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Cigarette SmokingNCT04688177

The Association of Cigarette Smoking on Exercise Capacity and Skeletal Muscle Function in Taiwan Adult Smokers

An observational study of Cigarette Smoking, run by National Taiwan University Hospital at 1 site in Taiwan.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

Background and purpose: Cigarette smoking would post threats to physical health. Even though studies suggested that long-term cigarette smoking would lead to cardiovascular diseases, pulmonary diseases, or even cancer development, the smoking population all around the world was still common. Read more about this study

Who is it for?
Ages 20 to 55 yearsHealthy volunteers can take part
Conditions the study is for
Cigarette Smoking
What is being tested?
Body Composition, Heart rate variability and Grip Strength
How many people
52 participants
Where
1 siteTaiwan
Study dates
3 Dec 2020to 29 Apr 2021
Phase
Observational
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 20 to 55 years
  • All sexes
  • Healthy volunteers accepted
  • Adult

Study population: Subjects will be invited from community in Taipei City

Who may be able to join

  • male 20 ≤ age ≤ 45 years old
  • female 20 ≤ age ≤ 55 years old
  • age and gender-matched non-smokers

Who cannot join

  • uncontrolled cardiovascular diseases, neurological diseases, musculoskeletal system problems, or systemic diseases that contraindicate the exercise
  • women in pregnancy or menopausal women
  • any ongoing medication that has a documented effect on the autonomic nervous system (e.g., tricyclic anti-depressants)
  • has been diagnosed with autonomic nervous system disorders

Trial locations and contacts

1 site in 1 country.

Taiwan1 site
  • National Taiwan University, College of Medicine, Department of Physical Therapy

    Taipei, Zhongzheng, 100

Other trials in Taiwan

About this study

Background and purpose: Cigarette smoking would post threats to physical health. Even though studies suggested that long-term cigarette smoking would lead to cardiovascular diseases, pulmonary diseases, or even cancer development, the smoking population all around the world was still common. Before progressing into the disease stage, cigarette smokers might have presented decreasing exercise capacity, skeletal muscle function, and cardiac autonomic function as early signs of physiological function decline. The purposes of this study are (1) to investigate the difference in exercise capacity, skeletal muscle function, and cardiac autonomic function between smokers and never smokers, and (2) to test the hypothesis that cigarette smoking is an independent factor associated with exercise capacity.

Methods: This is a cross-sectional observational study. This study will invite 150 participants from community in Taipei City. The body composition will be analyzed by bioelectrical impedance analysis, and resting heart rate variability will be evaluated by the heart rate variability monitor. Besides, grip strength, exhale carbon monoxide concentration, pulmonary function test, respiratory muscle performance will be measured. Moreover, subject will have to fill up the Fagerström Test for Nicotine Dependence and Seven-Day Physical Activity Recall Questionnaire. Last will be the cardiopulmonary exercise testing. Statistical analyses will be performed by statistical software for social sciences (SPSS) statistical package v.21.0 for Windows. (IBM SPSS Statistics for Windows, Version 21.0. Armonk, NY: IBM Corp.) Between-group comparisons of exercise capacity, skeletal muscle function and heart rate variability parameters will be performed using independent Student's t-test. Pearson's correlation coefficient will be used to test the correlations between outcome parameters. Stepwise regression analysis will be used to examine the independent association between smoking and exercise capacity after controlling for confounders. The α level will be set at 0.05. The results of this study would provide the early effects of cigarette smoking on physical function, and highlight the importance of early detection and intervention.

Being tested
Body Composition, Heart rate variability, Grip Strength, Exhale Carbon Monoxide Concentration, Pulmonary Function Test
Keywords
cigarette smoking, exercise capacity, skeletal muscle function, heart rate variability
Medical subject headings
Cigarette Smoking

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Body CompositionDevice

    The subjects should lie in the supine position on a non-conducting surface for 5 min. 4 surface electrodes with cables will be attached to the right hand and ankle of subjects.

  • Heart rate variabilityDevice

    After supine quietly for 20 min, a lead I electrocardiogram will be taken for 5 min.

  • Grip StrengthDevice

    The participants will squeeze the hand dynamometer as hard as possible with the dominant hand. 3 successive measurements will be taken.

  • Exhale Carbon Monoxide ConcentrationDevice

    Subjects in sitting position, performing 1 inspiration, then exhale to carbon monoxide meter.

  • Pulmonary Function TestDevice

    Subjects should be in a sitting position with a nose clip, then perform pulmonary function test. Participants should perform at least 3 acceptable attempts, but no more than 8 attempts in total.

  • Respiratory Muscle FunctionDevice

    Subject will perform both maximal inspiratory pressure and maximal expiratory pressure for 3 times in sitting position with the nose clip.

  • Fagerström Test for Nicotine DependenceBehavioural

    Fagerström Test for Nicotine Dependence Traditional Chinese version will be adopted. It is a 6-item questionnaire that could help quantify the smoking frequency, amounts, and level of dependence.

