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Published: 06 March 2023

Promoting physical activity and other behavioural support can help people wanting to reduce their smoking to quit in the short-term. However, physical activity delivers no noticeable benefits in the rates of people stopping smoking after nine months, according to a study in collaboration with St Georges, University of London and published in the journal Addiction.

The Trial of physical Activity and Reduction of Smoking (TARS) study, led by the University of Plymouth with funding from the National Institute for Health and Care Research, took place across four cities – London, Plymouth, Nottingham and Oxford – before the COVID-19 pandemic.

Tailored support 

Its aim was to provide a definitive answer as to whether future NHS services should be adapted to provide additional support to smokers not ready to quit but who do wish to reduce their smoking, with the hope of increasing sustained abstinence from smoking and associated health benefits. 

The study also sought to look into previous suggestions that behavioural support for these smokers, compared with offering no additional support, can lead to smoking reduction and more attempts to quit.

A total of 915 smokers were recruited to the study. Half were offered up to eight, weekly face-to-face or phone motivational support sessions to reduce their smoking and increase moderate to vigorous physical activity. This was an approach which had previously shown encouraging signs in a pilot study. Results were compared to the other half of participants who were offered usual NHS advice on quitting.

Short term benefits only

Researchers found that engaging with the motivational support had some short-term benefits, with 19% of those receiving the additional support saying they had at least halved the number of cigarettes smoked by three months and 14% had still halved their smoking after the nine months. This compared to around 10% of those receiving the standard advice reported having halved their cigarette intake at both milestones. 

However, just 2% of those who received the additional support had abstained from smoking between three and nine months. Less than 1% of those receiving the standard advice abstained from smoking for those six months.

After three months, people who received the additional support took part in an extra 81 minutes of physical activity each week compared to those receiving no support. However this difference between groups was not sustained at nine months. 

With the additional support costing health services in the region of £240 per person, the researchers say their findings show the approach is neither effective for long-term smoking cessation or cost-effective.

Further research needed

Professor Michael Ussher, Professor of Behavioural Medicine at St George’s, University of London, who was involved in the study said: 

Quitting smoking is one of the best things people can do for their health. But our research highlights the difficulty in supporting smokers to make the transition from wanting to reduce the amount they smoke to quitting completely. Quitting isn’t easy and people can take multiple attempts to stop. We need to do further research to see how best to support people wanting to cut down their smoking, in order to improve both their own health and population health.

- Professor Michael Ussher -

Major health challenge

Professor Adrian Taylor at the University of Plymouth who led the study added:

This is a further demonstration of the scale of the challenge facing society if we are to achieve the UK Government’s stated aim of being smoke free by 2030. However, it is potentially only through additional difficult national policy decisions such as even higher taxation on tobacco, the subsidised promotion of vaping, and increasing the legal age of tobacco purchasing, in line with other countries such as New Zealand, that the huge costs of smoking for our NHS Services will be reduced.

- Professor Adrian Taylor -

The research also involved the University Hospitals Plymouth NHS Trust, University of Oxford, University of Nottingham, University of Exeter, and Plymouth City Council.

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