Smoking Termination Enhancement Project (STEP)

Inclusion criteria

• Aged between 18 and 65 years old
• Capable of providing informed consent, attend all study visits and comply with the protocol
• Daily smoker for at least one year and currently smoke an average of at least 10 cigarettes per day
• Report a motivation to quit smoking in the next month of at least 5 on a 10-point scale
• Score of 20 or greater on 16-item Anxiety Sensitivity Index
• Physically inactive as defined as participating in moderate-intensity exercise less than 2 days/week (duration must be 30 minutes or less each time)

Exclusion criteria

• Use of other tobacco products
• General medical condition(s) that contraindicate exercise
• Resting blood pressure of ≥ 160 systolic and/or 100 diastolic who are not receiving treatment for high blood pressure
• Blood lipid levels ≥ 240 mg/dl with LDL-C ≥ 160 mg/dl or triglyceride levels ≥ 300 mg/dl (individuals receiving medical treatment for lipid abnormalities with lipid levels above the cut-offs will be eligible with physician written approval)
• Body mass index ≥40
• Currently suicidal or high suicide risk
• Current or past psychotic disorders of any type, or comorbid psychiatric conditions that are relative or absolute contraindications to the use of any treatment option in the study protocol
• Currently pregnant, planning on becoming pregnant in the next year, or current breastfeeding
• Alcohol or drug dependence; abuse of depressants, dissociative anesthetics, hallucinogens, opioids, or cocaine within the last 6 months
• Psychotherapy initiated within the past three months, or ongoing psychotherapy of any duration directed specifically toward the treatment of anxiety or mood disorder other than general supportive therapy
• Current use of any psychotherapy or pharmacotherapy for smoking cessation not provided by the researchers, including Chantix, Zyban, Welbutrin and Nortriptyline.