o n . S p e c i a l t h a n k s a r e a l s o due t o D r . T e d Rhodes f o r a s s i s t a n c e w i t h t h e s t u d y a n d t o D r . K e n n e t h C r a i g f o r l o a n o f e q u i p m e n t . Sam C h i w a , P a u l L a r o c h e l l e a n d Ken R e e s o r s e r v e d a s a s s i s t a n t s i n t h e s t u d y , f o r w h i c h t h e i r h e l p i s a l s o a p p r e c i a t e d . 1 INTRODUCTION C i g a r e t t e smoking i s an a d d i c t i v e behavior with s t a g - g e r i n g medical and economic consequences. I t has been l i n k e d to lung cancer, cancer of the mouth and t h r o a t , c a r d i o v a s - c u l a r d i s e a s e , and pulmonary d i s e a s e i n c l u d i n g b r o n c h i t i s and emphysema ( S h i l l i n g t o n , 1977). The U.S. Surgeon General (1979) estimated t h a t approximately $27 b i l l i o n i s spent each year i n m e d i c a l expenses, decreased work p r o d u c t i v i t y and work absenteeism, and a c c i d e n t s a t t r i b u t e d to smoking. In view of the adverse e f f e c t s of t h i s behavior i t i s not s u r - p r i s i n g t h a t the m a j o r i t y of smokers not o n l y express a d e s i r e t o q u i t but a l s o have i n i t i a t e d a t l e a s t one s e r i o u s attempt to do so (USPHS, 1976). Given the magnitude of the problems caused by smoking a number of techniques have been developed i n an attempt to d i s c o v e r an e f f e c t i v e treatment f o r smoking. Yet d e s p i t e the v a s t amount of r e s e a r c h i n t h i s area, the e f f e c t i v e n e s s of smoking c e s s a t i o n methods i s unimpressive. Reviews of the l i t e r a t u r e on smoking i n d i c a t e t h a t although i n i t i a l success r a t e s are h i g h , abstinence r a t e s are much lower. M c F a l l and Hammen (1971) summarized the r e s u l t s of e i g h t prominent s t u d i e s on smoking c e s s a t i o n . They found a post-treatment r e d u c t i o n i n c i g a r e t t e consumption to 30-40% of b a s e l i n e 2 frequency, returning to 75% of baseline frequency at a 4 to 6 month follow-up. Hunt and Bespalec (1974) summarized data from 8 0 studies on smoking cessation and found that less than one-third of subjects who are able to quit smoking at the end of treatment maintain nonsmoking over the following six to twelve months. I t seems, therefore, that one problem with present smoking cessation techniques l i e s i n th e i r r e l a t i v e l y poor long-term e f f e c t s (Bernstein and Glasgow, 1979) . Another concern with methods for eliminating smoking stems from the fact that although nonaversive strategies are available, aversive techniques are more popular (Lichtenstein and Brown, 1980). Rapid smoking i s the most common aversion technique, wherein subjects are required to puff rapidly on a cigarette every f i v e to six seconds, inhaling normally, u n t i l they can tolerate no more. While t h i s method y i e l d s favorable r e s u l t s (Lando, 1976; Best, Owen, and Trentadue, 1978) i t i s rather unpleasant to the smoker. Furthermore, i t induces i n subjects a number of p o t e n t i a l l y harmful physi- o l o g i c a l changes which have been of concern to several re- searchers (tLichtenste'ih a n d Glasgow, 1977; M i l l e r , S c h i l l i n g , Logan, and Johnson, 1977). The use of rapid smoking, there- fore, seems to be limited by a car e f u l preselection of c l i e n t s i n view of i t s physiological e f f e c t s and unpleasant nature. From the above discussion i t can be concluded that two current issues pertaining to smoking cessation techniques are 3 t h a t : 1) although i n i t i a l smoking r e d u c t i o n r a t e s are im- p r e s s i v e , r a t e s f o r maintenance of nonsmoking are r e l a t i v e l y d i s a p p o i n t i n g , and 2) most s t r a t e g i e s have implemented a v e r s i v e techniques which are unpleasant and not without p o t e n t i a l u n d e s i r a b l e consequences. These two concerns have l e d numerous r e s e a r c h e r s to suggest t h a t smoking c e s s a t i o n programs i n c o r p o r a t e techniques which f a c i l i t a t e maintenance of nonsmoking and which are nonaversive ( B e r n s t e i n , 1969; Hunt and Matarazzo, 1973; L i c h t e n s t e i n and Brown, 1980). I t i s p a r t l y i n response t o these suggestions t h a t p s y c h o l o g i s t s have recommended the use of e x e r c i s e i n t r e a t - ment f o r smoking. L i c h t e n s t e i n and Brown (1980) and Engs and M u l h a l l (1982) d i s c u s s " l i f e s t y l e b a l a n c i n g " i n smoking r e l a p s e p r e v e n t i o n , wherein a " p o s i t i v e l y a d d i c t i n g " a c t i v i t y such as p h y s i c a l e x e r c i s e r e p l a c e s smoking. Hunt and Matarazzo (1973) suggest the use of e x e r c i s e i n an approach where s u p p o r t i v e techniques are i n c o r p o r a t e d i n t o i n d i v i d u a l l y - t a i l o r e d programs f o r non-smoking. These sug- g e s t i o n s have r e s t e d on the assumption t h a t an i n v e r s e r e l a - t i o n s h i p e x i s t s between smoking and e x e r c i s e . However, r e s e a r c h on the e f f e c t s of e x e r c i s e on c i g a r e t t e smoking has been l i m i t e d t o date, w i t h no s i n g l e adequately c o n t r o l l e d study demonstrating t h a t the former i n h i b i t s the l a t t e r . The purpose of t h i s t h e s i s , t h e r e f o r e , i s to i n v e s t i g a t e the e f f e c t s of e x e r c i s e on c i g a r e t t e smoking. A review of the r e s e a r c h s u g g e s t i n g an i n v e r s e r e l a t i o n - 4 s h i p between a e r o b i c e x e r c i s e and c i g a r e t t e smoking i s pre- sented below. I t i s f o l l o w e d by an examination of a c u r r e n t theory of smoking which c o u l d p r e d i c t an i n c r e a s e r a t h e r than decrease i n smoking f o l l o w i n g e x e r c i s e . F i n a l l y , a statement of purpose f o r the prese n t study and experimental hypotheses are presented. L i t e r a t u r e Review on E x e r c i s e and Smoking 5 Evidence suggesting an i n v e r s e r e l a t i o n s h i p between e x e r c i s e and smoking stems from a n e c d o t a l r e p o r t s as w e l l as c o r r e l a t i o n a l and experimental r e s e a r c h . V a r i o u s s t u d i e s a l s o suggest a p h y s i o l o g i c a l i n c o m p a t i b i l i t y between these two b e h a v i o r s . F i n a l l y , r e s e a r c h e x i s t s which suggests t h a t smoking and e x e r c i s e are both l i n k e d t o p s y c h o l o g i c a l v a r i - a b l e s which may mediate an e f f e c t of the former on the l a t - t e r . These s t u d i e s are presented below. Anecdotal Reports and C o r r e l a t i o n a l S t u d i e s Morgan, G i l d i n e r and Wright (1976) conducted a m a i l survey to determine the e x e r c i s e performance and smoking be- h a v i o r of members of a running c l u b , who averaged 35 m i l e s per week. Of the 141 members, 35 had been smokers, of whom a l l but t h r e e abandoned smoking a f t e r j o i n i n g the c l u b . In a s i m i l a r a n e c d o t a l r e p o r t on e x e r c i s e and smoking, Hickey, Mulcahy, Bourke, Graham and Wilson-Davis (1975) que s t i o n e d men about t h e i r work and l e i s u r e a c t i v i t y over the p r e v i o u s s i x months. They found a s i g n i f i c a n t i n v e r s e c o r r e l a t i o n between heavy l e i s u r e a c t i v i t y , i n c l u d i n g running, squash, t e n n i s and swimming, and smoking i n men 25 to 60 years o l d . Although t h i s f i n d i n g was based e x c l u s i v e l y on r e t r o s p e c t i v e s e l f - r e p o r t of change i n smoking, i t suggests t h a t e x e r c i s e reduces smoking. 6 In an a e r o b i c e x e r c i s e program f o r 237 NASA employees (Durbeck, Heinzelmann, Schacter, H a s k e l l , Payne, Moxley, Nemiroff, L i m o n c e l l i , A r n o l d i , and Fox, 1972) 35 to 55 year o l d men e x e r c i s e d f o r 30 minutes, three times per week. At the c o n c l u s i o n of the 12-month program approximately 15 per- cent of "good adherers" r e p o r t e d a decrease i n smoking, com- pared t o 10 and 5 pe r c e n t f o r e q u a l l y l a r g e groups of " f a i r " and "poor" e x e r c i s e adherers, r e s p e c t i v e l y . Two c o r r e l a t i o n a l s t u d i e s f a i l e d to f i n d an e f f e c t of e x e r c i s e on smoking. Bonanno and L i e s (1974) engaged 19 middle-aged coronary-prone male smokers i n a 12-week super- v i s e d a e r o b i c e x e r c i s e program of walking and j o g g i n g . N e i t h e r s u b j e c t s i n the experimental group nor those i n a matched n o - e x e r c i s e c o n t r o l group d i s c o n t i n u e d or substan- t i a l l y decreased smoking d u r i n g the program. Engs and M u l h a l l (1982) i n v e s t i g a t e d the smoking h a b i t s of u n i v e r s i t y undergraduates b e f o r e and a f t e r 15-week courses r e q u i r i n g e i t h e r strenuous a c t i v i t y such as jog g i n g and c o n d i t i o n i n g e x e r c i s e s , or l e i s u r e a c t i v i t y such as b i l l i a r d s and r i f l e r y . No p r e - to post-program changes i n smoking behavior were found f o r s u b j e c t s i n e i t h e r group. I n t e r p r e t a t i o n of data i n the above s t u d i e s i s d i f f i c u l t f o r a number of reasons. The r e s e a r c h e r s , with the e x c e p t i o n of Engs and M u l h a l l , d i d not d e s i g n t h e i r s t u d i e s to examine s p e c i f i c a l l y the r e l a t i o n s h i p between these two v a r i a b l e s and t h e r e f o r e they l a c k e d c o n t r o l procedures. The smokers were not r e p r e s e n t a t i v e of the g e n e r a l p o p u l a t i o n as three of 7 these programs were designed f o r those a t r i s k f o r coronary h e a r t d i s e a s e . Consequently, most s u b j e c t s were middle-aged coronary-prone men who may have been changing other l i f e s t y l e b e h a v i o r s i n a d d i t i o n t o p h y s i c a l a c t i v i t y . Another d i f - f i c u l t y w i t h i n t e r p r e t a t i o n i s t h a t although the frequency, i n t e n s i t y and d u r a t i o n of e x e r c i s e were r e p o r t e d i n most s t u d i e s e x e r c i s e adherence was not always monitored. F i n a l - l y , the assessment of smoking behavior was r e t r o s p e c t i v e f o r the most p a r t and based s o l e l y on s e l f - r e p o r t . One aspect of the Engs and M u l h a l l (1982) study which may mask an e f f e c t of smoking i s the f a c t t h a t most students i n the group (85 of 100 i n the strenuous a c t i v i t y group and 72 of 100 i n the l e i s u r e a c t i v i t y group) d i d not smoke, and o n l y a very s m a l l percentage of s u b j e c t s (2 percent i n the former and 12 per- cent i n the l a t t e r group) i n i t i a l l y smoked at l e a s t one package of c i g a r e t t e s d a i l y . Experimental S t u d i e s on E x e r c i s e and Smoking The r e l a t i o n s h i p between e x e r c i s e and smoking has been i n v e s t i g a t e d i n c i d e n t a l l y i n s t u d i e s on the r e l a t i o n s h i p between p h y s i c a l a c t i v i t y and coronary r i s k f a c t o r s . Mann, G a r r e t t , F a r h i , Murray, B i l l i n g s , Shute, and Schwarten (1969) t r a i n e d 106 men, aged 25 to 60 y e a r s , i n a strenuous program of s u p e r v i s e d e x e r c i s e , i n c l u d i n g c a l i s t h e n i c s , walking, j o g g i n g and running i n an attempt to reduce the r i s k of coronary h e a r t d i s e a s e . Each s u b j e c t was e x e r c i s e d a t one of 8 three i n t e n s i t i e s a c c o r d i n g t o h i s f i t n e s s l e v e l , f o r f i v e days per week f o r s i x months. At the end of the program, 22% r e p o r t e d a decrease i n smoking, versus 7% f o r a n o - e x e r c i s e c o n t r o l group. One d i f f i c u l t y w i t h data i n t e r p r e t a t i o n i n t h i s study a r i s e s from the f a c t t h a t no mention i s made of the p r o p o r t i o n of s u b j e c t s who i n i t i a l l y smoked. I f i t i s assumed t h a t smokers were p r o p o r t i o n a l l y r e p r e s e n t e d i n both groups, as s u b j e c t s were randomly assi g n e d to the groups, then the data suggest t h a t e x e r c i s e i s i n v e r s e l y r e l a t e d to smoking. Heinzelmann and Bagley (1970) e x e r c i s e d 239 i n i t i a l l y sedentary men, 45 to 59 years o l d , f o r one hour, three times per week f o r 18 months. The study does not mention the nature of e x e r c i s e performed; however, i t was most l i k e l y a e r o b i c as i t was designed t o improve cardio-pulmonary f u n c t i o n of men at r i s k f o r coronary h e a r t d i s e a s e . A randomly assi g n e d c o n t r o l group of 142 men d i d not e x e r c i s e , b u t : f i l l e d out q u e s t i o n n a i r e s on h e a l t h a t t i t u d e s and b e l i e f s , and r e c e i v e d m e d i c a l e v a l u a t i o n s a t standard t h r e e - t o four-month, i n t e r - v a l s . Twenty percent of men i n both the experimental and c o n t r o l groups r e p o r t e d smoking l e s s a t the end of 18 months. I t may be t h a t f i l l i n g out the h e a l t h q u e s t i o n n a i r e s and p o s s i b l e exposure to the experimental s u b j e c t s , who were r e c r u i t e d from the same u n i v e r s i t y s e t t i n g , may have spurred the c o n t r o l s u b j e c t s to i n i t i a t e t h e i r own e x e r c i s e program d u r i n g the course of the study. The experimenters would have 9 been uninformed of t h i s as change i n e x e r c i s e h a b i t s of con- t r o l s u b j e c t s was not assessed a t the. end of the study. Two unpublished s t u d i e s were designed s p e c i f i c a l l y to assess the e f f e c t s of e x e r c i s e i n treatment f o r smoking. Johnson, Rosenbaum, Framer and Wildman (1979) assessed the i n f l u e n c e of an 8-week e x e r c i s e program on c i g a r e t t e consump- t i o n and p h y s i c a l f i t n e s s . The study compared the e f f e c t s on smoking of two e x e r c i s e programs the f i r s t i n v o l v i n g 30 minutes of walking per day, the second c o n s i s t i n g of an i n - cremental program of walking and a weekly e x e r c i s e s e s s i o n which began a t the same l e v e l as the f i r s t . S ubjects