Integrating a simple and brief home-based exercise programme within a UK stop smoking service: a mixed method feasibility study

Background Smoking remains a leading cause of morbidity and mortality. Exercise improves physical health and reduces cigarette cravings and nicotine withdrawal symptoms, but has required attendance at multiple sessions using specialised equipment that limits delivery in a service. The purpose of this study was to test the feasibility of delivering a simple and brief home-based exercise intervention with existing smoking cessation support in a stop-smoking service.

Methods We used a mixed-methods approach in a UK stop-smoking service operating from general practitioner surgeries and libraries near the most deprived areas in Surrey. Smokers recruited through the service gave written consent and received a 12-week exercise programme that included 5 min of home-based jumping activities and an activity diary with educational instructions 1 week before their quit date. Feasibility was assessed by recruitment, retention, adherence to the exercise programme, and follow-up and completion of assessments. Semi-structured interviews with trial participants (n=16), people who declined to take part (n=21), and smoking cessation advisors (n=10) assessed views and attitudes to participation and delivery of the intervention. Interviews were audio-recorded, transcribed verbatim, and analysed using thematic analysis (NVivo, version 12.0).

Findings 30 eligible trial participants consented, with 14 (47%) lost to follow-up, 16 participants (eight females, eight males; mean age 48 years [SD 11]) completed a mean of 47 (SD 18) of 74 prescribed exercise sessions over the 12-week period, resulting in 63% adherence. The exercise programme was received positively by most who engaged with it; fitting into their daily routine was an important outcome for completion. Of the participants who declined to take part (15 females, six males; mean age 48 years [SD 12]), many were positively disposed to the idea of participation, especially if the programme could be offered later in their treatment. All smoking cessation advisors (six females, four males; mean age 48 years [SD 20]) were supportive of the exercise programme, but several favoured the delivery by someone independent of the service.

Interpretation A simple and brief exercise intervention may be feasible for smokers receiving smoking cessation treatment in a UK stop-smoking service. However, substantial attrition and non-compliance, along with some delivery components, need to be addressed before to a definitive trial.