Exercise and Reduced Nicotine Content Cigarettes in Adult Female Smokers: A Pilot Trial

Int J Environ Res Public Health. 2022 May 29;19(11):6647. doi: 10.3390/ijerph19116647.


Background: Although Reduced Nicotine Cigarettes (RNC) are suggested to improve smoking cessation and cardiometabolic health in relation to cancer risk, the effectiveness of exercise training with RNC on smoking cessation and cardiometabolic health is unknown. Methods: Female smokers (N = 27) were randomized to: (1) usual nicotine cigarettes (i.e., control), (2) RNC or (3) RNC plus exercise treatment for 12 weeks. Smoking withdrawal symptoms (e.g., Wisconsin Smoking Withdrawal Scale) and cardiometabolic health (e.g., weight, VO2max, resting respiratory exchange ratio (RER), glucose, HOMA-IR) were examined before and after treatment. Results: Treatments had no differential effect on weight (p = 0.80; partial η2 = 0.29), VO2max (p = 0.20, partial η2 = 0.18), or total cholesterol/HDL ratios (p = 0.59, partial η2 = 0.06). However, RNC + Exercise tended to maintain RER (i.e., fat oxidation; p = 0.10, partial η2 = 0.10) as well as insulin resistance (p = 0.13, partial η2 = 0.25) and cortisol compared (p = 0.06, partial η2 = 0.30) with control and RNC. Increased VO2max was also associated with lower nicotine dependence scores (r = −0.50, p < 0.05). Conclusion: In this pilot study, improved fitness was associated with lower nicotine dependence. Additional work is warranted to examine the effects of exercise in smokers as a tool to improving smoking cessation and lower disease risk.

Keywords: cardiovascular disease; insulin resistance; obesity; physical activity; smoking cessation.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Cardiovascular Diseases*
  • Exercise
  • Female
  • Humans
  • Nicotine
  • Pilot Projects
  • Smokers
  • Tobacco Products*
  • Tobacco Use Disorder* / therapy


  • Nicotine