i n both groups r e c e i v e d , i n a d d i t i o n to e x e r c i s e , i n s t r u c t i o n i n s e l f - m o n i t o r i n g , r e l a x a t i o n t r a i n i n g , c i g a r e t t e r e f u s a l t r a i n i n g and b e h a v i o r a l a n a l y s i s of smoking. R e s u l t s i n d i - c ate no d i f f e r e n c e i n smoking behavior between the groups e i t h e r post-treatment or a t a one year f o l l o w - u p . Subjects i n both programs s i g n i f i c a n t l y decreased smoking, r e t u r n i n g to 67% of b a s e l i n e frequency a t a one-year follow-up. The l a c k of a n o - e x e r c i s e c o n t r o l group and the use of a m u l t i - component treatment package f o r smoking c e s s a t i o n p r e c l u d e s any assessment of the e f f e c t s of e x e r c i s e on smoking. An important f i n d i n g , however, i s t h a t post-treatment c i g a r e t t e smoking was s i g n i f i c a n t l y i n v e r s e l y r e l a t e d t o p r e - and p o s t - treatment a e r o b i c c a p a c i t y (r = and r = -0.86, respec- t i v e l y ) as determined by a step t e s t , s u g g e s t i n g t h a t smoking i s r e l a t e d t o i n i t i a l l e v e l of p h y s i c a l f i t n e s s and p h y s i c a l 10 improvement f o l l o w i n g e x e r c i s e . In a study by Howley, C a l l a h a n and Yaeter (1980), a 2 X 2 f a c t o r i a l d e sign was implemented to determine the separate and combined e f f e c t s of e x e r c i s e and self-management s t r a t e g i e s on smoking. Subjec t s i n an e x e r c i s e group f o l l o w e d an i n d i v i d u a l i z e d e x e r c i s e p l a n i n c l u d i n g walking and running, which was g r a d u a l l y i n c r e a s e d d u r i n g the study. Smokers i n a self-management group l e a r n e d s e l f - c o n t r o l procedures f o r d e a l i n g w i t h smoking s i t u a t i o n s . In both groups s e l f - m o n i t o r i n g , c o n t r a c t i n g , and s o c i a l f a c i l i t a t i o n were used f o r treatment adherence. A t h i r d group r e c e i v e d both exer- c i s e and self-management t r a i n i n g components, w h i l e a f i n a l group served as a delayed treatment c o n t r o l . R e s u l t s i n d i c a t e t h a t a l l three treatment groups s i g n i f i c a n t l y reduced t h e i r smoking r a t e and t h a t there was no d i f f e r e n c e among these groups post-treatment nor a t six-week and six-month f o l l o w - ups . In both the Howley e t a l . and Johnson e t a l . s t u d i e s , p h y s i o l o g i c a l i n d i c e s of r e c o v e r y were used to assess exer- c i s e adherence. However, changes i n these measures cannot be a t t r i b u t e d s o l e l y to e x e r c i s e p a r t i c i p a t i o n , as smoking c e s s a t i o n alone i s s u f f i c i e n t t o improve a e r o b i c c a p a c i t y (Rode, Ross and Shepard, 1972). I t may be, t h e r e f o r e , t h a t i n these s t u d i e s p h y s i o l o g i c a l i n d i c e s of r e c o v e r y d i d not r e f l e c t e x e r c i s e adherence a c c u r a t e l y . Another d i f f i c u l t y w i t h data i n t e r p r e t a t i o n i n these s t u d i e s stems from the f a c t 11 t h a t no c o n t r o l s were made f o r s u b j e c t e x p e c t a n c i e s and be- l i e f s t h a t the treatment would reduce smoking. As programs i n both s t u d i e s were presented as anti-smoking treatments, s u b j e c t s v o l u n t e e r i n g f o r the s t u d i e s may have reduced smoking p a r t l y or wholly as a r e s u l t of these n o n s p e c i f i c treatment f a c t o r s (McFall and Hammen, 1971). F i n a l l y , con- c l u s i v e i n t e r p r e t a t i o n of an e f f e c t of e x e r c i s e i n the Howley e t a l . study i s hampered by the f a c t t h a t seven of the 36 s u b j e c t s i n the three treatment groups dropped out of the study (no drop-out data are presented f o r the e x e r c i s e group a l o n e ) , w h i l e f o u r of the nine s u b j e c t s i n the e x e r c i s e group f a i l e d t o adhere to the e x e r c i s e regimen. P h y s i o l o g i c a l I n c o m p a t i b i l i t y between A e r o b i c E x e r c i s e and Smoking There e x i s t s evidence s u g g e s t i n g t h a t a e r o b i c e x e r c i s e i s i n c o m p a t i b l e w i t h smoking. While a e r o b i c e x e r c i s e i n - creases cardio-pulmonary f u n c t i o n , c i g a r e t t e smoking produces p h y s i o l o g i c a l changes i n an o p p o s i t e d i r e c t i o n '(Cooper, Gey, and Bottenberg,1969). S t u d i e s c o n f i r m i n g t h i s f i n d i n g i n d i - c a t e t h a t : 1) smokers perform worse than nonsmokers on c a r - d i o v a s c u l a r and pulmonary t e s t s , 2) smokers' e x e r c i s e per- formance decreases f o l l o w i n g c i g a r e t t e consumption, and 3) nonsmokers respond more f a v o r a b l y than smokers to p h y s i c a l t r a i n i n g programs. A review of these s t u d i e s i s presented below. 12 In a comparison of smokers' and nonsmokers' c a r d i o - pulmonary performance, Cunningham, Montoye, H i g g i n s , and K e l l e r (1972) engaged male and female smokers i n a bench s t e p p i n g t e s t and found they had s i g n i f i c a n t l y higher h e a r t r a t e s than nonsmokers p r e - and three minutes p o s t - e x e r c i s e . Shaver (1973) found d i f f e r e n c e s i n e x e r c i s e performance between female smokers and nonsmokers on three measures of c a r d i o v a s c u l a r and pulmonary e f f i c i e n c y : a bench step t e s t , a 60 yar'd run-walk t e s t and a r e p e t i t i v e t r e a d m i l l t e s t . Furthermore, Franks (1970) noted t h a t when smokers a b s t a i n from t h e i r u s u a l p a t t e r n of smoking f o r one day, they expe- r i e n c e an improvement i n three c a r d i a c measures: d i a s t o l i c b lood p r e s s u r e , s t r o k e volume and c a r d i a c sympatho-adrenergic a c t i v i t y , i n response to e x e r c i s e . Krone, Goldbarg, Balkoura, S c h u e s s l e r and Resnekov (1972) determined smokers' e x e r c i s e performance both b e f o r e and a f t e r c i g a r e t t e smoking. In the f i r s t s e s s i o n nine male smokers aged 21 to 27 years pedaled a b i c y c l e ergometer f o r 18 minutes a t a h e a r t r a t e e l e v a t i o n of up to 150 beats per minute, r e s t e d f o r 30 minutes, and repeated the e x e r c i s e . T h i s sequence was l a t e r repeated f o r a second s e s s i o n , except t h a t the s u b j e c t smoked a s i n g l e c i g a r e t t e d u r i n g the 30- minute r e s t p e r i o d . The authors found an i n c r e a s e i n h e a r t r a t e and a decrease i n s t r o k e volume d u r i n g e x e r c i s e a f t e r smoking a c i g a r e t t e . The same r e s u l t s were found by Goldbarg, Krone and Resnekov (1971) u s i n g a s i m i l a r methodology with 13 nine male h a b i t u a l smokers, aged 22 to 26 y e a r s . F u r t h e r support f o r the p h y s i o l o g i c a l i n c o m p a t i b i l i t y between a e r o b i c e x e r c i s e and smoking i s p r o v i d e d by s t u d i e s comparing the response of smokers and nonsmokers to p h y s i c a l t r a i n i n g programs. Cooper, Gey, and Bottenberg (1969) t e s t e d endurance performance u s i n g a running t e s t i n 419 young a i r - men (mean age 19.1 years) b e f o r e and a f t e r s i x weeks of b a s i c t r a i n i n g . They found t h a t smokers had lower r e s p i r a - t o r y minute volume and oxygen consumption a t e q u i v a l e n t h e a r t r a t e s compared to nonsmokers both before and a f t e r t r a i n i n g . T h i s impairment was s i g n i f i c a n t i n s u b j e c t s who had smoked f o r over s i x months, and performance was i n v e r s e l y r e l a t e d t o d a i l y c i g a r e t t e consumption. S i m i l a r l y , Peterson and K e l l y (1969) c o n d i t i o n e d 60 men i n an eight-week running program and found t h a t smokers i n c r e a s e d t h e i r maximal oxygen uptake (MV02) l e v e l s a t a lower r a t e than nonsmokers. The above f i n d i n g s of an i n c o m p a t i b i l i t y between exer- c i s e and smoking are c o n s i s t e n t w i t h the f a c t t h a t two com- pounds i n c i g a r e t t e s , carbon monoxide (CO) and n i c o t i n e , have been l i n k e d t o decreased cardio-pulmonary e f f i c i e n c y . Carbon monoxide i n c i g a r e t t e smoke binds t o hemoglobin thus l e a v i n g l e s s a v a i l a b l e f o r oxygen t r a n s p o r t i n the blood (Montoye, Gayle and H i g g i n s , 19 80). A smoker may have approximately 5 per c e n t or more of h i s blo o d c e l l s b l o c k e d by CO, making oxy- gen t r a n s p o r t more d i f f i c u l t (Astrand and Rodahl, 1970). Body t i s s u e s a l s o r e c e i v e l e s s oxygen because CO reduces 14 p e r i p h e r a l blood flow, pulmonary d i f f u s i o n c a p a c i t y and v i t a l c a p a c i t y (Montoye e t a l . , 19 80). Furthermore, CO i n c r e a s e s airway r e s i s t a n c e , which i n t e r f e r e s with oxygen-carrying c a p a c i t y and causes v a s t c o n s t r i c t i o n of blood v e s s e l s , r e s u l t i n g i n i n c r e a s e d h e a r t r a t e (Rode and Shepard, 1971) . Carbon monoxide, t h e r e f o r e , i s a t l e a s t p a r t i a l l y respon- s i b l e f o r smokers' reduced cardiopulmonary f u n c t i o n . A second harmful agent i n tobacco, n i c o t i n e , decreases c a r d i a c output and s t r o k e volume ;(Astrand and Rodahl, 1970). I t a l s o s t i m u l a t e s the r e l e a s e of catecholamines, which r a i s e h e a r t r a t e and t h e r e f o r e i n c r e a s e the h e a r t ' s work-load (Astrand and Rodahl, 1970). C o l l e c t i v e l y , the above f i n d i n g s i n d i c a t e t h a t smoking induces numerous p h y s i o l o g i c a l changes op p o s i t e to those produced by a e r o b i c e x e r c i s e . I t i s p o s s i b l e , t h e r e f o r e , t h a t smokers exposed to a e r o b i c e x e r c i s e may be encouraged to decrease t h e i r smoking i n order to p a r t i c i p a t e more e f f e c - t i v e l y i n p h y s i c a l a c t i v i t y . C o n v e r s e l y , i f they were to smoke l e s s they would become aware of the improved q u a l i t y of t h e i r e x e r c i s e performance. T h i s p o s i t i v e feedback r e g a r d i n g p h y s i c a l f i t n e s s may, i n t u r n , p r o v i d e f u r t h e r m o t i v a t i o n f o r smoking a b s t i n e n c e . C o n s i s t e n t with t h i s h y p o t h e s i s , Paxton and S c o t t (1981) found t h a t improvement i n lung f u n c t i o n f o l l o w i n g smoking c e s s a t i o n was i n v e r s e l y c o r r e l a t e d w i t h r e l a p s e , and suggested t h a t p o s i t i v e feedback r e g a r d i n g p h y s i o l o g i c a l change r e s u l t e d i n g r e a t e r maintenance of treatment suc c e s s . 15 P s y c h o l o g i c a l F a c t o r s R e l a t e d t o E x e r c i s e and Smoking A number of p s y c h o l o g i c a l f a c t o r s have been l i n k e d to e i t h e r an i n c r e a s e or decrease i n c i g a r e t t e smoking ( L i c h t e n s t e i n and Brown, 19 80). Research suggests t h a t these same v a r i a b l e s may be a f f e c t e d by p h y s i c a l a c t i v i t y (Martin and Dubbert, 1982). To the extent t h a t e x e r c i s e may reduce p s y c h o l o g i c a l s t a t e s r e l a t e d to i n c r e a s e d smoking or i n c r e a s e mental s t a t e s known to reduce smoking, i t may modify smoking through these mediating v a r i a b l e s . One v a r i a b l e which i s n e g a t i v e l y r e l a t e d to smoking i s h e a l t h awareness. Research suggests t h a t smokers are l e s s l i k e l y t o guard t h e i r h e a l t h than are nonsmokers. E i s e r , Sutton, and Wober (1979) found t h a t smokers were l e s s l i k e l y to b e l i e v e t h a t smoking was ' r e a l l y dangerous', were l e s s prone to wearing seat b e l t s , and were more l i k e l y to b e l i e v e t h a t i n d i v i d u a l s have a r i g h t to r i s k t h e i r own h e a l t h r a t h e r than a moral r e s p o n s i b i l i t y t o p r o t e c t themselves from h e a l t h r i s k s . To the extent t h a t e x e r c i s e improves one's a t t i t u d e towards h e a l t h and w e l l - b e i n g , i t may mediate a r e d u c t i o n i n smoking. Two s t u d i e s a t t e s t to the improvement i n h e a l t h a t t i t u d e f o l l o w i n g p a r t i c i p a t i o n i n e x e r c i s e programs. Heinzelmann and Bagley (1970) found more p o s i t i v e f e e l i n g s r e g a r d i n g h e a l t h h a b i t s and behavior, w h i l e Durbeck et a l . (1972) r e p o r t e d i n c r e a s e d p o s i t i v e f e e l i n g s about h e a l t h s t a t u s . Smoking presumably would be a n t i t h e t i c a l to an i n c r e a s e d concern over one's h e a l t h p a t t e r n s and a smoker might, 16 t h e r e f o r e , abandon h i s smoking to mai n t a i n c o n s i s t e n c y w i t h h i s newly a c q u i r e d b e l i e f s r e g a r d i n g h i s h e a l t h l i f e s t y l e . G o t t l i e b , Freidman, Cooney, Gordon and M a r l a t t (1981) d i d , i n f a c t , f i n d t h a t h e a l t h was by f a r the most common reason c i t e d by smokers to attempt smoking c e s s a t i o n . F u r t h e r support f o r h e a l t h as a mediat i n g v a r i a b l e i n smoking ce s s a - t i o n i s p r o v i d e d by S h i p l e y (19 81) who found t h a t ex-smokers with an i n t e r n a l h e a l t h l o c u s of c o n t r o l (HLC - the b e l i e f t h a t one c o n t r o l s h i s / h e r health) remained a b s t i n e n t longer than those w i t h an e x t e r n a l HLC. Va r i o u s s t u d i e s have i n d i c a t e d t h a t e x e r c i s e decreases f e e l i n g s of s t r e s s , t e n s i o n and a n x i e t y (McCrae, Costa and Bosse, 1978; L i c h t e n s t e i n and Brown, 1980). Moreover, these f a c t o r s are known to be a s s o c i a t e d w i t h smoking. S u b j e c t s p a r t i c i p a t i n g i n a NASA-US P u b l i c H e a l t h S e r v i c e Health E d u c a t i o n and Enhancement program (Durbeck et a l . 