Acute Exercise Intensity Responses in Women Who Smoke

High-Intensity Treadmill Exercise Elicits Greater Acute Cardiovascular Workload Without Detectable Respiratory or Cognitive Advantage in Female Healthcare Professionals Who Smoke: A Randomized Trial

Cigarette smoking is associated with adverse cardiovascular, respiratory, and cognitive effects. Acute aerobic exercise may influence cardiovascular workload, respiratory function, and cognitive performance; however, evidence comparing the immediate effects of different exercise intensities in people who smoke remains limited. This randomized controlled trial investigated the immediate effects of a single high-intensity versus low-intensity treadmill exercise session on rate-pressure product, spirometric outcomes, and cognitive performance in female healthcare professionals working in special education settings who smoke. The study provides information on the immediate cardiovascular, respiratory, and cognitive responses to different intensities of treadmill exercise in this population.

Study Overview

• Status: Completed
• Conditions: Smokers
• Intervention / Treatment: Other: High Intensity Exercise; Other: Low Intensity Exercise

Detailed Description

Primary Objective To compare the immediate effects of a single high-intensity versus low-intensity treadmill exercise session on cardiovascular workload, as assessed by the baseline-to-postexercise change in rate-pressure product, in female healthcare professionals working in special education settings who smoke. Secondary Objectives To compare the immediate effects of a single high-intensity versus low-intensity treadmill exercise session on spirometric outcomes, including forced vital capacity, forced expiratory volume in 1 second, the FEV₁/FVC ratio, and peak expiratory flow, in female healthcare professionals working in special education settings who smoke. To compare the immediate effects of a single high-intensity versus low-intensity treadmill exercise session on cognitive performance, as assessed using the Stroop Test and the Montreal Cognitive Assessment, in female healthcare professionals working in special education settings who smoke. Study Questions Did a single high-intensity treadmill exercise session produce a greater immediate rate-pressure-product response than a single low-intensity treadmill exercise session in female healthcare professionals working in special education settings who smoke? Did the immediate changes in spirometric outcomes differ between the high-intensity and low-intensity treadmill exercise groups? Did the immediate changes in Stroop Test and Montreal Cognitive Assessment scores differ between the high-intensity and low-intensity treadmill exercise groups? Study Hypothesis It was hypothesized that high-intensity treadmill exercise would elicit a greater immediate rate-pressure-product response and different acute respiratory and cognitive responses than low-intensity treadmill exercise in female healthcare professionals working in special education settings who smoke.

• Study Type: Interventional
• Enrollment (Actual): 30
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Turkey (Türkiye)
  • Istanbul, Turkey (Türkiye)
    • Istanbul Gedik University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• Current cigarette smoking, irrespective of nicotine dependence level
• Voluntary agreement to participate in the study
• Completion of the Fagerström Test for Nicotine Dependence
• Absence of a known medical condition that would contraindicate treadmill exercise or interfere with cardiopulmonary assessment

Exclusion Criteria:

• Diagnosed cardiac or pulmonary disease
• Orthopedic, neurological, vestibular, or systemic disease that could affect exercise performance
• Use of bronchodilator medication
• Orthopedic or cardiopulmonary surgery within the preceding year
• Pregnancy
• Clinically relevant sensory loss
• Leg-length discrepancy that could affect exercise performance
• Participation in another clinical study during the preceding month

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: high-intensity aerobic exercise group	Other: High Intensity Exercise; high intensity exercise
Active Comparator: low-intensity aerobic exercise group	Other: Low Intensity Exercise; low intensity exercise

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Rate-Pressure Product (RPP)	Rate-pressure product (RPP) is calculated by multiplying heart rate (beats/min) by systolic blood pressure (mmHg) and dividing the result by 100. RPP provides an index of myocardial oxygen demand and cardiac workload. There is no fixed minimum or maximum value. Higher RPP values indicate greater myocardial workload and oxygen consumption.	Duration of change in 1 day.

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
The Fagerström Test for Nicotine Dependence (FTND)	The Fagerström Test for Nicotine Dependence (FTND) is a 6-item questionnaire used to assess the level of nicotine dependence. Total scores range from 0 to 10, with higher scores indicating greater nicotine dependence.	Duration of change in 1 day.
Cognitive status measurement with MOCA	The Montreal Cognitive Assessment (MoCA) is a screening tool used to assess global cognitive function, including attention, executive function, memory, language, visuospatial ability, abstraction, calculation, and orientation. Total scores range from 0 to 30, with higher scores indicating better cognitive function.	Duration of change in 1 day.
Cognitive status measurement with Stroop Test	The Stroop Test assesses selective attention, cognitive flexibility, and inhibitory control. The primary outcome is the completion time (seconds) required to complete the interference condition. There is no fixed minimum or maximum value. Shorter completion times indicate better cognitive performance, whereas longer completion times indicate poorer cognitive performance.	Duration of change in 1 day.
FEV1 Measurement	Respiratory Function Test. The COSMED microQuark spirometer used. Lung volume was evaluated. Forced Expiratory Volume in 1 Second (FEV₁) is measured using spirometry and represents the volume of air (liters) that can be forcibly exhaled during the first second of a forced expiration. There is no fixed minimum or maximum value. Higher FEV₁ values indicate better pulmonary function.	Duration of change in 1 day.
FVC Measurement	Respiratory Function Test. The COSMED microQuark spirometer used. Lung volume was evaluated. Forced Vital Capacity (FVC) is measured using spirometry and represents the total volume of air (liters) that can be forcibly exhaled after a maximal inspiration. There is no fixed minimum or maximum value. Higher FVC values indicate better pulmonary function.	Duration of change in 1 day.

Collaborators and Investigators

• Sponsor: Istanbul Medipol University Hospital
• Collaborators: Istanbul Gedik University

Study record dates

Study Major Dates

• Study Start (Actual): September 3, 2023
• Primary Completion (Actual): December 3, 2024
• Study Completion (Actual): November 15, 2025

Study Registration Dates

• First Submitted: January 28, 2025
• First Submitted That Met QC Criteria: January 28, 2025
• First Posted (Actual): February 3, 2025

Study Record Updates

• Last Update Posted (Actual): July 17, 2026
• Last Update Submitted That Met QC Criteria: July 16, 2026
• Last Verified: July 1, 2026

More Information

Terms related to this study

• Keywords: exercise; aerobic; smoker
• Additional Relevant MeSH Terms: Behavior; Motor Activity; Motor Activity; Movement; Musculoskeletal Physiological Phenomena; Musculoskeletal and Neural Physiological Phenomena; Physical Conditioning, Human; Exercise; High-Intensity Interval Training
• Other Study ID Numbers: E56365223-050.02.02.2023.13754

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No