  • Seven-Day Physical Activity Recall QuestionnaireBehavioural

    Physical activity will be measured by the Chinese Version of the Seven-Day Physical Activity Recall Questionnaire. Participants will need to recall the time (hours) they spent in various leisure activities in the past 7 days.

  • Cardiopulmonary exercise testingDevice

    Bruce protocol as the treadmill evaluation protocol will be adopted for cardiopulmonary exercise testing.

Study groups in NCT04688177
Study groupRoleWhat they receive
smokerscigarette smokers male 20 ≤ age ≤ 45 years old female 20 ≤ age ≤ 55 years old
Receives: Device: Body Composition; Device: Heart rate variability; Device: Grip Strength; Device: Exhale Carbon Monoxide Concentration; Device: Pulmonary Function Test; Device: Respiratory Muscle Function; Behavioral: Fagerström Test for Nicotine Dependence; Behavioral: Seven-Day Physical Activity Recall Questionnaire; Device: Cardiopulmonary exercise testing
never smokersage and gender-matched non-smokers
Receives: Device: Body Composition; Device: Heart rate variability; Device: Grip Strength; Device: Exhale Carbon Monoxide Concentration; Device: Pulmonary Function Test; Device: Respiratory Muscle Function; Behavioral: Fagerström Test for Nicotine Dependence; Behavioral: Seven-Day Physical Activity Recall Questionnaire; Device: Cardiopulmonary exercise testing

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Maximal oxygen uptake

    Maximal oxygen uptake, VO2max (ml/kg/min), as an indicator of exercise capacity. Cardiopulmonary exercise testing will be used to evaluate the maximal exercise capacity by a computer-controlled breath-by-breath metabolic measurement system (Carefusion Corporation, Yorba Linda, CA, USA) base on the treadmill. Bruce protocol, which is a graded treadmill evaluation protocol will be adopted.

    Measured: After finishing all the other measurement. The measurement will be lasted 15 minutes.

Secondary outcomes (10)
  1. Skeletal muscle function

    Skeletal muscle function will be assessed by measuring the grip strength of the dominant hand using a hand dynamometer (Jamar, Jackson, MI, USA).

    Measured: After finishing heart rate variability and body composition measurement. The measurement will be lasted 5 minutes.

  2. Cardiac autonomic function

    Heart rate variability will be measured by HRV monitor (8Z11, Wegene Technology Inc., Taiwan) in this study.

    Measured: After body composition measurement. The measurement will be lasted 20 minutes.

  3. Skeletal muscle mass

    Skeletal muscle mass (kilogram, kg) will be measured by a bioelectrical impedance analyzer (BIA). (Maltron BioScan 920, Maltron International Ltd., Esgender, UK). The subjects should lie in the supine position on a non-conducting surface for 5 min. Skeletal muscle mass will be calculated by the equation of Janssen and colleagues.

    Measured: After collecting basic data of subjects. The measurement will be lasted 5-10 minutes.

  4. Exhale carbon monoxide concentration

    Exhale carbon monoxide will be measured by the carbon monoxide meter (CO Check+, MD Diagnostics LTD) for current smoking status evaluation.

    Measured: After finishing heart rate variability and body composition measurement. The measurement will be lasted 1-3 minutes.

  5. Forced expiratory volume in one second

    Pulmonary function will be measured by a portable MicroLab® Spirometer (CareFusion, Basingstoke, UK). The outcome measure will include: forced expiratory volume in one second (FEV1, unit: liter).

    Measured: The pulmonary function measurement will be lasted 15 minutes.

  6. Forced vital capacity

    Pulmonary function will be measured by a portable MicroLab® Spirometer (CareFusion, Basingstoke, UK). The outcome measure will include: forced vital capacity (FVC, unit: liter)

    Measured: The pulmonary function measurement will be lasted 15 minutes.

  7. FEV1/FVC ratio

    Pulmonary function will be measured by a portable MicroLab® Spirometer (CareFusion, Basingstoke, UK). The outcome measure will include: FEV1/FVC ratio, which is useful for detecting possible dysfunction of the respiratory system in clinical practice.

    Measured: The pulmonary function measurement will be lasted 15 minutes.

  8. Respiratory muscle function

    Maximal inspiratory pressure (PImax, unit: cmH2O) and maximal expiratory pressure (PEmax, unit: cmH2O) will be measured by a respiratory pressure meter, which could represent the respiratory muscle strength.

    Measured: After pulmonary function test measurement. The measurement will be lasted 10 minutes.

  9. Level of nicotine dependence

    Fagerström Test for Nicotine Dependence (FTND) Traditional Chinese version will be adopted for quantifying the level of nicotine dependence. FTND is a 6-item questionnaire. The minimum value is 0 points and maximum values is 6 points. The higher score represents the greater nicotine dependence.

    Measured: After respiratory muscle function measurement. The measurement will be lasted 3-5 minutes.