1972) reported decreased f e e l i n g s of s t r e s s and t e n s i o n a f t e r e x e r c i s i n g , as d i d those i n e x e r c i s e programs f o r men a t r i s k f o r coronary h e a r t d i s e a s e (Heinzelmann and Bagley, 1970; F o l k i n s , 1976). Cooper (1977) r e p o r t e d a " g r e a t e r a b i l i t y to r e s i s t a l l types of s t r e s s " f o l l o w i n g p h y s i c a l f i t n e s s t r a i n i n g , and Cureton (1963) r e p o r t e d t e n s i o n r e d u c t i o n i n a d u l t s p a r t i c i p a t i n g i n a p h y s i c a l c o n d i t i o n i n g program. Morgan (1979) reviewed seven s t u d i e s i n which the e f f e c t s of acute a e r o b i c a c t i v i t y are i n v e s t i g a t e d . Of these, two f a i l e d to demonstrate a decrement i n p e r c e i v e d a n x i e t y f o l l o w i n g e x e r c i s e . In both 17 s t u d i e s , however, the e x e r c i s e c o n s i s t e d simply of walking, s u g g e s t i n g t h a t p h y s i c a l a c t i v i t y may need to be more vi g o r o u s to achieve a s i g n i f i c a n t r e d u c t i o n i n a n x i e t y . Of the f i v e remaining s t u d i e s , f o u r c o n s i s t e d of i n v e s t i g a t i o n s where s u b j e c t s ran and one e n t a i l e d p a r t i c i p a t i o n i n r a c q u e t b a l l . A l l f i v e s t u d i e s demonstrated a r e d u c t i o n i n a n x i e t y through s e l f - r e p o r t . F o l k i n s and Sime (1981) reviewed s i x s t u d i e s i n v e s t i g a t i n g the e f f e c t of p h y s i c a l f i t n e s s t r a i n i n g on a n x i e t y , t e n s i o n and/or w e l l - b e i n g , of which a l l show an improvement i n a f f e c t (obtained by s e l f - r e p o r t ) i n response to e x e r c i s e . They note t h a t the decrement i n n e g a t i v e emo- t i o n s i s p a r t i c u l a r l y e v i d e n t w i t h s u b j e c t s who are e i t h e r i n i t i a l l y l e s s p h y s i c a l l y f i t or more p s y c h o l o g i c a l l y d i s - t r e s s e d . Ikard and Tompkins (19 73) p r o v i d e evidence t h a t people smoke f o r two major reasons: to i n c r e a s e p o s i t i v e a f f e c t and to decrease negative a f f e c t . Furthermore, smokers main- t a i n smoking when they r e a l i z e t h a t i t i s a source of reward and/or a means of c o n t r o l l i n g n e g a t i v e a f f e c t . I f e x e r c i s e has a s i m i l a r e f f e c t on mental s t a t e , i t may decrease the need f o r smoking. Numerous s t u d i e s r e p o r t t h a t s u b j e c t s " f e e l b e t t e r " a f t e r e x e r c i s e (Morgan, Roberts, Brand and Feinerman, 1970). F o l k i n s and Sime (1981) reviewed seven s t u d i e s a s s e s s i n g the e f f e c t of e x e r c i s e on d e p r e s s i o n , mood and w e l l - b e i n g . Of these, s i x demonstrated a s i g n i f i c a n t p o s t - e x e r c i s e improvement i n a f f e c t , as determined by 18 q u e s t i o n n a i r e , w h i l e the seventh found t h i s i n depressed, but not i n normal s u b j e c t s . F u r t h e r support f o r i n c r e a s e d p o s i t i v e a f f e c t f o l l o w i n g e x e r c i s e stems from r e s e a r c h i n d i c a t i n g t h a t p h y s i c a l a c t i v i t y r e l e a s e s beta-endorphins, substances i n the b r a i n known to a c t as o p i a t e s , i n h i b i t i n g p a i n and improving mood s t a t e s ( A p p e n z e l l e r , 1981; A p p e n z e l l e r , Standefer, A p p e n z e l l e r and A t k i n s o n , 1980). P h y s i c a l e x e r c i s e a l s o a c t i v a t e s the sym- pathetic!; nervous system, r e s u l t i n g i n p o s i t i v e emotional s t a t e s (Dimsdale and Moss, 1980). Furthermore, e x e r c i s e reduces f e e l i n g s of c h r o n i c f a t i g u e , known to be a s s o c i a t e d w i t h d e p r e s s i o n (Dimsdale and Moss, 1980). In a d d i t i o n to h e a l t h awareness and n e g a t i v e a f f e c t , o t h e r v a r i a b l e s may a l s o mediate an e f f e c t of e x e r c i s e on smoking. Some people smoke f o r s o c i a l approval ( L i c h t e n s t e i n and Brown, 1980). A smoker might a l s o c u l t i v a t e s o c i a l a pproval by engaging i n r e g u l a r e x e r c i s e and becoming more p h y s i c a l l y f i t . E x e r c i s e enhances se l f - i m a g e and c o n f i d e n c e (Heinzelmann and Bagley, 1970; Collingwood and W i l l e t t , 1971; Cooper, 1977) and t h e r e f o r e might a c t u a l l y decrease one's i n i t i a l need f o r s o c i a l a p p r o v a l . Other f a c t o r s l i n k e d to c i g a r e t t e smoking i n c l u d e boredom ( L i c h t e n s t e i n and Brown, 1980) and a need f o r sensorimotor s t i m u l a t i o n (Flaxman, 1979), both of which may be combatted u s i n g e x e r c i s e . In c o n c l u s i o n , the above s t u d i e s c o n f i r m t h a t a number of p s y c h o l o g i c a l f a c t o r s may be r e s p o n s i b l e f o r smoking. 19 Furthermore, e x e r c i s e has been demonstrated t o be r e l a t e d to many of these v a r i a b l e s . I f smoking and e x e r c i s e are r e l a t e d to p s y c h o l o g i c a l s t a t e s i n an o p p o s i t e d i r e c t i o n , e x e r c i s e p a r t i c i p a t i o n may induce a decrement i n smoking. Summary of Research on E x e r c i s e and Smoking Although the above s t u d i e s i n d i c a t e t h a t e x e r c i s e and smoking may be i n v e r s e l y r e l a t e d , f i r m c o n c l u s i o n s r e g a r d i n g the e f f e c t s of e x e r c i s e on smoking cannot be made on the b a s i s of evidence p r o v i d e d . Of the s t u d i e s reviewed, on l y f o u r were concerned s p e c i f i c a l l y w i t h an examination of the r e l a - t i o n s h i p between these two v a r i a b l e s . Of these f o u r , the r e s u l t s of two (Johnson e t a l . , 1979; Howley e t a l . , 1980) suggest t h a t e x e r c i s e may l e a d t o a decrement i n smoking, but e x e r c i s e i s not manipulated to the e x c l u s i o n o f other t r e a t - ment f a c t o r s . While Morgan e t a l . (1976) found a r e d u c t i o n i n smoking f o l l o w i n g p a r t i c i p a t i o n i n an e x e r c i s e program, the study was r e t r o s p e c t i v e , and i n f o r m a t i o n on smoking was pr o v i d e d s o l e l y by s e l f - r e p o r t . F i n a l l y , the c o r r e l a t i o n a l study by Engs and M u l h a l l (1982) f a i l e d t o f i n d a decrease i n smoking f o l l o w i n g enrolment i n p h y s i c a l e d u c a t i o n courses, but o n l y a s m a l l percentage o f s u b j e c t s were r e g u l a r smokers who consumed at l e a s t one package of c i g a r e t t e s per day. The remaining r e s e a r c h on the e f f e c t s o f a e r o b i c exer- c i s e on smoking i s o f t e n r e t r o s p e c t i v e and a n e c d o t a l , with s t u d i e s a s s e s s i n g the r e l a t i o n s h i p between these two v a r i a b l e s 20 o n l y as p a r t of a l a r g e r p r o j e c t . In c o n c l u s i o n , there i s a need f o r w e l l - c o n t r o l l e d e m p i r i c a l r e s e a r c h e x p l o r i n g the e f f e c t s of a e r o b i c e x e r c i s e on smoking before a d e c i s i o n r e g a r d i n g i t s c l i n i c a l u t i l i t y can be made. Schachter's Model of Smoking: I m p l i c a t i o n s f o r E x e r c i s e Schachter (1977) proposed a model of smoking which would p r e d i c t a change i n smoking f o l l o w i n g e x e r c i s e i n a d i r e c t i o n o p p o s i t e t o t h a t suggested by r e s e a r c h on e x e r c i s e and smoking reviewed above; i . e . , i t would p r e d i c t a pos t - e x e r c i s e i n c r e a s e r a t h e r than decrease i n smoking. He sug- gested t h a t people smoke to r e g u l a t e n i c o t i n e , and t h a t an i n t e r n a l homeostatic mechanism i s r e s p o n s i b l e f o r mo n i t o r i n g n i c o t i n e l e v e l s i n the body. A c c o r d i n g t o Schachter, when a smoker's n i c o t i n e r e s e r v e s are d e p l e t e d he w i l l compensate f o r t h i s l o s s by i n c r e a s i n g h i s c i g a r e t t e consumption. Furthermore, Schachter e x p l a i n s t h a t when u r i n a r y pH decreases, i . e . , when u r i n e becomes more a c i d i c , as i t does when sub- j e c t s are s t r e s s e d , the r a t e o f n i c o t i n e e x c r e t i o n i n c r e a s e s (Wesson, 1969)'. T h i s would r e s u l t i n i n c r e a s e d r a t e s of smoking i n order to compensate f o r n i c o t i n e l o s s . Schachter (1977) presented a s e r i e s of f i v e s t u d i e s to v e r i f y t h a t smokers r e g u l a t e n i c o t i n e . In the f i r s t (Schachter, 1977) he demonstrated t h a t heavy smokers c o n s i s t e n t l y consume more low- than h i g h - n i c o t i n e c i g a r e t t e s when these are a l t e r - nated on a weekly b a s i s . In a second study, an i n c r e a s e i n 21 smoking was found f o l l o w i n g u r i n e a c i d i f i c a t i o n by v i t a m i n C i n t a k e , but smoking d i d not i n c r e a s e when u r i n e was a l k a l i z e d u s i n g sodium b i c a r b o n a t e or was unchanged u s i n g a placebo (Schachter, Kozlowski and S i l v e r s t e i n , 1977). Next, S i l v e r - s t e i n , Kozlowski and Schachter (1977) determined the e f f e c t s of p a r t y going on u r i n a r y pH and smoking, and found t h a t smokers have lower bedtime u r i n a r y pH and r e p o r t smoking more c i g a r e t t e s on days i n which they a t t e n d p a r t i e s than on 'nonparty' days. In a p a r a l l e l manner, Schachter, S i l v e r s t e i n , Kozlowski, Herman, and L i e b l i n g (197 7) found lower u r i n a r y pH l e v e l s and a g r e a t e r i n c r e a s e i n smoking r a t e and number of p u f f s taken per c i g a r e t t e f o l l o w i n g e l e c t r i c shock. F i n a l l y , Schachter, S i l v e r s t e i n and P e r l i c k (1977) separated the e f f e c t s of p s y c h o l o g i c a l s t r e s s from those of u r i n a r y a c i d i f i c a t i o n on c i g a r e t t e smoking. In a 2 X 2 f a c t o r i a l d e s i g n , s u b j e c t s were giv e n e i t h e r sodium b i c a r b o n a t e or a placebo and were p l a c e d i n a high or low s t r e s s c o n d i t i o n . S u b j e c t s were then e s c o r t e d to a w a i t i n g room where smoking r a t e and number of p u f f s taken f o r each c i g a r e t t e were un- o b t r u s i v e l y observed. In the h i g h - s t r e s s placebo c o n d i t i o n u r i n e was s i g n i f i c a n t l y a c i d i f i e d , whereas the h i g h - s t r e s s b i c a r b o n a t e c o n d i t i o n d i d not a c i d i f y the u r i n e . R e s u l t s i n d i c a t e t h a t the m anipulations i n c r e a s e d smoking only when pH was decreased, sugge s t i n g t h a t smoking was i n f l u e n c e d by p h a r m a c o l o g i c a l r a t h e r than p s y c h o l o g i c a l m a n i p u l a t i o n s . The r e l a t i o n s h i p between u r i n a r y pH and smoking as 22 p r e d i c t e d by Schachter was a l s o v e r i f i e d by Dobbs, S t r i c k l e r and Maxwell (1981). These i n v e s t i g a t o r s p l a c e d .undergraduates under s t r e s s by l e a d i n g them to b e l i e v e they would be asked to speak i n f r o n t of graduate students and f a c u l t y . Subjects were then exposed to e i t h e r a r e l a x a t i o n tape (S-R), a s t r e s s - provoking tape (S-S), or a n e u t r a l tape (S-N). Subjects i n a c o n t r o l group (N-N) d i d not a n t i c i p a t e having to g i v e a speech and l i s t e n e d to a n e u t r a l tape. U r i n a r y pH measures were ob t a i n e d d u r i n g b a s e l i n e , and 10 and 35 minutes pos t - treatment. In a d d i t i o n , measures of p u f f r a t e and centimeters of c i g a r e t t e smoked were obt a i n e d b e f o r e , and f o r 35 minutes f o l l o w i n g treatment. Analyses r e v e a l e d s i g n i f i c a n t l y g r e a t e r u r i n e a c i d i f i c a t i o n d u r i n g treatment f o r the S-S group than f o r the N-N and S-R groups and a s i g n i f i c a n t decrease i n p u f f r a t e and amount smoked f o r the S-R group than f o r the other two s t r e s s groups. In a d d i t i o n , changes i n amount of c i g a - r e t t e smoked d u r i n g a 35-minute post-treatment s e s s i o n were n e g a t i v e l y c o r r e l a t e d w i t h treatment pH l e v e l s , s u g g e s t i n g t h a t the i n c r e a s e i n smoking under s t r e s s f u l c o n d i t i o n s was r e l a t e d t o u r i n e a c i d i f i c a t i o n . In c o n t r a s t to the above f i n d i n g s , Schachter's sugges- t i o n t h a t u r i n a r y pH may mediate changes i n smoking behavior was not borne out by M a r s h a l l , Green, E p s t e i n , Rogers and McCoy (1980) who examined the e f f e c t of c o f f e e d r i n k i n g and u r i n a r y pH on c i g a r e t t e smoking. In a w i t h i n - s u b j e c t s design smokers were giv e n water, c o f f e e , c o f f e e and sodium 23 b i c a r b o n a t e or c o f f e e and a s c o r b i c a c i d , and were subsequent- l y asked to remain i n a w a i t i n g room f o r one hour. Pre- to p o s t - s e s s i o n u r i n e analyses i n d i c a t e d t h a t c o f f e e d i d not a c i d i f y the u r i n e ; y e t s u b j e c t s smoked more c i g a r e t t e s i n s e s s i o n s f o l l o w i n g c o f f e e consumption, su g g e s t i n g t h a t smoking behavior was a l t e r e d i n response to c o f f e e d r i n k i n g r a t h e r than to u r i n a r y pH changes. One d i f f i c u l t y with i n t e r p r e t a t i o n of these r e s u l t s , however, i s t h a t the manip- u l a t i o n s f a i l e d t o a c i d i f y the u r i n e . T h i s i s important, as i n c r e a s i n g the a l k a l i n i t y of the u r i n e does not a l t e r appre- c i a b l y n i c o t i n e e x c r e t i o n (Schachter, 1980), and t h e r e f o r e no consequent change i n smoking should have o c c u r r e d . The above s t u d i e s i n d i c a t e t h a t Schachter's theory of n i c o t i n e a d d i c t i o n has some e m p i r i c a l support. The theory p o i n t s to the importance of u r i n a r y pH as a mediating v a r i - a ble i n the d e t e r m i n a t i o n of smoking. T h i s has important i m p l i c a t i o n s f o r the p r e s e n t study, s i n c e one f a c t o r known to decrease u r i n a r y pH i s e x e r c i s e , which a c i d i f i e s u r i n e f o r approximately one hour a f t e r acute strenuous a c t i v i t y (Wesson, 1969). As u r i n e a c i d i f i c a t i o n s t i m u l a t e s n i c o t i n e e x c r e t i o n , smokers would be expected to i n c r e a s e t h e i r c i g a r e t t e con- sumption f o l l o w i n g e x e r c i s e . 