The effects of a facilitated physical activity intervention for depressed patients on smoking and alcohol outcomes

First published: 10 May 2019 | Last updated: 20 May 2019

Aims: While the prevalence of smoking has been steadily reducing over the past 3 decades among the general population there has been less change among people with depression. Alcohol consumption is also greater among people with depression. Little is known about whether interventions designed to reduce depression have any consequence on smoking and alcohol consumption. The aim of the present study is to examine secondary data on smoking and alcohol use over time among patients in the TREAD study (Chalder et al, 2012).

Methods: Patients with diagnosed depression were recruited from primary care into a 12 month randomised controlled trial to receive usual care (eg, antidepressants, cognitive behavioural therapy) or usual care plus an augmented physical activity intervention (for up to 9 months)(Haase et al, 2010).

Results: Overall, of the 361 participants, at baseline 36% and 39% reported smoking and drinking alcohol, respectively, with about 16% classified as heavy users for each substance. Logistic regression revealed the proportion of heavy smokers and alcohol users was no different between groups at 4, 8 and 12 months after baseline. Sensitivity analysis to examine the effects of general practitioner clustering and missing data (using multiple imputation by chained equations) revealed no different effects.

Conclusions: Over time there was also no change in the proportion classified as heavy smokers or alcohol users despite substantial reductions in depression in both arms of the trial, and a greater proportion of participants achieving at least 1000 METs at 8 and 12 months in the physical activity arm than the control arm.

Chalder, M., Wiles, N. J., Campbell, J. Hollinghurst, S. P., Haase, A. M., Taylor, A. H., et al Facilitated physical activity as a treatment for depressed adults: randomised controlled trial. BMJ 2012; 344: e2758.

Haase, A.M., Taylor, A.H., Fox, K.R., Thorp, H. Lewis, G. Rationale and development of the physical activity counselling intervention for a pragmatic TRial of Exercise and Depression in the UK (TREAD-UK). Mental Health & Physical Activity 2010; 3: 85-91.


Mr Nick Turner, University of Bristol Dr Tom Thompson, University of Plymouth Prof John Campbell, University of Exeter Medical School Prof Glyn Lewis, University College London

Conflicts of interest:

No conflict of interest.

Professor Adrian H Taylor