Open Access Highly Accessed Research article

Physical activity as an aid to smoking cessation during pregnancy: Two feasibility studies

Michael Ussher1*, Paul Aveyard2, Tim Coleman3, Lianne Straus4, Robert West5, Bess Marcus6, Beth Lewis7 and Isaac Manyonda8

Author Affiliations

1 Division of Community Health Sciences, St. George's University of London, London, SW17 0RE, UK

2 Department of Primary Care and General Practice, University of Birmingham, Edgbaston, B15 2TT, UK

3 School of Community Health Sciences, Division of Primary Care, Queen's University Medical Centre, Nottingham, NG7 2UH, UK

4 Barcelona Centre for International Health Research (CRESIB), Hospital Clínic de Barcelona, Universitat de Barcelona, Rosselló 132, 4a planta, 08036 Barcelona, Spain

5 Cancer Research UK Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, 2-16 Torrington Place, London, WC1E 6BT, UK

6 Department of Community Health and Department of Psychiatry and Human Behavior, Brown University, 121 South Main Street, Providence, Rhode Island, 02903, USA

7 School of Kinesiology, University of Minnesota, 209 Cooke Hall, 1900 University Ave, Minneapolis, MN 55455, USA

8 Department of Obstetrics and Gynecology, St George's Hospital, Blackshaw Road, London, SW17 0QT, UK

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BMC Public Health 2008, 8:328  doi:10.1186/1471-2458-8-328

Published: 23 September 2008



Pharmacotherapies for smoking cessation have not been adequately tested in pregnancy and women are reluctant to use them. Behavioural support alone has a modest effect on cessation rates; therefore, more effective interventions are needed. Even moderate intensity physical activity (e.g. brisk walk) reduces urges to smoke and there is some evidence it increases cessation rates in non-pregnant smokers. Two pilot studies assessed i) the feasibility of recruiting pregnant women to a trial of physical activity for smoking cessation, ii) adherence to physical activity and iii) womens' perceptions of the intervention.


Pregnant smokers volunteered for an intervention combining smoking cessation support, physical activity counselling and supervised exercise (e.g. treadmill walking). The first study provided six weekly treatment sessions. The second study provided 15 sessions over eight weeks. Physical activity levels and continuous smoking abstinence (verified by expired carbon monoxide) were monitored up to eight months gestation.


Overall, 11.6% (32/277) of women recorded as smokers at their first antenatal booking visit were recruited. At eight months gestation 25% (8/32) of the women achieved continuous smoking abstinence. Abstinent women attended at least 85% of treatment sessions and 75% (6/8) achieved the target level of 110 minutes/week of physical activity at end-of-treatment. Increased physical activity was maintained at eight months gestation only in the second study. Women reported that the intervention helped weight management, reduced cigarette cravings and increased confidence for quitting.


It is feasible to recruit pregnant smokers to a trial of physical activity for smoking cessation and this is likely to be popular. A large randomised controlled trial is needed to examine the efficacy of this intervention.