24 Statement of Purpose and Hypotheses The p r e s e n t study was designed to examine the acute e f f e c t s of two i n t e n s i t i e s of e x e r c i s e and a n o - e x e r c i s e c o n t r o l on smoking r a t e and topography. I t was p r e d i c t e d t h a t c i g a r e t t e smoking would be i n v e r s e l y r e l a t e d to e x e r c i s e i n t e n s i t y , being lowest f o l - lowing h i g h - i n t e n s i t y e x e r c i s e , i n t e r m e d i a t e f o l l o w i n g low- i n t e n s i t y e x e r c i s e , and g r e a t e s t f o l l o w i n g no e x e r c i s e . T h i s would apply f o r a l l the smoking i n d i c e s assessed, i n - c l u d i n g the number and weight of c i g a r e t t e s smoked, p u f f frequency per c i g a r e t t e and c i g a r e t t e d u r a t i o n . Furthermore, l a t e n c y to smoke was expected to be d i r e c t l y r e l a t e d to e x e r c i s e i n t e n s i t y . A second purpose of the study was to examine the r e l a - t i o n s h i p between u r i n a r y pH, e x e r c i s e and c i g a r e t t e smoking a c c o r d i n g to Schachter's h y p o t h e s i s . I f Schachter's hypoth- e s i s holds then, c o n t r a r y to the above p r e d i c t i o n , strenuous e x e r c i s e would be expected to l e a d to a decrease i n u r i n a r y pH and t h e r e f o r e to a subsequent i n c r e a s e i n smoking. 25 METHOD Subjects E i g h t e e n male s u b j e c t s between the ages df 20 and 30 (mean age = 25.5), who had smoked f o r an average of 10.3 years (range = 3 to 17 years) were r e c r u i t e d through adver- tisements posted a t the U n i v e r s i t y of B r i t i s h Columbia campus and a t v a r i o u s p u b l i c l o c a t i o n s i n West P o i n t Grey and K i t s i l a n o . C r i t e r i a f o r i n c l u s i o n i n the experiment were: 1. The s u b j e c t had to be 20 to 30 years o l d . I t was necessary to s e l e c t a homogeneous group of s u b j e c t s w i t h r e s p e c t to age i n order to minimize extraneous f a c t o r s which may have i n f l u e n c e d e x e r c i s e . 2. The s u b j e c t had to be screened by a PARQ ( P h y s i c a l A c t i v i t y Readiness Q u e s t i o n n a i r e ) , which was completed to determine t h a t he had no medical c o n d i t i o n which p r e c l u d e d h i s p a r t i c i p a t i o n i n the study. 3. S u b j e c t s c o u l d not be on any m e d i c a t i o n which a l t e r e d t h e i r cardiopulmonary f u n c t i o n or smoking r a t e d u r i n g , or f o r one day b e f o r e the study. 4. The s u b j e c t had to be i n poor to average p h y s i c a l c o n d i - t i o n as determined by h i s r e p o r t of weekly p h y s i c a l a c t i v i t y on a s c r e e n i n g q u e s t i o n n a i r e . Weekly a c t i v i t i e s were t r a n s - formed i n t o a e r o b i c p o i n t s (Cooper, 1977), and o n l y s u b j e c t s w i t h accumulated p o i n t s p l a c i n g them i n a below-average f i t n e s s 26 category were s e l e c t e d f o r the study. 5. The s u b j e c t s had to have smoked at l e a s t one package of c i g a r e t t e s d a i l y f o r the l a s t t hree y e a r s . I f there had been a gap i n the s u b j e c t ' s smoking h i s t o r y , the t h r e e - y e a r p e r i o d was lengthened by t h a t amount. V o l u n t e e r s p a r t i c i p a t i n g i n smoking c e s s a t i o n programs or implementing smoking r e d u c t i o n s t r a t e g i e s , as w e l l as those who attempted to q u i t smoking w i t h i n 30 days of the study were screened out. Apparatus Urine samples were c o l l e c t e d i n 150ml p l a s t i c specimen c o n t a i n e r s and analyzed u s i n g an O r i o n Research Model 701A D i g i t a l I o n a l y z e r pH meter. Subjects were e x e r c i s e d on a Monark s t a t i o n a r y b i c y c l e . Heart r a t e was recorded u s i n g a Grass polygraph D.C. d r i v e r a m p l i f i e r , model 7DAB and a Grass p r e a m p l i f i e r , model 7P4 A, and Beckman one centimeter s i l v e r s i l v e r - c h l o r i d e e l e c t r o d e s . Blood p r e s s u r e was measured w i t h an Accoson sphygmomanometer and b l o o d p r e s s u r e c u f f , and a Dittman stethoscope. C i g a r e t t e b u t t s were weighed on a Canlab S a r t o r i u s model 2603 a n a l y t i c balance. Other equipment i n c l u d e d a W i t t n e r Super M i n i T a k t e l l metronome, a s c a l e f o r measuring s u b j e c t s ' body weight, and two stopwatches. Procedure The study was conducted i n two classrooms, one designated 27 the e x e r c i s e l a b o r a t o r y and the other a w a i t i n g room, i n the Chemical E n g i n e e r i n g B u i l d i n g a t The U n i v e r s i t y of B r i t i s h Columbia. Each s u b j e c t p a r t i c i p a t e d i n f o u r s e s s i o n s , three e xperimental s e s s i o n s and a d e b r i e f i n g s e s s i o n , on f o u r con- s e c u t i v e days at the same time each day. E x e r c i s e m o n i t o r i n g and f i t n e s s t e s t i n g were performed by an experimenter t r a i n e d i n cardio-pulmonary r e s u s c i t a t i o n . As a s a f e t y p r e c a u t i o n an a s s i s t a n t was present a t a l l s e s s i o n s . During i n i t i a l telephone c o n t a c t , the experimenter e x p l a i n e d the study to i n t e r e s t e d p o t e n t i a l s u b j e c t s and screened them to ensure they f i t the s p e c i f i e d c r i t e r i a . At the f i r s t s e s s i o n s u b j e c t s were r e q u i r e d to s i g n a consent form which s t a t e d t h a t the purpose of the study was to examine the p h y s i o l o g i c a l e f f e c t s of three d i f f e r e n t i n t e n s i t i e s of e x e r c i s e on c i g a r e t t e smokers. I t i n c l u d e d i n f o r m a t i o n on the procedure of the study, i . e . , e x e r c i s e s e s s i o n s and s e l f - m o n i t o r i n g of c i g a r e t t e i n t a k e . M i s i n f o r m i n g s u b j e c t s of the purpose of the study was intended to minimize demand charac- t e r i s t i c s and e x p e c t a n c i e s of change i n smoking behavior. P r i o r to p a r t i c i p a t i o n i n the study s u b j e c t s a l s o com- p l e t e d the PAR-Q and a q u e s t i o n n a i r e about t h e i r smoking and e x e r c i s e h i s t o r i e s . Questions assessed pa s t and c u r r e n t attempts at r e d u c i n g or q u i t t i n g smoking and the p r e s e n t r a t e of smoking as w e l l as the frequency and i n t e n s i t y of e x e r c i s e i n which the s u b j e c t s had p r e v i o u s l y engaged and i n which they were p r e s e n t l y engaged. 28 Subjects were asked to a b s t a i n from smoking f o r one- h a l f hour, from e a t i n g , and from d r i n k i n g beverages c o n t a i n - i n g c a f f e i n e and a l c o h o l f o r two hours b e f o r e each s e s s i o n , as these would a f f e c t t h e i r h e a r t r a t e . Subjects were asked i f they had a b s t a i n e d from these upon t h e i r a r r i v a l a t the l a b o r a t o r y , and those not having done so were to have been resche d u l e d . Subjects p r o v i d e d u r i n e samples b e f o r e and a t 15 and 64 minutes f o l l o w i n g e x e r c i s e and a t e q u i v a l e n t i n t e r v a l s i n the n o - e x e r c i s e c o n d i t i o n . These were c o l l e c t e d i n sampling c o n t a i n e r s and analyzed w i t h i n f o u r hours on a D i g i t a l I o n a l y z e r pH meter. Sampling c o n t a i n e r s were reused a f t e r b e i n g washed and r i n s e d with d i s t i l l e d water. The design of the study c o n s i s t e d of a repeated measures de s i g n i n which each s u b j e c t p a r t i c i p a t e d i n three s e s s i o n s , each one a t a d i f f e r e n t e x e r c i s e i n t e n s i t y . P r i o r to each s e s s i o n measures of body weight and b l o o d p r e s s u r e were taken. During two of the f i r s t t h r e e s e s s i o n s of t h e study each s u b j e c t was r e q u i r e d to e x e r c i s e f o r 10 minutes on a s t a t i o n a r y b i c y c l e a t one of two d i f f e r e n t i n t e n s i t i e s , one r e s u l t i n g i n a h e a r t r a t e of 130-135 bpm (66% t o 69% of maximal h e a r t rate) and the other a h e a r t r a t e of 160-165 bpm (82% to 85% of maximal h e a r t r a t e ) . S u b j e c t s ' h e a r t r a t e s were monitored v i a a Grass Polygraph ECG machine. A metro- nome was s e t a t 100 beats per minute, pacing s u b j e c t s ' p e d a l - i n g a t 50 rpms. Subjects s t a r t e d p e d a l i n g and w i t h i n 5 29 s e c o n d s a w o r k - l o a d o f two o r t h r e e k i l o p o n d s f o r a l o w o r h i g h i n t e n s i t y w o r k o u t , r e s p e c t i v e l y , was a d d e d . A f t e r 55 s e c o n d s t o one m i n u t e a r e c o r d i n g was made o f t h e h e a r t r a t e and i f n e c e s s a r y , t h e w o r k - l o a d was i n c r e a s e d u n t i l t h e t a r g e t h e a r t r a t e was a c h i e v e d . A f t e r t e n m i n u t e s o f e x e r c i s e , t h e w o r k l o a d was r e d u c e d t o n e a r z e r o r e s i s t a n c e a n d s u b j e c t s c o n t i n u e d t o p e d a l f o r an a d d i t i o n a l t w o - m i n u t e r e c o v e r y p e r i o d . I m m e d i a t e l y a f t e r w a r d a n d a t 3 0 - s e c o n d i n t e r v a l s t h e r e a f t e r s u b j e c t s r a t e d t h e i r r e s p i r a t i o n r a t e s on a s e v e n p o i n t s c a l e u n t i l t h e y i n d i c a t e d t h a t t h e y w e r e b r e a t h i n g n o r m a l l y . B l o o d p r e s s u r e was t a k e n 3 1/2 m i n u t e s f o l l o w i n g e x e r c i s e . M a x i m a l o x y g e n u p t a k e (MV02) was p r e d i c t e d f o r e a c h s u b j e c t on t h e b a s i s o f h i s h e a r t r a t e a n d t h e c o r r e s p o n d i n g w o r k - l o a d d u r i n g t h e f o u r t h t o s i x t h m i n u t e o f l o w e x e r c i s e i n t e n s i t y a n d t h e s u b j e c t ' s w e i g h t u s i n g a nomograph ( A s t r a n d . and R o d a h l , 1970) . I n t h e n o - e x e r c i s e c o n d i t i o n s u b j e c t s ' h e a r t r a t e s w e r e m o n i t o r e d f o r 10 m i n u t e s w h i l e t h e y r e m a i n e d s e a t e d i n a c h a i r . A l l o t h e r p r o c e d u r e s w e r e t h e same a s t h o s e o f t h e e x e r c i s e c o n d i t i o n s , w i t h t h e e x c e p t i o n o f t h e s e l f - r a t i n g o f r e s p i r a t i o n r a t e w h i c h was d e l e t e d i n t h i s c o n d i t i o n f o r t h e l a s t e i g h t s u b j e c t s , a s t h e f i r s t t e n v o l u n t e e r s h a d c o n s i s - t e n t l y r a t e d t h e i r b r e a t h i n g as b e i n g ' c o m p l e t e l y n o r m a l ' f o l l o w i n g h e a r t r a t e m o n i t o r i n g . When h e a r t r a t e m o n i t o r i n g was c o m p l e t e d a n d b l o o d 30 p r e s s u r e measurements were repeated, s u b j e c t s were ushered i n t o the w a i t i n g room where they remained f o r one hour. They were ad v i s e d t h a t smoking was pe r m i t t e d d u r i n g t h i s p e r i o d . To s t a n d a r d i z e a c t i v i t y d u r i n g the w a i t i n g p e r i o d , r e a d i n g m a t e r i a l , i n c l u d i n g a d a i l y newspaper, Time, Macleans, and People was p r o v i d e d . Subjects were a l s o asked t o remain i n t h e i r gym c l o t h i n g u n t i l the l a s t u r i n e sample of each s e s s i o n was ob t a i n e d . They were p r o v i d e d w i t h a schedule so t h a t they would know i n advance of a l l s e s s i o n s e x a c t l y when they would be asked t o g i v e u r i n e samples. In order to s t a n d a r d i z e c i g a r e t t e smoking i n t h e w a i t i n g room, i f a s u b j e c t was smoking when i t was time to p r o v i d e a u r i n e specimen, e i t h e r at 15 or 64 minutes f o l l o w i n g e x e r c i s e , the observer was i n s t r u c t e d to wait u n t i l the s u b j e c t had f i n i s h e d h i s c i g a r e t t e b e f o r e ask- i n g him to p r o v i d e a u r i n e sample. The number and weight of c i g a r e t t e s were p r o r a t e d i f the s u b j e c t extended h i s time i n the w a i t i n g room beyond 6 4 minutes. Subjects were u n o b t r u s i v e l y observed by a male a s s i s t a n t whose presence i n the w a i t i n g room was o s t e n s i b l y f o r the purpose of prompting the s u b j e c t s a t times when u r i n e s p e c i - mens were to be c o l l e c t e d . In order t o s t a n d a r d i z e and m i n i - mize any i n t e r a c t i o n between the s u b j e c t and the observer, s u b j e c t s were b r i e f l y i n t r o d u c e d by f i r s t name and were t o l d t h a t the observer would be working i n the w a i t i n g room. The observer was a l s o i n s t r u c t e d to be r e a d i n g o r w r i t i n g , t o look up f o r a moment and to say " H i " when i n t r o d u c e d . In 31 a d d i t i o n , he was coached on p o l i t e l y t e r m i n a t i n g any conver- s a t i o n i n i t i a t e d by the s u b j e c t w i t h , "I would l i k e t o chat with you now, but I've got to get t h i s f i n i s h e d f o r my next c l a s s " . The observer d i d not smoke, but had on h i s desk i n c l e a r view of the s u b j e c t a package of c i g a r e t t e s , matches and an empty a s h t r a y . Measurement of smoking l a t e n c y began f o u r minutes a f t e r the s u b j e c t dismounted from the b i c y c l e ergometer when he en- t e r e d the w a i t i n g room. At t h a t time the observer a c t i v a t e d a stopwatch and when the s u b j e c t took h i s f i r s t i n h a l a t i o n while l i g h t i n g h i s f i r s t c i g a r e t t e , the observer recorded the time. The observer a l s o recorded the number of p u f f s taken from the f i r s t c i g a r e t t e (a p u f f d e f i n e d as an i n s t a n c e where the c i g a r e t t e i s i n c o n t a c t w i t h a smoker's l i p s and f l a r i n g ) and the time a t which i t was e x t i n g u i s h e d (defined as the time when the c i g a r e t t e came i n t o i n i t i a l c o n t a c t w i t h the a s h t r a y w h i l e being e x t i n g u i s h e d ) . As an a d d i t i o n a l measure of smoking r a t e , one hour a f t e r e x e r c i s e , c i g a r e t t e b u t t s d i s c a r d e d i n an a s h t r a y a f t e r the s u b j e c t s ' stay i n the w a i t i n g room were counted. Furthermore, the weight of c i g a r e t t e smoked i n the w a i t i n g room was c a l c u - l a t e d . T h i s was done by deducting the combined weight i n grams (to f o u r decimal p l a c e s ) of the a s h t r a y and i t s con- t e n t s a f t e r the s e s s i o n from the combined weight of the ash- t r a y and as many unused c i g a r e t t e s of the s u b j e c t ' s brand smoked d u r i n g the w a i t i n g p e r i o d . 