Using Mobile Health to Assess Physical Activity Guideline Adherence and Smoking Urges: A Secondary Analysis of mActive-Smoke
ABSTRACT
Background:
Rates of cigarette smoking are decreasing due to public health initiatives, pharmacological aids, and clinician focus on smoking cessation. However, a sedentary lifestyle increases cardiovascular risk and therefore inactive smokers have a particularly enhanced risk of cardiovascular disease.
Objective:
In this secondary analysis of mActive-Smoke, a 12-week observational study, we investigate adherence to guideline-recommended moderate-vigorous physical activity (MVPA) in smokers and its association with urge to smoke.
Methods:
We enrolled 60 active smokers (≥3 cigarettes/day) and recorded continuous step counts with the Fitbit Charge HR. MVPA was defined as cadence ≥100 steps/min. Participants were prompted to report instantaneous smoking urges via text message three times a day, on a Likert scale from one to nine. We used a mixed-effects linear model for repeated measures, controlling for demographics and baseline activity level, to investigate the association between MVPA and urge.
Results:
Fifty-three participants (aged 40±12 years, 57% [30/53] women, 49% [26/53] nonwhite, 38% [20/53] obese) recorded six to 12 weeks of data; a mean of 69 days per participant were analyzed. Among all participants, median daily MVPA was 6 minutes (IQR 2-13), which differed by sex (12 min [IQR 3-20] for men versus 3.5 min [IQR 1-9] for women, P =.004) and BMI (2.5 min [IQR 1-8.3] for obese versus 10 min [IQR 3-15] for non-obese, P =0.04). The median total MVPA minutes per week was 80 (IQR 31-162). Only 9.8% (95% CI 4.1%, 21.8%) of participants met national guidelines of 150 min/week of MVPA on at least 50% of weeks. Adjusted models showed no association between the number of MVPA minutes per day and mean daily smoking urge (P =.72).
Conclusions:
The prevalence of MVPA was low in adult smokers, who rarely met national guidelines for MVPA. Given poor attainment of guideline-recommended physical activity goals, more work is required to address risk factors in smokers through physical activity promotion.
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