Updated

Teenage smokers may have better luck quitting if physical activity is added to a traditional cessation program, and exercise is particularly effective with boys, West Virginia University researchers conclude in a study released Monday.

The report doesn't examine why physical activity was more powerful with boys than girls, but lead researcher Kimberly Horn said that will be the topic of future studies. The research appears online in the journal Pediatrics.

Horn's team spent six months tracking 233 students with a mean age of 16½ from 19 West Virginia high schools. They typically smoked a half-pack on weekdays and a pack a day on weekends.

Most had started smoking around age 11 and had moderate to high nicotine addiction.

West Virginia has the nation's worst smoking problem, with federal statistics showing that 29 percent of people under 18 smoke. That compares with a national average of 20 percent.

"This study demonstrates that our West Virginia kids can quit smoking, given the right tools," Horn said. "We simply need to make sure we're getting the right tools out there in the schools and the communities."

The study was funded by the Centers for Disease Control and Prevention. Although others have looked at the intersection of physical activity and smoking cessation in adults, the researchers say they could find no similar studies looking at youth.

The teens who participated didn't engage in physical activity during their sessions; they merely got about five minutes of motivational instruction during their sessions and were given journals and pedometers to track their activities.

But even that small amount of time emphasizing the importance of exercise "may have a high payoff in terms of both health and health economics," Horn said.

All the children in the study participated in the American Lung Association cessation program Not on Tobacco, or N-O-T.

WVU's Prevention Research Center helped develop N-O-T, which has been used with more than 150,000 teens since 1999. The voluntary program includes group activities, discussions, journaling and role-playing. In 10 sessions, it offers advice on health behaviors, stress management and life skills.

One group also got N-O-T and a brief intervention, simulating what they might find in their schools or communities. It consisted of one 10- to 15-minute discussion about the dangers of smoking and general health advice, plus some literature.

The other group had discussions about physical activity during each session of the N-O-T program.

All the teens who had the physical activity component had higher quit rates, Horn said, but the boys' success rates were twice as high as girls who had the same program.

Generally, she said, teenage boys are more physically active than girls, who seem to lose interest in exercise during their teen years.

Future studies will have to examine not only that difference but also the types, duration and intensity of physical activities the boys chose.

"The main rationale for the study was driven by our high rates of smoking and our low levels of physical activity," Horn said, "and what we found is that those two behaviors go hand in hand."