32 A p i t c h e r of water and g l a s s e s were a v a i l a b l e f o r sub- j e c t s i n the w a i t i n g room to e l i m i n a t e the p o s s i b i l i t y t h a t they would decrease t h e i r smoking i n response to d e h y d r a t i o n induced by e x e r c i s e . Records were kept of the amount of water drunk a t each s e s s i o n f o r each s u b j e c t . The amount of water consumed was taken as the d i f f e r e n c e i n m i l l i l i t e r s between the water p i t c h e r contents a t the b e g i n n i n g and a t the end of the s e s s i o n , with any water remaining i n the sub- j e c t ' s g l a s s r e t u r n e d to the p i t c h e r b e f o r e the f i n a l measure- ment was made. Subjects monitored t h e i r d a i l y c i g a r e t t e consumption u s i n g s m a l l t a l l y cards and a p e n c i l which f i t c o n v e n i e n t l y i n t o t h e i r c i g a r e t t e packages. The t a l l y cards were d i v i d e d i n t o s e c t i o n s corresponding to an h o u r l y sequence beg i n n i n g w i t h the o b s e r v a t i o n p e r i o d . Subjects were asked to p l a c e a t a l l y mark i n the a p p r o p r i a t e time segment each time they had a c i g a r e t t e to permit a c a l c u l a t i o n of d a i l y smoking r a t e . S u b j e c t s were a l s o asked to r e c o r d to the n e a r e s t hour the time a t which they r e t i r e d and awoke each day. The r a t i o n a l e p r o v i d e d f o r t h i s was t h a t i t was necessary to know how long they s l e p t i n order to e v a l u a t e a c c u r a t e l y t h e i r e x e r c i s e per- formance. Subje c t s handed i n a t a l l y c a r d a t the beginning of each experimental s e s s i o n and were p r o v i d e d w i t h a new c a r d f o r the f o l l o w i n g day. During the .fourth s e s s i o n s u b j e c t s handed i n t h e i r l a s t t a l l y c a r d and completed a post-study q u e s t i o n n a i r e which 33 assessed t h e i r b e l i e f s and e x p e c t a t i o n s r e g a r d i n g the study. The q u e s t i o n n a i r e asked f o r t h e i r p e r c e p t i o n s of the .purpose of the study i n order to assess the c r e d i b i l i t y of the r a t i o n a l e p r o v i d e d d u r i n g i n i t i a l c o n t a c t . In a d d i t i o n , s u b j e c t s were questioned as to whether they b e l i e v e d exer- c i s e would a f f e c t t h e i r smoking behavior. S u b j e c t s were de- b r i e f e d as to the a c t u a l purpose of the study, and were gi v e n time to ask q u e s t i o n s . They were p a i d $25 and were o f f e r e d i n f o r m a t i o n r e g a r d i n g t h e i r p h y s i c a l f i t n e s s (aerobic c a p a c i t y ) which was d e r i v e d from t h e i r e x e r c i s e performance. Dependent V a r i a b l e s Smoking behavior was assessed u s i n g measures of smoking r a t e and d i r e c t and i n d i r e c t measures of smoking topography f o r each s u b j e c t . Smoking r a t e was determined by s u b j e c t s ' s e l f - m o n i t o r i n g of c i g a r e t t e s consumed f o r one hour and 23 hours p o s t - e x e r c i s e , and by a count of c i g a r e t t e b u t t s d i s - carded i n an a s h t r a y d u r i n g t h e i r s tay i n the w a i t i n g room. Top o g r a p h i c a l measures of smoking i n c l u d e d l a t e n c y to smoke and p u f f frequency f o r the f i r s t c i g a r e t t e consumed f o l l o w i n g e x e r c i s e , and weight of c i g a r e t t e ( s ) smoked one hour p o s t - e x e r c i s e . In a d d i t i o n , c i g a r e t t e d u r a t i o n was c a l - c u l a t e d by s u b t r a c t i n g e x t i n c t i o n time from the time the c i g a r e t t e was l i t , f o r the f i r s t c i g a r e t t e f o l l o w i n g e x e r c i s e . 34 RESULTS Eighte e n v o l u n t e e r s p a r t i c i p a t e d i n the e n t i r e study. One a d d i t i o n a l s u b j e c t dropped out a f t e r the f i r s t s e s s i o n , and h i s data are not i n c l u d e d i n the a n a l y s e s . Post study q u e s t i o n n a i r e s a d m i n i s t e r e d to s u b j e c t s d u r i n g the d e b r i e f i n g s e s s i o n r e v e a l e d t h a t they were unaware of the a c t u a l purpose of the study. Furthermore, s u b j e c t s d i d not r e a l i z e t h a t t h e i r c i g a r e t t e or water consumption was being monitored i n the w a i t i n g room. Sub j e c t s ' r e p o r t s of weekly p h y s i c a l a c t i v i t y on a s c r e e n i n g q u e s t i o n n a i r e were analyzed and i t was found t h a t s u b j e c t s accumulated a weekly average of 19.2 a e r o b i c p o i n t s (range = 5 to 30), which, a c c o r d i n g to Cooper (1977) i s i n - s u f f i c i e n t f o r m a i n t a i n i n g one's a e r o b i c f i t n e s s l e v e l . Con- s i s t e n t w i t h these s e l f - r e p o r t data, maximal oxygen uptake (MV02) l e v e l s , p r e d i c t e d f o r each s u b j e c t on the b a s i s of e x e r c i s e performance d u r i n g l o w - i n t e n s i t y e x e r c i s e , ranged from 36 to 55 ml/kg/min (mean of 45.3 ml/kg/min), p l a c i n g most v o l u n t e e r s i n the low-average range f o r a e r o b i c f i t n e s s . Data Analyses H a r t l e y F-max t e s t s conducted on a l l the data b e f o r e analyses of v a r i a n c e (ANOVAs) were conducted i n d i c a t e d t h a t 35 i n every case the v a r i a n c e s across the c o n d i t i o n s were homo- geneous. For measures of u r i n a r y pH, the v a r i a n c e s were homogeneous across both c o n d i t i o n s and time p e r i o d s i n which the samples were taken. M a n i p u l a t i o n Checks Measures of u r i n a r y pH, taken be f o r e and a t 15 and 64 minutes f o l l o w i n g e x e r c i s e , averaged 6.28 (SD = .81), 5.94 (SD = .80) and 6.34 (SD = .80) f o r the h i g h - i n t e n s i t y exer- c i s e c o n d i t i o n , 6.23 (SD = .70), 5.98 (SD = .84) and 6.60 (SD = .80) f o r the l o w - i n t e n s i t y e x e r c i s e c o n d i t i o n , and 5.95 (SD = .81), 5.94 (SD = .88) and 6.20 (SD = .87) f o r the no - e x e r c i s e c o n d i t i o n , r e s p e c t i v e l y . A two-way ( c o n d i t i o n X time i n which the u r i n e sample was obtained) repeated measures ANOVA was c a l c u l a t e d on measures of u r i n a r y pH, and the r e s u l t s are t a b u l a t e d i n Table 1. There was a s i g - n i f i c a n t main e f f e c t f o r time (F(2,34) = 17.15, p < .01) and a s i g n i f i c a n t e f f e c t f o r samples ob t a i n e d 15 minutes f o l l o w - i n g e x e r c i s e versus those obtained 6 4 minutes f o l l o w i n g exer- c i s e (F(l,17) = 59.04, p < .01). A s i g n i f i c a n t i n t e r a c t i o n e f f e c t was found f o r c o n d i t i o n by time i n which the u r i n e sample was obt a i n e d (F(4,68) = 2.87, p < .05) wit h a s i g n i f i c a n t e f f e c t i n the i n t e r a c t i o n between the n o - e x e r c i s e c o n d i t i o n versus e x e r c i s e c o n d i t i o n s and both o v e r a l l time as w e l l as 15 minutes versus 64 minutes f o l l o w i n g e x e r c i s e ( i . e . , C 3 - C±C2 X T, F(2,34) = 4.14, p < .05; C 3 ~ C 1 C 2 X T 2 " T 3 ' ^(1,17) = 4.63, p < .05). A Table 1 Summary ANOVA Table f o r U r i n a r y pH Measures e r r o r term SS df MS c C x S C 3 " " C 1 C 2 ( C 3 — C.^) x S C l * ' C 2 < C 1 — C 2) x S T T x S T l • - T T 2 3 < Ti T 2 T 3 ) x S T 2 • " T 3 ( T 2 — T 3) x S C x T C x T x S ( c 3 - C 1 C 2 ) X (T x - T 2 T 3 ) ( C 3 - C 1 C 2 ) x ( T 1 ( C 3 - C 1 C 2 ) X (T 2 - T 3) < C 3 — C l C 2 ) x ( T 2 ( C 1 " C 2 ) X ( T 1 - T T ) 2 3 ' ( C 1 — C 2 ) x ( T l - ( C 1 " C 2 ) x ( T 2 3 ; ( C 1 — C ^ x ^ - (c 3 - C 1 C 2 ) X T <C3 — C±C2) x T T/C 1 T x S T/C 2 T x S T/C- T x S s S x C S x T S x C x T 1.602 1.401 2 1 .801 1. 401 .978 1.319 .200 1 .200 .347 4.929 2 2.465 1 7 . 1 4 7 * * .006 1 .006 .028 4.924 1 4. 924 5 9 . 0 4 1 * * 1.093 4 .273 2 .872 * - T 2 T 3 ) x S .206 1 . 206 3.441 - T 3 ) x S .392 1 . 392 4 . 633 * T 2 T 3 ) x S .269 1 .269 2.459 T 3 ) x S .227 1 .227 1.907 x S .598 2 .299 4 .139 * 1.698 2 . 849 5 .909* 3.560 2 1.780 1 2 . 3 8 8 * * 0.764 2 0.382 2.659 62.152 27.848 4.887 6.470 17 34 34 68 3.656 „ .819 .144 .095 h i g h - i n t e n s i t y e x e r c i s e c o n d i t i o n l o w - i n t e n s i t y e x e r c i s e c o n d i t i o n n o - e x e r c i s e c o n d i t i o n * p < .05 ** p < .01 37 s i g n i f i c a n t e f f e c t was a l s o found f o r time w i t h i n the h i g h - i n t e n s i t y e x e r c i s e c o n d i t i o n (F(2,34) = 5.91, p < .05) and the l o w - i n t e n s i t y e x e r c i s e c o n d i t i o n (F(2,34) = 2.39, p < .01), but t h e r e was no time e f f e c t f o r the n o - e x e r c i s e con- d i t i o n . A t w o - t a i l e d Dunnett's t e s t r e v e a l e d s i g n i f i c a n t p r e - t o 15-minute p o s t - e x e r c i s e u r i n e a c i d i f i c a t i o n f o r the h i g h - i n t e n s i t y e x e r c i s e c o n d i t i o n (t(17) = 3.51, p < .01) and a s i g n i f i c a n t pre- to 64-minute p o s t - e x e r c i s e i n c r e a s e i n u r i n e a l k a l i n i t y f o r the l o w - i n t e n s i t y e x e r c i s e c o n d i t i o n (t(17) = 2.57, p < .05). Repeated r a t i n g s of b r e a t h l e s s n e s s were taken f o r the f i r s t t en s u b j e c t s immediately a f t e r the two e x e r c i s e s e s s i o n s and a t the c o r r e s p o n d i n g i n t e r v a l s i n the c o n t r o l c o n d i t i o n . Ratings of b r e a t h l e s s n e s s i n the n o - e x e r c i s e c o n d i t i o n were subsequently d i s c o n t i n u e d as a l l v o l u n t e e r s had c o n s i s t e n t l y i n d i c a t e d t h e i r b r e a t h i n g was "completely normal" on a seven- p o i n t s c a l e . For the remaining e i g h t s u b j e c t s b r e a t h l e s s n e s s r a t i n g s were completed on l y a f t e r e x e r c i s i n g . The f i r s t t en s u b j e c t s r a t e d themselves as b r e a t h i n g normally a f t e r an average of 2.75 (SD = 1.31) and 1.95 (SD = 1.44) minutes f o r the h i g h , and low, i n t e n s i t y e x e r c i s e c o n d i t i o n s r e s p e c t i v e l y (mean = 2.56 and 1.81 f o r a l l 18 s u b j e c t s ) . There was a s i g n i f i c a n t d i f f e r e n c e i n r a t i n g s of b r e a t h l e s s n e s s among the three c o n d i t i o n s as determined by a repeated measures ANOVA, f o r the f i r s t t en s u b j e c t s (F(2,18) = 21.85, p < .001). R e s u l t s of a Tukey 1s Honestly S i g n i f i c a n t D i f f e r e n c e t e s t 38 conducted on a l l p o s s i b l e p a i r w i s e comparisons i n d i c a t e d a s i g n i f i c a n t d i f f e r e n c e i n b r e a t h l e s s n e s s r a t i n g s between the n o - e x e r c i s e and h i g h - e x e r c i s e groups (X^ - X^ = 2.75) and between the n o - e x e r c i s e and low - e x e r c i s e groups (X^ - X^ = 1.95) (CV = 1.09, p < .05, k = 3, r = 18). A S c h e f f e t e s t conducted on comparisons of each c o n d i t i o n w i t h the other two ( i . e . , - C 2 C 3 ' C 2 ~ C 1 C 3 ' C 3 ~ C1 C2^ i n d i c a t e d a s i g - n i f i c a n t d i f f e r e n c e between the h i g h - e x e r c i s e versus the no- and l o w - e x e r c i s e c o n d i t i o n s (F = 22.38, p < .01) and between the n o - e x e r c i s e versus the h i - and low - e x e r c i s e c o n d i t i o n s (F = 39.78, p < .01). Pulse r a t e s , taken immediately a f t e r the two-minute re c o v e r y p e r i o d , were h i g h e s t f o r the hi g h i n t e n s i t y e x e r c i s e c o n d i t i o n (mean = 120.3, SD = 9.34), i n t e r m e d i a t e i n the low i n t e n s i t y e x e r c i s e c o n d i t i o n (mean = 104.2, SD = 5.46) and lowest i n the c o n t r o l c o n d i t i o n (mean = 69.6, SD = 9.34). A repeated measures ANOVA showed a s i g n i f i c a n t d i f f e r e n c e among the three c o n d i t i o n s (F(2,34) = 353.93, p <C .001) and planned o r t h o g o n a l c o n t r a s t s r e v e a l e d a s i g n i f i c a n t d i f f e r e n c e be- tween the experimental and c o n t r o l c o n d i t i o n s ( t ( l , 1 7 ) = 20.6, p C .001) and between the h i g h and low i n t e n s i t y exer- c i s e c o n d i t i o n s ( t ( l , 1 7 ) = 11.87, p < .001). R e l i a b i l i t y Checks R e l i a b i l i t y checks were' made by an independent observer on 26 pe r c e n t of the o b s e r v a t i o n s , i n c l u d i n g l a t e n c y to smoke, 39 time e x t i n g u i s h e d and number of p u f f s , a l l taken f o r the f i r s t c i g a r e t t e smoked i n the w a i t i n g room. There was a p e r f e c t c o r r e l a t i o n between the two observers f o r the l a t e n c y measure and a near p e r f e c t c o r r e l a t i o n f o r measures of c i g a r e t t e e x t i n c t i o n time (r = .99, p < .001) and number of p u f f s per c i g a r e t t e (r = .98, p < .001). Pearson c o r r e l a t i o n s were c a l c u l a t e d f o r the observer's r e c o r d of the number of c i g a r e t t e s smoked by the s u b j e c t i n the w a i t i n g room and s u b j e c t s ' s e l f - r e p o r t v i a t a l l y cards of the number of c i g a r e t t e s smoked d u r i n g the same p e r i o d . The c o r r e l a t i o n was .76 (p < .001), i n d i c a t i n g t h a t s u b j e c t s ' s e l f - r e p o r t i s a f a i r l y r e l i a b l e i n d i c a n t of smoking behavior w i t h i n the experimental s e s s i o n . Dependent Var1ables Two way '(order x condition)^ repeated measures ANOVAs were conducted on measures of smoking r a t e and topography, wi t h order e f f e c t s counterbalanced. Analyses r e v e a l e d no main e f f e c t f o r order and no order by c o n d i t i o n i n t e r a c t i o n on any measures. The c e l l s were, t h e r e f o r e , c o l l a p s e d across order and one-way repeated measures ANOVAs were computed f o r each of the smoking v a r i a b l e s . Scores f