Does Moderate Intensity Exercise Help Prevent Smoking Relapse Among Women?

Inclusion Criteria:

* Healthy sedentary smokers (\> 4 per day for at least one year)
* Ages 18 to 65 years
* Must be able to give informed consent
* Must live in the area for the next 3 months
* Willing to use the nicotine patch to attempt smoking cessation
* Must receive consent to participate from primary care physician

Exclusion Criteria:

* Cannot read or write fluently in the English language
* Pregnancy or plans to attempt pregnancy
* 60 minutes or more per week of moderate or vigorous physical activity
* Smokes cigars, pipes, or uses smokeless tobacco at least once per week
* Currently in a quit smoking program
* Currently using NRT of any kind or using any other quit smoking method or treatment
* Never had an adverse reaction to the nicotine patch resulting in discontinuation of use
* Poor willingness or inability to comply with protocol requirements
* An employee of the Centers for Behavioral and Preventive Medicine
* Previous participant in Commit to Quit or Fit to Quit smoking cessation studies
* Another member of the household is or has been enrolled in this study
* Currently taking a medication that might impact heart rate response, including but not limited to:

Acebutolol Atenolol Carvedilol Metoprolol Nadolol Pindolol Propranolol Timolol

Medical problems:

* Cardiac disease of any kind such as angina, a history of myocardial infarction or valve disease including mitral valve prolapse. Anyone with an interventional procedure such as a stent
* Pain, discomfort (or other anginal equivalent) in the chest, neck, jaw, arms or other areas that may be due to ischemia
* Cerebrovasular disease such as stroke or history of transient ischemic attacks
* Peripheral vascular disease (such as claudication)
* Diabetes (both Type I and II)
* Chronic infectious disease (HIV, hepatitis) (hepatitis A is okay)
* Liver disease
* Cystic fibrosis (CF)
* Chronic obstructive pulmonary disease (COPD) (see asthma and bronchitis under questionable)
* Interstitial lung disease
* Emphysema
* Chronic Bronchitis
* Orthopnea (difficulty breathing except in the upright position) or paroxysmal nocturnal dyspnea (sudden shortness of breath at night typically triggered by lying down)
* Current diagnosis of Chronic Fatigue Syndrome
* Current diagnosis of Fibromyalgia
* Abnormal exercise stress test
* Hypertension (anyone currently being followed and/or treated for hypertension)
* Cancer treatment (other than skin cancer) within the past 6 months
* Musculoskeletal problems such as osteoarthritis, gout, osteoporosis or back, hip or knee pain that can interfere with physical activity (i.e., walking at a brisk pace - about 3-mph)
* Any other serious medical condition that might make exercise unsafe or unwise

Psychiatric Problems

* Hospitalization for a psychiatric disorder in the last 6 months
* Currently suicidal or psychotic, (or suicidal/psychotic in last 6 months)
* Self-report of more than three alcoholic drinks per day on 5 or more days; 5 or more alcoholic drinks on 3 or more days
* Taking these specific medications for psychiatric problems: Mood stabilizer (Lithium, Depakote, Neurontin), Antipsychotics (Haldol, Clozaril, Risperdal)
* Must be on other current psychiatric medications for at least three months

REQUIRES MD CONSENT FOR THE SPECIFIC CONDITION

* Lightheadedness, dizziness, vertigo, or fainting
* Last electrocardiogram (EKG) performed was abnormal
* Anemia
* Previous ETT for medical reason with normal results
* Irregular heart beats or palpitations in the past two years
* Heart murmurs in the past two years - the person will need physician's consent and an echocardiogram showing no evidence of significant heart disease