o r the number of c i g a r e t t e s consumed 23 hours p o s t - e x e r c i s e were a d j u s t e d by d i v i d i n g these scores by the number of waking hours '(calculated from the s u b j e c t ' s r e p o r t on the t a l l y c a r d of the time he r e t i r e d and awoke each day). There was no d i f f e r e n c e i n the ANOVA r e s u l t s of these scores 40 and the unadjusted s c o r e s ; the l a t t e r were, t h e r e f o r e , used i n subsequent a n a l y s e s . The o n l y smoking measure f o r which a s i g n i f i c a n t over- a l l f i n d i n g was o b t a i n e d was c i g a r e t t e d u r a t i o n (F(2,34) = 3.31, p < .05), which was l o n g e s t f o l l o w i n g the c o n t r o l c o n d i t i o n and s h o r t e s t a f t e r h i g h - i n t e n s i t y e x e r c i s e . Planned o r t h o g o n a l c o n t r a s t s i n d i c a t e d a s i g n i f i c a n t d i f f e r e n c e i n t h i s smoking v a r i a b l e between the e x e r c i s e c o n d i t i o n s and c o n t r o l c o n d i t i o n ( t ( l , 1 7 ) = -2.45, p < .05), but not between the h i g h - versus l o w - i n t e n s i t y e x e r c i s e c o n d i t i o n s . Means and standard d e v i a t i o n s f o r a l l the smoking measures are presented i n Table.2. C o r r e l a t i o n a l S t a t i s t i c s Pearson c o r r e l a t i o n s were c a l c u l a t e d between c i g a r e t t e d u r a t i o n and p r e - to 15 minute p o s t - e x e r c i s e u r i n a r y pH change f o r the h i g h - i n t e n s i t y e x e r c i s e c o n d i t i o n , f o r which u r i n e a c i d i f i e d s i g n i f i c a n t l y . A s i g n i f i c a n t i n v e r s e r e l a t i o n s h i p was found between c i g a r e t t e d u r a t i o n and change i n u r i n a r y pH f o l l o w i n g h i g h - i n t e n s i t y e x e r c i s e (r = -.41, p <. .05). Pearson c o r r e l a t i o n s were c a l c u l a t e d between c i g a r e t t e dura- t i o n and the remaining p h y s i o l o g i c a l measures across c o n d i t i o n s i n order to e x p l o r e any p o t e n t i a l r e l a t i o n s h i p s among these v a r i a b l e s . A B o n f e r r o n i c o r r e c t i o n f o r alpha l e v e l was c a l - c u l a t e d by d i v i d i n g the l e v e l of s i g n i f i c a n c e by seven com- p a r i s o n s i n each e x e r c i s e c o n d i t i o n and by s i x comparisons i n Table 2 Means and Standard D e v i a t i o n s o f Smoking Measures i n the Three Experimental C o n d i t i o n s Smoking High I n t e n s i t y Low, I n t e h s i t y t ; C o n t r o l Measures E x e r c i s e C o n d i t i o n E x e r c i s e C o n d i t i o n C o n d i t i o n Mean S.D. Mean S.D. Mean S.D. CIG 1 1.72 0.58 2.00 0.69 1.78 0.81 CIG 23 25.28 17.87 25.78 10.83 25.06 10.97 WTCIG 0.93 0.38 1.10 0.44 1.00 0.47 LAT 10.73 12.05 7.67 6.88 10. 86 12.64 PUFF 7.17' 2.50 7.94 3.28 7.33 2.06 DUR* 7.49 1.76 7.70 1.59 8.51 1.79 CIG 1 number of c i g a r e t t e s smoked i n w a i t i n g room 1 hour p o s t - e x e r c i s e CIG 23 number of c i g a r e t t e s smoked 23 hours p o s t - e x e r c i s e WTCIG weight of c i g a r e t t e ( s ) smoked i n w a i t i n g room LAT l a t e n c y to smoke i n w a i t i n g room p o s t ^ e x e r c i s e PUFF number of p u f f s f o r f i r s t c i g a r e t t e smoked i n w a i t i n g room DUR d u r a t i o n of f i r s t c i g a r e t t e smoked i n w a i t i n g room * a s i g n i f i c a n t d i f f e r e n c e (p < .05) across the thr e e c o n d i t i o n s 42 the c o n t r o l c o n d i t i o n , f o r which r a t i n g s o f b r e a t h l e s s n e s s were o m i t t e d ( K i r k , 1968). An i n i t i a l a l p h a l e v e l was s e t a t .10 due to the e x p l o r a t o r y n a t u r e of the a n a l y s e s . T h i s r e s u l t e d i n the a d o p t i o n o f a l p h a l e v e l s o f .014 and .017 f o r c o r r e l a t i o n s i n the e x p e r i m e n t a l and c o n t r o l c o n d i t i o n s , r e - s p e c t i v e l y . None o f these c o r r e l a t i o n s a t t a i n e d t h i s l e v e l of s i g n i f i c a n c e , s u g g e s t i n g t h a t these p h y s i o l o g i c a l v a r i a b l e s d i d not. mediate the e f f e c t o f e x e r c i s e on c i g a r e t t e d u r a t i o n . Pearson c o r r e l a t i o n s were a l s o c a l c u l a t e d among the smoking measures t o determine any i n t e r r e l a t i o n s between them. These c o r r e l a t i o n s are p r e s e n t e d f o r the two e x e r c i s e and the c o n t r o l c o n d i t i o n s i n T a b l e s 3, 4 and 5, r e s p e c t i v e l y . A B o n f e r r o n i c o r r e c t i o n f o r l e v e l o f s i g n i f i c a n c e , u s i n g .10 f o r an o v e r a l l a l p h a l e v e l , r e s u l t e d i n an a l p h a l e v e l o f .007 f o r the m a t r i x i n each c o n d i t i o n . One c o n s i s t e n t f i n d i n g i s / t h a t the weight and number o f c i g a r e t t e s consumed i n the w a i t - i n g room were s i g n i f i c a n t l y c o r r e l a t e d i n a l l the c o n d i t i o n s , i n d i c a t i n g t h a t t h e i r r e l a t i o n s h i p i s not i n f l u e n c e d by exer- c i s e . A d d i t i o n a l l y , t h r e e . s i g n i f i c a n t c o r r e l a t i o n s , those between weight of. c i g a r e t t e (s) consumed d u r i n g the f i r s t hour and both l a t e n c y t o smoke (negative c o r r e l a t i o n ) and number o f p u f f s f o r the f i r s t c i g a r e t t e , and between number of p u f f s f o r the f i r s t c i g a r e t t e and number of c i g a r e t t e s smoked i n the w a i t i n g room, are s i g n i f i c a n t o n l y i n the no- e x e r c i s e c o n d i t i o n . That these r e l a t i o n s h i p s were s i g n i f i c a n t i n t he c o n t r o l c o n d i t i o n but i n n e i t h e r o f the e x e r c i s e Table 3 C o r r e l a t i o n M a t r i x f o r Smoking Measures f o l l o w i n g No-Exercise C o n d i t i o n c i g l cig23 w t c i g l a t p u f f clg23 r = .52 w t c i g r = .85** .43 l a t r = -.54 -.32 -.63* p u f f r = .65* .52 .64* -.29 dur r = -.28 -.,03 .09" .02 -.004 c i g l = number of c i g a r e t t e s smoked 1 hour p o s t - e x e r c i s e cig23 = number of c i g a r e t t e s smoked 23 hours p o s t - e x e r c i s e w t c i g = weight of c i g a r e t t e ( s ) smoked 1 hour p o s t - e x e r c i s e l a t -= l a t e n c y to smoke p o s t - e x e r c i s e p u f f = number of p u f f s f o r f i r s t c i g a r e t t e p o s t - e x e r c i s e dur = d u r a t i o n of f i r s t c i g a r e t t e p o s t - e x e r c i s e * . P * - 0 0 5 ** p < .001 Table 4 C o r r e l a t i o n M a t r i x f o r Smoking Measures f o l l o w i n g Low-Intensity E x e r c i s e c i g l cig23 w t c i g l a t p u f f cig23 r = .55 w t c i g r = .84** .49 l a t r = -.10 -.43 -.25 p u f f r = .39 .19 .46 -.25 dur r = .02 .24 .16 .03 .47 c i g l = number of c i g a r e t t e s smoked 1 hour p o s t - e x e r c i s e c i g 2 3 = number of c i g a r e t t e s smoked 2 3 hours p o s t - e x e r c i s e w t c i g = weight of c i g a r e t t e ( s ) smoked 1 hour p o s t - e x e r c i s e l a t = l a t e n c y to smoke p o s t - e x e r c i s e p u f f = number of p u f f s f o r f i r s t c i g a r e t t e p o s t - e x e r c i s e dur = d u r a t i o n of f i r s t c i g a r e t t e p o s t - e x e r c i s e * p < .005 ** P < -001 45 Table 5 C o r r e l a t i o n M a t r i x f o r Smoking Measures f o l l o w i n g H i g h - I n t e n s i t y E x e r c i s e c i g l cig23 w t c i g l a t p u f f cig23 r = .41 w t c i g r = .96** .36 l a t r = -.41 -.18 -.32 p u f f r = .36 .19 .28 -.15 dur r = .27 .35 .37 -.18 -.14 c i g l = number of c i g a r e t t e s smoked 1 hour p o s t - e x e r c i s e c i g 2 3 = number of c i g a r e t t e s smoked 2 3 hours p o s t - e x e r c i s e w t c i g = weight of c i g a r e t t e ( s ) smoked 1 hour p o s t - e x e r c i s e l a t = l a t e n c y to smoke p o s t - e x e r c i s e p u f f = number of p u f f s f o r f i r s t e x e r c i s e c i g a r e t t e p o s t - e x e r c i s e dur = d u r a t i o n of f i r s t c i g a r e t t e p o s t - e x e r c i s e p < .005 p < .001 c o n d i t i o n s suggests t h a t the v a r i a b l e s are d i f f e r e n t i a l l y a f f e c t e d by e x e r c i s e . F i n a l l y , i t i s i n t e r e s t i n g t h a t a t o p o g r a p h i c a l measure of the f i r s t c i g a r e t t e smoked, p u f f r a t e , was s i g n i f i c a n t l y c o r r e l a t e d with a b e h a v i o r a l by- product of smoking, c i g a r e t t e weight, and a measure of smoking r a t e , number of c i g a r e t t e s consumed, both of which were ob- t a i n e d d u r i n g the^ f i r s t hour f o l l o w i n g e x e r c i s e . 47 DISCUSSION A s i g n i f i c a n t i n v e r s e r e l a t i o n s h i p was found i n t h i s study between e x e r c i s e i n t e n s i t y and c i g a r e t t e dura- t i o n . T h i s would appear to be the f i r s t c o n t r o l l e d demon- s t r a t i o n of an e f f e c t o f e x e r c i s e on c i g a r e t t e smoking, s i n c e t h e r e was no mention i n a r e c e n t e x h a u s t i v e review of the l i t e r a t u r e (Martin and Dubbert, 1982) of s t u d i e s showing t h i s e f f e c t . An a d d i t i o n a l f i n d i n g i s t h a t w h i l e weight and number of c i g a r e t t e s were s i g n i f i c a n t l y c o r r e - l a t e d a c r o s s c o n d i t i o n s , c o r r e l a t i o n s between p u f f f r e - quency and both weight and number o f c i g a r e t t e s were s i g - n i f i c a n t , o n l y i n the c o n t r o l c o n d i t i o n , s u g g e s t i n g t h a t t h e s e v a r i a b l e s are d i f f e r e n t i a l l y a f f e c t e d by e x e r c i s e . F i n a l l y , h i g h - i n t e n s i t y e x e r c i s e s i g n i f i c a n t l y reduced u r i n e pH a t 15 minutes p o s t - e x e r c i s e and t h e r e was a s i g - n i f i c a n t i n v e r s e r e l a t i o n s h i p between t h i s change i n pH l e v e l and c i g a r e t t e d u r a t i o n . No o t h e r s i g n i f i c a n t c o r r e l a t i o n s were found between c i g a r e t t e d u r a t i o n .and any o t h e r p h y s i o l o g i c a l measure. Why d i d e x e r c i s e reduce c i g a r e t t e d u r a t i o n and y e t f a i l 48 to suppress any other smoking measure? One p o s s i b l e reason i s t h a t c i g a r e t t e d u r a t i o n i s c l o s e l y r e l a t e d to the smoker's exposure to sidestream smoke, which i s r e l e a s e d d i r e c t l y i n t o the a i r . The remaining measures, except f o r weight of c i g a r e t t e consumed, p r i m a r i l y r e f l e c t exposure to mainstream smoke, which i s i n h a l e d d i r e c t l y by the smoker (F r e d e r i k s e n and M a r t i n , 1980). As s i d e s t r e a m smoke i s u n f i l t e r e d , i t c o n t a i n s h i g h e r c o n c e n t r a t i o n s of both n i c o t i n e and CO (USPHS, 1977). I t may be t h a t e x e r c i s e reduces one's t o l e r - ance f o r these harmful smoke elements and, to the extent that i c i g a r e t t e d u r a t i o n i s one of the smoking measures most d i r e c t l y r e l a t e d to s i d e s t r e a m smoke exposure, i t would more l i k e l y be suppressed f o l l o w i n g e x e r c i s e . T h i s study i s the f i r s t to i n d i c a t e t h a t m u l t i p l e topo- g r a p h i c a l measures are a f f e c t e d d i f f e r e n t i a l l y i n response to e x e r c i s e or u r i n a r y pH change. In one other study a s s e s s - i n g smoking f o l l o w i n g u r i n a r y pH change (Dobbs, e t a l . , 1981), the dependent v a r i a b l e s i n c l u d e d p u f f r a t e and l e n g t h of c i g a r e t t e smoked. In t h a t study, s t r e s s i n g s u b j e c t s by l e a d - i n g them to b e l i e v e they would be r e q u i r e d to g i v e a speech s i g n i f i c a n t l y a c i d i f i e d the u r i n e and had an i n h i b i t o r y e f f e c t on both smoking measures. Two of the Schachter s t u d - i e s (Schachter, S i l v e r s t e i n , Kozlowski, Herman, and L i e b l i n g , 1977; Schachter, S i l v e r s t e i n , and P e r l i c k , 1977) found a decrease i n u r i n a r y pH and i n both number of c i g a r e t t e s smoked and number of puffs; per c i g a r e t t e i n a one hour w a i t i n g 49 p e r i o d f o l l o w i n g e l e c t r i c shock. N e i t h e r the remaining Schachter study (Schachter, Kozlowski, and S i l v e r s t e i n , 1977) nor the M a r s h a l l e t a l . (1980) study, both of which assessed the i n f l u e n c e of u r i n a r y pH on smoking, used t o p o g r a p h i c a l aspects of smoking i n t h e i r a n a l y s e s , nor d i d the f o u r s t u d i e s d i r e c t l y examining the influence of e x e r c i s e on smoking (Engs and M u l h a l l , 1982; Howley e t a l . , 1980; Johnson et a l . , 1979; .Morgan e t a l . , 1976) . As suggested by Foy, Rychtank and Pr.ue (1981) there i s a need, t h e r e f o r e , f o r f u r t h e r r e s e a r c h to examine the r e l a t i o n s h i p s among t o p o g r a p h i c a l measures d u r i n g changing p a t t e r n s of c i g a r e t t e smoking. Although t h i s study found an e f f e c t of e x e r c i s e on smoking, the e x e r c i s e m a n i p u l a t i o n was ap p a r e n t l y weak as i t a f f e c t e d ; o n l y one of s i x smoking measures. Furthermore, the presence of an e f f e c t on onl y one of s i x v a r i a b l e s r a i s e s the p o s s i b i l i t y of a s i g n i f i c a n t f i n d i n g due to chance alone. C l e a r l y , the need e x i s t s f o r r e p l i c a t i o n of the presen t f i n d i n g . To maximize the e f f e c t of e x e r c i s e on smoking, c o n s i d e r a t i o n should be giv e n i n f u t u r e r e s e a r c h to p r o v i d i n g e x e r c i s e o f longer d u r a t i o n and to s c h e d u l i n g repeated exer- c i s e s e s s i o n s over a longer p e r i o d of time. In a d d i t i o n , f u t u r e s t u d i e s a s s e s s i n g d i r e c t l y the e f f e c t s of a e r o b i c e x e r c i s e on smoking should continue to i n c l u d e assessment of t o p o g r a p h i c a l aspects of smoking. Indeed, no e f f e c t o f exer- c i s e on smoking would have been found i n the presen t study were i t not f o r assessment of these smoking measures. 50 I f the f i n d i n g of an e f f e c t o f e x e r c i s e on smoking i s r e p l i c a t e d , both t h e o r e t i c a l and c l i n i c a l i m p l i c a t i o n s would ensue. At a t h e o r e t i c a l l e v e l , repeated demonstrations of a decrease i n both u r i n a r y pH and smoking f o l l o w i n g e x e r c i s e would suggest the need f o r re-examination of Schachter's h y p o t h e s i s . A c c o r d i n g t o Schachter (1977), a r e d u c t i o n i n u r i n a r y pH would r e s u l t i n a g r e a t e r r a t e o f d e p l e t i o n of n i c o t i n e , l e a d i n g to i n c r e a s e d smoking i n order t o r e s t o r e n i c o t i n e homeostasis. T h i s has been r e p l i c a t e d by r e s e a r c h examining t h e . e f f e c t of decreases i n u r i n a r y pH on smoking. The Schachter s t u d i e s demonstrated t h a t s t r e s s m anipulations r e s u l t e d i n a decrease i n u r i n a r y pH and a concomitant i n c r e a s e i n smoking r a t e . These f i n d i n g s were v e r i f i e d by Dobbs and h i s c o l l e a g u e s (1981). In t h e i r study, s u b j e c t s who were p s y c h o l o g i c a l l y s t r e s s e d and l i s t e n e d t o a n e u t r a l tape exper i e n c e d an average u r i n a r y pH decrease of s l i g h t l y over 0.2 pH (as i n d i c a t e d by a graph). R e s u l t s demonstrate t h a t these s u b j e c t s s i g n i f i c a n t l y i n c r e a s e d t h e i r p u f f r a t e and amount smoked. In the presen t study, a mean pH decrease of 0.248 and 0.347 was found f o r s u b j e c t s i n the low- and h i g h - i n t e n s i t y e x e r c i s e c o n d i t i o n s , r e s p e c t i v e l y . Since the pH changes i n the pr e s e n t study were of a g r e a t e r magnitude than those i n the Dobbs study, c o r r e s p o n d i n g l y g r e a t e r i n c r e a s e s i n smoking would be expected. Instead, r e s u l t s df the presen t study i n d i c a t e a s i g n i f i c a n t decrease i n c i g a r e t t e d u r a t i o n and no change i n the oth e r smoking measures, i n response t o u r i n e 51 a c i d i f i c a t i o n . Moreover, there was a s i g n i f i c a n t i n v e r s e r e l a t i o n s h i p between c i g a r e t t e d u r a t i o n and u r i n a r y pH. What f a c t o r s might account f o r the c o n t r a d i c t o r y r e s u l t s between the p r e s e n t study and the Schachter and Dobbs s t u d i e s ? One major d i f f e r e n c e between the s t u d i e s i s t h a t the p r e s e n t study i n v o l v e d p h y s i c a l r a t h e r than psycho- l o g i c a l s t r e s s . T h e r e f o r e , even though u r i n a r y pH l e v e l s were low due to p h y s i c a l s t r e s s , s u b j e c t s may have e x p e r i - enced a decrease i n t e n s i o n and a n x i e t y i n response to exer- c i s e . T h i s i n t u r n may have c u r t a i l e d r a t h e r than i n c r e a s e d smoking. There i s s u g g e s t i v e evidence t h a t s u b j e c t s i n the p r e s e n t study reduced smoking f o l l o w i n g e x e r c i s e due to these f a c t o r s . In a p o s t - e x p e r i m e n t a l q u e s t i o n n a i r e the most f r e - q u e n t l y s e l e c t e d item to account f o r r e d u c t i o n s i n smoking f o l l o w i n g e x e r c i s e ( s e l e c t e d by 6 of 11 s u b j e c t s ) was t h a t b i k i n g i n the study reduced f e e l i n g s of t e n s i o n and a n x i e t y . These r e s u l t s suggest t h a t p s y c h o l o g i c a l f a c t o r s may be e i t h e r more i n f l u e n t i a l than u r i n a r y pH i n determining p o s t - e x e r c i s e smoking, or i t may be t h a t pH changes::aire'merely c o r r e l a t e d and not c a u s a l l y r e l a t e d to smoking. F u r t h e r r e s e a r c h examining p o s t - e x e r c i s e change i n both u r i n a r y pH and p s y c h o l o g i c a l s t a t e i s necessary t o e v a l u a t e the e f f e c t s of these two v a r i a b l e s on smoking. In a d d i t i o n to p r o v i d i n g an impetus f o r a re-examination of Schachter's n i c o t i n e a d d i c t i o n h y p o t h e s i s , r e p l i c a t i o n of an e f f e c t of e x e r c i s e on smoking would have c l i n i c a l i m p l i c a t i o n s . 52 I f f u t u r e r e s e a r c h confirms t h a t e x e r c i s e reduces smoking, then e x e r c i s e c o u l d be used i n a DRO ( D i f f e r e n t i a l R e i n f o r c e - ment of Other Behavior) s t r a t e g y f o r smoking c e s s a t i o n , where u n d e s i r a b l e behavior i s e l i m i n a t e d by encouraging the d e v e l - opment of i n c o m p a t i b l e responses (Homer and Peterson, 1980). Behavior m o d i f i e r s p r e f e r the use of t h i s approach over the use of a v e r s i v e response e l i m i n a t i o n procedures as i t i s more e t h i c a l l y a c c e p t a b l e , has fewer s i d e e f f e c t s , and r e s u l t s i n a more durable and g e n e r a l i z a b l e response r e d u c t i o n (Homer and Peterson, 1980). Des p i t e the above advantages of DRO, there e x i s t s o n l y one mention i n the l i t e r a t u r e of the.use of t h i s procedure f o r e l i m i n a t i n g smoking (Barton and Barton, 1978). One reason why t h i s approach has not been used more r e g u l a r l y i n smoking treatment i s t h a t very few behaviors have been demonstrated to be i n c o m p a t i b l e w i t h smoking. I f f u r t h e r r e s e a r c h i n d i c a t e s t h a t smoking and e x e r c i s e are i n c o m p a t i b l e , the use of t h i s s t r a t e g y may be a p p l i e d t o smoking i n t e r v e n t i o n . In c o n c l u s i o n , w h i l e the p r e s e n t study demonstrated a s u p p r e s s i v e e f f e c t of e x e r c i s e on smoking, r e p l i c a t i o n of t h i s f i n d i n g i s necessary b e f o r e d e f i n i t i v e c o n c l u s i o n s r e g a r d i n g the r e l a t i o n s h i p between these two v a r i a b l e s can be made. I m p l i c a t i o n s f o r f u r t h e r r e s e a r c h are t w o f o l d . F i r s t , demon- s t r a t i o n of smoking r e d u c t i o n f o l l o w i n g p o s t - e x e r c i s e u r i n e a c i d i f i c a t i o n would l e a d to a re-examination of the r o l e of n i c o t i n e and u r i n a r y pH i n smoking. Secondly, e x e r c i s e c o u l d 53 be used therapeutically in a DRQ strategy for smoking cessa- t i o n . 54 REFERENCES A p p e n z e l l e r , 0 . What makes us run? The New England J o u r n a l of Medicine, 1981, 305, 578-579. 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J o u r n a l of C o n s u l t i n g and C l i n i c a l Psychology, 1971, 1, 80-86. M i l l e r , L. C , S c h i l l i n g , A. F., Logan, D. L., and Johnson, R. L. P o t e n t i a l hazards of r a p i d smoking as a t echnique f o r the m o d i f i c a t i o n of smoking b e h a v i o r . New England J o u r n a l of M e d i c i n e , 1977, 590-596. Montoye, H. J . , G ayle, R., and H i g g i n s , M. Smoking H a b i t s , a l c o h o l consumption and maximal oxygen i n t a k e . M e d i c i n e and S c i e n c e i n S p o r t s and E x e r c i s e ^ 1980, 12_, 316-321. Morgan, W. P. A n x i e t y r e d u c t i o n f o l l o w i n g acute p h y s i c a l a c t i v i t y . P s y c h i a t r i c A n n a l s , 1979, 9_, 36-45. 62 Morgan, R. , G i l d i n e r , H.L., and Wright, G. Smoking r e d u c t i o n i n a d u l t s who take up e x e r c i s e : A survey of a running c l u b f o r a d u l t s . Canadian A s s o c i a t i o n f o r Hea l t h , Physical"' Education, and .-Recreation J o u r n a l , 1976, 5_, 39- 43. Morgan, W. P., Roberts, J . A., Brand, F. R., and Feinerman, A. D. P s y c h o l o g i c a l e f f e c t o f c h r o n i c p h y s i c a l a c t i v i t y . Medicine and Science i n Sports and E x e r c i s e , 1970, 2_, 213-217. Paxton, R., and S c o t t , S. Non-smoking rei n f o r c e m e n t by improvement i n lung f u n c t i o n . A d d i c t i v e Behaviors, 1981, 6, 313-315. Peterson, F. J . , and K e l l y , D. L. The e f f e c t s o f c i g a r e t t e smoking upon the a c q u i s i t i o n o f p h y s i c a l f i t n e s s d u r i n g t r a i n i n g as measured by a e r o b i c c a p a c i t y . J o u r n a l of American C o l l e g e H e a l t h A s s o c i a t i o n , 1969, 1_7, 250-254. Rode, A., Ross, R., and Shepard, R. J . Smoking withdrawal programs: Pe r s o n a l and c a r d i o r e s p i r a t o r y f i t n e s s . A r c h i v e s of Environmental He a l t h , 1972, 24, 27-36. Rode, A., and Shepard, R. J . The i n f l u e n c e of c i g a r e t t e 63 smoking upon the oxygen cost of breathing i n near- maximal exercise. Medicine and Science i n Sports and Exercise, 1971, 3_, 51-55. Schachter, S. Nicotine regulation i n heavy and l i g h t smokers. Journal of Experimental Psychology, 1977, 106, 5-12. Schachter, S. Urinary. pH; and- the psychology of nicotine addiction. In Davidson, P. 0., and Davidson, S. M. (Eds.), Behavioral Medicine: Changing Health L i f e - s t y l e s . N.Y.: Brunner/Mazel, 1980. Schachter, S., Kozlowski, L.T., and S i l v e r s t e i n , B. Effects of urinary pH on cigarette smoking. Journal of Experimental Psychology, 1977, 106, 13-19. Schachter, S., S i l v e r s t e i n , B., Kozlowski, L. T., Herman, C. P., and L i e b l i n g , B. E f f e c t s of stress on cigarette smoking and urinary pH. Journal of Experimental Psychology, 1977, 106, 24-30. Schachter, S., S i l v e r s t e i n , B., and P e r l i c k , D. Psychological and pharmacological explanations of smoking under stress. Journal of Experimental Psychology, 1977, 106, 31-40. 64 Shaver, L. G. Smoking and s e l e c t e d p h y s i c a l f i t n e s s measures. C o l l e g e H e a l t h , 1973, 21, 489-492. S h i l l i n g t o n , E. S e l e c t e d economic consequences of c i g a r e t t e smoking. Ottawa: Research bureau; Non-medical use of drugs d i r e c t o r a t e . H e a l t h P r o t e c t i o n Branch, Department o f N a t i o n a l H e a l t h and W e l f a r e , 1977. S h i p l e y , H. R.. Maintenance of smoking c e s s a t i o n : E f f e c t s o f f o l l o w - u p l e t t e r s , smoking m o t i v a t i o n , muscle t e n - s i o n , and h e a l t h l o c u s of c o n t r o l . J o u r n a l o f Con- s u l t i n g and C l i n i c a l Psychology, 1981, A9_, 982-984. S i l v e r s t e i n , B., K o z l o w s k i , L. T., and Schachter, S. S o c i a l l i f e , c i g a r e t t e smoking, and u r i n a r y pH. J o u r n a l of E x p e r i m e n t a l Psychology, 1977, 106, 20-23. U.S. Department o f H e a l t h , E d u c a t i o n and W e l f a r e . Smoking and H e a l t h : A r e p o r t of the Surgeon G e n e r a l . Washington, D.C: DHEW P u b l i c a t i o n no. (PHS) 79-50066, 1979. U.S. P u b l i c H e a l t h S e r v i c e . A d u l t use of tobacco, 1975. A t l a n t a : Center f o r D i s e a s e C o n t r o l , 1976. 65 U.S. P u b l i c H e a l t h S e r v i c e . The Smoking D i g e s t . Washington, D.C. U n i t e d S t a t e s Department of H e a l t h , E d u c a t i o n and W e l f a r e , 1977. Wesson, L. G. P h y s i o l o g y of the Human Kidney. New York: Grune and S t r a t t o n , 1969. APPENDIX A INFORMATION FOR PHONE CONTACT T h i s study i n v e s t i g a t e s the p h y s i o l o g i c a l e f f e c t s of d i f f e r e n t i n t e n s i t i e s of e x e r c i s e on c i g a r e t t e smokers. We w i l l ask you to come to the l a b i n the Chemical E n g i n e e r i n g b u i l d i n g a t the same time on 4 c o n s e c u t i v e days to p e d a l on a s t a t i o n a r y b i c y c l e f o r 10 minutes. During one of these s e s s i o n s , you w i l l j u s t be s i t t i n g on the b i k e without doing any e x e r c i s e . We w i l l be t a k i n g v a r i o u s p h y s i o l o g i c a l measures b e f o r e , d u r i n g , and a f t e r you e x e r c i s e on the b i c y c l e . These measures i n c l u d e b l o o d p r e s s u r e , ECG, a u r i n e sample, and weight. At the f i r s t s e s s i o n we w i l l ask you to complete a q u e s t i o n n a i r e on your smoking and e x e r c i s e h i s t o r y . A f t e r each e x e r c i s e s e s s i o n , we r e q u i r e t h a t you w a i t i n an adjacent room f o r 1 hour u n t i l we have ob t a i n e d the l a s t u r i n e sample. However d u r i n g t h i s time you are f r e e to work q u i e t l y on whatever you l i k e (reading, w r i t i n g , homework, etc.) so be sure to b r i n g something to work on. You w i l l be r e q u i r e d to a b s t a i n from e a t i n g , or d r i n k i n g c a f f e i n a t e d or a l c o h o l i c beverages f o r 2 hours be f o r e each s e s s i o n , and from smoking f o r 1/2 hour be f o r e each s e s s i o n . Immediately a f t e r e x e r c i s e you w i l l be p e r m i t t e d to smoke, and a p i t c h e r of water w i l l be a v a i l a b l e i n case you are t h i r s t y . / A f t e r the f i r s t s e s s i o n , we w i l l g i v e you a t a l l y c a r d t o keep t r a c k of the number of c i g a r e t t e s you smoke each day between the e x e r c i s e s e s s i o n s , i . e . , f o r three days. T h i s i n f o r m a t i o n w i l l a s s i s t us i n i n t e r p r e t i n g the d i f f e r e n c e s among p a r t i c i p a n t s i n terms of p h y s i o l o g i c a l e f f e c t s to be observed f o l l o w i n g e x e r c i s e s e s s i o n s . At the l a s t s e s s i o n , you w i l l r e c e i v e $25 f o r your par- t i c i p a t i o n i n the study and we w i l l g i v e you p e r s o n a l feed- back on the measures t h a t we have taken. Do you have any q u e s t i o n s ? (Get name, phone number, times a v a i l a b l e , and schedule s e s s i o n s ) . 67 APPENDIX B PHYSICAL ACT I V I T Y READINESS QUESTIONNAIRE (PAR-Q) A S e l f - a d m i n i s t e r e d Q u e s t i o n n a i r e f o r A d u l t s PAR-Q i s d e s i g n e d t o h e l p y o u h e l p y o u r s e l f . Many h e a l t h b e n e f i t s a r e a s s o c i a t e d w i t h r e g u l a r e x e r c i s e , and t h e c o m p l e t i o n o f PAR-Q i s a s e n s i b l e f i r s t s t e p t o t a k e i f y o u a r e p l a n n i n g t o i n c r e a s e t h e amount o f p h y s i c a l a c t i v i t y i n y o u r l i f e . F o r most p e o p l e p h y s i c a l a c t i v i t y s h o u l d n o t p o s e any p r o b l e m o r h a z a r d . PAR-Q has been d e s i g n e d t o i d e n t i f y t h e s m a l l number o f a d u l t s f o r whom p h y s i c a l a c t i v i t y m i g h t be i n a p p r o p r i a t e o r t h o s e who s h o u l d have m e d i c a l a d v i c e c o n c e r n - i n g t h e t y p e o f a c t i v i t y most s u i t a b l e f o r them. Common s e n s e i s y o u r b e s t g u i d e i n a n s w e r i n g t h e s e few q u e s t i o n s . P l e a s e r e a d them c a r e f u l l y a nd c h e c k ( ; ) YES o p p o s i t e t h e q u e s t i o n i f i t a p p l i e s t o y o u . YES ( ) 1 . Has y o u r d o c t o r e v e r s a i d y o u have h e a r t t r o u b l e ? ( ) 2 . Do y o u f r e q u e n t l y have p a i n s i n y o u r h e a r t and c h e s t ? ( ) 3. Do y o u o f t e n f e e l f a i n t o r have s p e l l s o f s e v e r e d i z z i n e s s ? ( ) 4 . Has a d o c t o r e v e r s a i d y o u r b l o o d p r e s s u r e was t o o h i g h ? 68 Has a d o c t o r e v e r t o l d you t h a t you have a bone o r j o i n t p roblem such as a r t h r i t i s t h a t has been a g g r a v a t e d by e x e r c i s e , or might be made worse w i t h e x e r c i s e ? I s t h e r e a good p h y s i c a l r e a s o n n o t mentioned here why you s h o u l d not f o l l o w an a c t i v i t y program even i f you wanted t o ? A r e you o v er age 65 and n o t accustomed t o v i g o r o u s e x e r c i s e ? 69 APPENDIX C P h y s i o l o g i c a l Responses to E x e r c i s e Among Smokers O u t l i n e of Study Throughout the 4 days of the study - R e f r a i n as much as p o s s i b l e from t a k i n g any drugs, medications and a l c o h o l s i n c e these substances may e f f e c t your p h y s i o l o g i c a l r e s - ponses to e x e r c i s e . From your f i r s t s e s s i o n to your l a s t , r e c o r d the time at which you smoke every c i g a r e t t e i n c l u d i n g those smoked d u r i n g , and between s e s s i o n s . 2 hours p r i o r t o each s e s s i o n - a b s t a i n from e a t i n g , and from d r i n k i n g a l c o h o l and c a f f e i n a t e d beverages. 1/2 hour p r i o r to each s e s s i o n - a b s t a i n from smoking. Sessions A. In the l a b 1. p r e - e x e r c i s e measures of p u l s e and b l o o d p r e s s u r e w i l l be taken and samples of u r i n e w i l l be c o l l e c t e d . (5 min.) 2. ECG m o n i t o r i n g w h i l e p e d a l i n g an e x e r c i s e b i c y c l e . (10 min.) 3. p o s t - e x e r c i s e measure of b l o o d p r e s s u r e . (5 min.) T o t a l time i n the l a b : 20 min. B. In the w a i t i n g area U r i n e specimens c o l l e c t e d a f t e r 15, and 60 minutes. Note: During the hours you spend i n the w a i t i n g room, you may work at the desk on any r e a d i n g or s t u d y i n g you b r i n g w i t h you. Although you may smoke d u r i n g t h i s time and d r i n k water which w i l l be p r o v i d e d , you may not eat u n t i l the f i n a l measures are taken. 70 APPENDIX D Consent Form The purpose of t h i s study i s to examine the p h y s i o - l o g i c a l response to e x e r c i s e among c i g a r e t t e smokers. Four 1 1/2 hour s e s s i o n s w i l l be scheduled on c o n s e c u t i v e weekdays du r i n g which you w i l l p e dal a s t a t i o n a r y e x e r c i s e b i c y c l e f o r approximately 10 minutes. The r e s i s t a n c e or the drag a g a i n s t which you w i l l p e d a l , however, w i l l vary from one s e s s i o n to the next. While you are p e d a l i n g , changes i n your.-heart r a t e w i l l be monitored by an instrument (ECG) v i a e l e c t r o d e s a t t a c h e d to your c h e s t by s t i c k y tape. There w i l l a l s o be a s e s s i o n where your h e a r t r a t e w i l l be monitored w h i l e you are seated and engaging i n no e x e r c i s e . To ensure t h a t your h e a r t r a t e i s u n a f f e c t e d by f a c t o r s other than e x e r c i s e , i t i s e s s e n t i a l t h a t you: (1) r e f r a i n from engaging i n other v i g o r o u s p h y s i c a l a c t i v i t y d u r i n g the f o u r days of the study; (2) r e f r a i n from smoking, e a t i n g , and d r i n k i n g c o f f e e , t e a , or c o l a beverages w i t h i n two hours of each s e s s i o n , and (3) r e f r a i n from consuming a l c o h o l i c beverages each day b e f o r e each s e s s i o n . In a d d i t i o n to h e a r t r a t e changes, we are a l s o i n t e r e s t e d i n changes t h a t occur i n the: u r i n e as a r e s u l t of e x e r c i s e . A c c o r d i n g l y , we w i l l ask t h a t you p r o v i d e a u r i n e specimen 71 b e f o r e e x e r c i s i n g and t h a t you remain i n the l a b o r a t o r y w a i t i n g room f o r one hour a f t e r w a r d . The second and t h i r d u r i n e specimens w i l l be c o l l e c t e d 15 and 60 minutes a f t e r completing the e x e r c i s e . Since your p h y s i o l o g i c a l response to e x e r c i s e may vary a c c o r d i n g to the amount you smoke, i t i s a l s o important t h a t you keep a t a l l y on the c a r d p r o v i d e d of the number of c i g a r e t t e s you smoke d u r i n g the study and the times a t which you smoke them. T h i s i n f o r m a t i o n w i l l a s s i s t us i n accounting f o r any d i f f e r e n c e among the p a r t i c i p a n t s i n terms .'of t h e i r p h y s i o l o g i c a l response to the e x e r c i s e i n which they engage d u r i n g the s e s s i o n s . A f t e r the f o u r t h s e s s i o n , you w i l l be p a i d $25 f o r p a r t i c i p a t i n g i n the study and g i v e n feedback i f you would l i k e i t r e g a r d i n g your l e v e l bf a e r o b i c f i t n e s s . You may, of course, withdraw from the study a t any time. I have read the d e s c r i p t i o n above, had a l l my q u e s t i o n s answered to my s a t i s f a c t i o n , and do hereby consent to par- t i c i p a t e i n t h i s study. Date: P a r t i c i p a n t ' s S i g n a t u r e : Witness: 72 APPENDIX E SUBJECTIVE RATINGS OF BREATHLESSNESS FORM S u b j e c t no. S e s s i o n no. C o n d i t i o n no. P l e a s e c i r c l e t h e number w h i c h r e p r e s e n t s how y o u f e e l r i g h t now. 1. 2. A s o u t o f b r e a t h a s I ' v e e v e r b e e n 7. b r e a t h i n g c o m p l e t e l y n o r m a l 1. 2. As o u t o f b r e a t h a s I ' v e e v e r b e e n b r e a t h i n g c o m p l e t e l y n o r m a l 1. 2, A s o u t o f b r e a t h a s I ' v e e v e r b e e n 5. 7. b r e a t h i n g c o m p l e t e l y n o r m a l 1. A s o u t o f b r e a t h a s I ' v e e v e r b e e n 2. b r e a t h i n g c o m p l e t e l y n o r m a l 1. : A s o u t o f b r e a t h a s I ' v e e v e r b e e n 4 V b r e a t h i n g c o m p l e t e l y n o r m a l 1. 2, A s o u t o f b r e a t h as I ' v e e v e r b e e n 4. . 5. 6. 7. b r e a t h i n g c o m p l e t e l y n o r m a l 1. : As . o u t o f '. b r e a t h a s I ' v e e v e r b e e n b r e a t h i n g c o m p l e t e l y n o r m a l 1. 2. As o u t o f b r e a t h a s 1 1ve e v e r b e e n b r e a t h i n g c o m p l e t e l y n o r m a l 1. 2 A s o u t o f b r e a t h a s I ' v e e v e r b e e n 5. 7. b r e a t h i n g c o m p l e t e l y n o r m a l 73 APPENDIX F Experimental S c r i p t : W aiting Room At f i r s t s e s s i o n E l : (working a t the t a b l e , i n view of where s u b j e c t w i l l s i t ) -• - knock on the door - ( E l s t a r t s stopwatch) E2: (S's name, "You can s i t , (E2 gestures towards a s e a t ) , r e l a x and work q u i e t l y on whatever you have brought, or look through the magazines i f you l i k e . T h i s i s ( E l ' s name)" E l : (looks up) " H i " (Then resumes work) E2: "He w i l l be working here w h i l e you are w a i t i n g and w i l l l e t you know when i t ' s time to take samples. We'd l i k e you t o w a i t i n your gym s t r i p and change a f t e r a l l the sampels have been taken. Any q u e s t i o n s ? " (allow time f o r S t o respond). E l : ( a f t e r 11 minutes) "Okay (S's name), time f o r the u r i n e specimen j u s t l i k e b e f o r e " (Hand S the c o n t a i n e r and thank him when he r e t u r n s ) . E l : ( a f t e r 60 minutes "The hour's over (S's name). A f t e r you do the u r i n e sample t h a t w i l l be i t f o r today". (Hand S the c o n t a i n e r and thank him when he r e t u r n s ) . 74 Subsequent s e s s i o n s : F o l l o w b a s i c a l l y the same s c r i p t with some m o d i f i c a t i o n c o n s i d e r i n g t h a t S has been through the procedure a l r e a d y . D e v i a t i o n s from S c r i p t : Any c o n v e r s a t i o n w i t h S should be minimized s i n c e i n t e r a c t i o n w i t h s u b j e c t may i n f l u e n c e t h e i r smoking behavior. T h i s can be accomplished by: 1) answering q u e s t i o n s p e r t a i n i n g to the experiment as b r i e f l y as p o s s i b l e from the i n f o r m a t i o n on t h e i r schedule and r e t u r n i n g back to work or 2) p o l i t e l y t e r m i n a t i n g any a d d i t i o n a l c o n v e r s a t i o n : "I'd l i k e t o chat but I've got to get t h i s f i n i s h e d f o r my next c l a s s " (or something s i m i l a r ) . Remember, S does not know t h a t h i s smoking behavior i s being observed so t r y and be as u n o b t r u s i v e as p o s s i b l e i n n o t i n g the time. A l s o , do not acknowledge a t any time t h a t the study i s i n any way connected w i t h Psychology. F i n a l l y , d u r i n g the s e s s i o n S may ask f o r a l i g h t , or f o r a c i g a r e t t e . Acknowledge the request, g i v e them a c i g a r e t t e or l i g h t , then r e t u r n back to work (make sure both are a v a i l a b l e a t each s e s s i o n ) . 75 APPENDIX G EXERCISE AND SMOKING QUESTIONNAIRE Name: Age: Sex: Address: Phone Number: Best time to c a l l : Occupation: Do you e x e r c i s e r e g u l a r l y ? I f yes, d e s c r i b e your exer- c i s e h a b i t s P l e a s e c i r c l e a l l of the p h y s i c a l a c t i v i t i e s i n the f o l l o w i n g l i s t i n which you have engaged d u r i n g the pa s t f o u r weeks: a e r i a l t e n n i s , badminton, b a s k e t b a l l , boxing, c a l i s t h e n i c s , c u r l i n g , b i c y c l i n g , s t a t i o n a r y c y c l i n g , dancing (please s p e c i f y step below), f e n c i n g , f o o t b a l l , g o l f , h a n d b a l l , hockey, k a r a t e , kung-fu, l a c r o s s e , r a c q u e t b a l l , r o p e - s k i p p i n g , rowing, running ( s t a t i o n a r y ) , r u n n i n g / j o g g i n g , s k a t i n g , s k i i n g , squash, swimming, t e n n i s , v o l l e y b a l l , walking, w r e s t l i n g , other s p o r t s not mentioned above. En t e r the a c t i v i t y ( i e s ) you have c i r c l e d i n the appro- p r i a t e space(s) below and p r o v i d e as acc u r a t e an estimate as 76 you can of each of the f o l l o w i n g : q u a n t i t y or d i s t a n c e t r a v e l l e d on each o c c a s i o n (e.g., m i l e s , yards, s e t s ) , time i n minutes t o complete the a c t i v i t y , and average number of times you engaged i n the a c t i v i t y each week. Average Weekly A c t i v i t y Q u a n t i t y / D i s t a n c e Time Frequency C i r c l e a number below to i n d i c a t e : 1. How p h y s i c a l l y a c t i v e you c o n s i d e r y o u r s e l f t o be now. 1 2 3 4 5 very a c t i v e average i n a c t i v e very a c t i v e i n a c t i v e 2. Your c u r r e n t l e v e l of p h y s i c a l f i t n e s s . 1 2 3 4 5 very f i t average u n f i t very f i t u n f i t What brand of c i g a r e t t e do you smoke? How many c i g a r e t t e s per day do you smoke on the average on a weekday?_ on weekends?_ How long have you been smoking? years Have you made any attempts to q u i t smoking i n the l a s t 6 months? Ye s No I f so, when and f o r how long? Are you p r e s e n t l y attempting to c u t down or stop smoking? Yes No Are you p r e s e n t l y on any medication? I f so, pl e a s e s p e c i f y the type, dosage, and frequency: Thank you f o r your c o o p e r a t i o n i n f i l l i n g out t h i s q u e s t i o n n a i r e . 78 APPENDIX H P o s t - S t u d y Q u e s t i o n n a i r e 1 . What was t h e p u r p o s e o f t h e s t u d y ? 2. D i d y o u make any d e l i b e r a t e a t t e m p t d u r i n g t h e s t u d y t o a l t e r y o u r smoking b e h a v i o r ? Yes No I f s o , p l e a s e s p e c i f y what y o u d i d and w h e t h e r y o u b e l i e v e i t d i d i n f a c t a f f e c t y o u r s m o k i n g . 3. D i d y o u e x p e c t a t any t i m e t h a t p a r t i c i p a t i o n i n t h e s t u d y w o u l d a f f e c t y o u r smoking? 79 Yes No I f yes, what aspect of the procedure d i d you b e l i e v e would a f f e c t your smoking? How d i d you expect your smoking would be e f f e c t e d ? Increased Decreased When d i d you expect your smoking would.be e f f e c t e d ? p r i o r t o f i r s t s e s s i o n between 1st & 2nd s e s s i o n between 2nd & 3rd s e s s i o n between 3rd & 4th s e s s i o n f o l l o w i n g f o u r t h 4. Do you t h i n k t h a t the e x e r c i s e you engaged i n d u r i n g any of the s e s s i o n s a f f e c t e d your smoking? Yes No I f yes, how was your smoking a f f e c t e d ? Increased Decreased Why do you t h i n k i t was a f f e c t e d i n t h i s way? 5. Check any of the f o l l o w i n g e x p l a n a t i o n s you b e l i e v e account f o r the changes i n your smoking be h a v i o r : E x p l a n a t i o n s f o r i n c r e a s e d smoking: f e l t more tense and anxious due to the e v a l u a t i v e nature of the study or exposure to a h e a l t h - promoting environment. 80 you were bored i n the w a i t i n g room. you always smoke i n w a i t i n g rooms and/or when you read. you wanted to reward y o u r s e l f f o r having engaged i n e x e r c i s e . you f e l t uncomfortable smoking i n f r o n t of. the other person i n the w a i t i n g room. E x p l a n a t i o n s f o r decreased smoking: I f you f e e l you decreased you smoking behavior a f t e r e x e r c i s e was i t f o r any of the f o l l o w i n g reasons? (please check): you were t r y i n g t o r e c o v e r from the e x e r c i s e , i . e . , "catch your b r e a t h " and smoking hindered t h i s . p a r t i c i p a t i n g i n e x e r c i s e made you more aware of your h e a l t h h a b i t s and thus motivated you to decrease your smoking. e x e r c i s i n g reduced f e e l i n g s of t e n s i o n and a n x i e t y ; t h e r e f o r e , you needed to smoke l e s s . Thank you f o r f i l l i n g out t h i s q u e s t i o n n a i r e .

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