  10. Seven-day physical activity recall questionnaire

    Physical activity will be measured by the Chinese Version of the Seven-Day Physical Activity Recall Questionnaire. Participants will need to recall the time (hours) they spent in various leisure activities in the past 7 days. The energy expenditure (kcal/day) = metabolic equivalents (METs)*time (hour)*body weight (kg)/7 days.

    Measured: After respiratory muscle function measurement. The measurement will be lasted 3-5 minutes.

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted29 Dec 2020
  2. Study start3 Dec 2020
  3. Primary completion29 Apr 2021
  4. Study completion29 Apr 2021

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Other
Time perspective
Cross-sectional
Enrolment
52 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04688177
Sponsor's protocol ID
202010123RIND
Status last verified
Dec 2020
First submitted
14 Dec 2020
Last updated
24 Jan 2022
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided

Publications

  • Jamal A, Phillips E, Gentzke AS, Homa DM, Babb SD, King BA, Neff LJ. Current Cigarette Smoking Among Adults - United States, 2016. MMWR Morb Mortal Wkly Rep. 2018 Jan 19;67(2):53-59. doi: 10.15585/mmwr.mm6702a1.

    PubMed 29346338
  • Chen YL, Wu SC, Chen YT, Hsiao PC, Yu YH, Ting TT, Chen CY, Tu YK, Huang JH, Yang HJ, Li CY, Strong C, Yen CF, Yen CF, Chen WJ. E-Cigarette Use in a Country With Prevalent Tobacco Smoking: A Population-Based Study in Taiwan. J Epidemiol. 2019 Apr 5;29(4):155-163. doi: 10.2188/jea.JE20170300. Epub 2018 Sep 1.

    PubMed 30175730
  • Yoshida T, Tuder RM. Pathobiology of cigarette smoke-induced chronic obstructive pulmonary disease. Physiol Rev. 2007 Jul;87(3):1047-82. doi: 10.1152/physrev.00048.2006.

    PubMed 17615396
  • Tindle HA, Stevenson Duncan M, Greevy RA, Vasan RS, Kundu S, Massion PP, Freiberg MS. Lifetime Smoking History and Risk of Lung Cancer: Results From the Framingham Heart Study. J Natl Cancer Inst. 2018 Nov 1;110(11):1201-1207. doi: 10.1093/jnci/djy041.

    PubMed 29788259
  • Thun MJ, Carter BD, Feskanich D, Freedman ND, Prentice R, Lopez AD, Hartge P, Gapstur SM. 50-year trends in smoking-related mortality in the United States. N Engl J Med. 2013 Jan 24;368(4):351-64. doi: 10.1056/NEJMsa1211127.

    PubMed 23343064
  • Teo KK, Ounpuu S, Hawken S, Pandey MR, Valentin V, Hunt D, Diaz R, Rashed W, Freeman R, Jiang L, Zhang X, Yusuf S; INTERHEART Study Investigators. Tobacco use and risk of myocardial infarction in 52 countries in the INTERHEART study: a case-control study. Lancet. 2006 Aug 19;368(9536):647-58. doi: 10.1016/S0140-6736(06)69249-0.

    PubMed 16920470
  • Watson M, Dardari Z, Kianoush S, Hall ME, DeFilippis AP, Keith RJ, Benjamin EJ, Rodriguez CJ, Bhatnagar A, Lima JA, Butler J, Blaha MJ, Rifai MA. Relation Between Cigarette Smoking and Heart Failure (from the Multiethnic Study of Atherosclerosis). Am J Cardiol. 2019 Jun 15;123(12):1972-1977. doi: 10.1016/j.amjcard.2019.03.015. Epub 2019 Mar 18.

    PubMed 30967285
  • Doll R, Peto R, Boreham J, Sutherland I. Mortality in relation to smoking: 50 years' observations on male British doctors. BMJ. 2004 Jun 26;328(7455):1519. doi: 10.1136/bmj.38142.554479.AE. Epub 2004 Jun 22.

    PubMed 15213107
  • Furlanetto KC, Mantoani LC, Bisca G, Morita AA, Zabatiero J, Proenca M, Kovelis D, Pitta F. Reduction of physical activity in daily life and its determinants in smokers without airflow obstruction. Respirology. 2014 Apr;19(3):369-75. doi: 10.1111/resp.12236. Epub 2014 Feb 2.

    PubMed 24483840
  • Hawari FI. The effect of habitual waterpipe tobacco smoking on pulmonary function and exercise capacity in young healthy males: A pilot study. Respir Med. 2017 Mar;124:102. doi: 10.1016/j.rmed.2017.02.006. Epub 2017 Feb 11. No abstract available.

    PubMed 28237402
  • Mesquita R, Goncalves CG, Hayashi D, Costa Vde S, Teixeira Dde C, de Freitas ER, Felcar JM, Pitta F, Molari M, Probst VS. Smoking status and its relationship with exercise capacity, physical activity in daily life and quality of life in physically independent, elderly individuals. Physiotherapy. 2015 Mar;101(1):55-61. doi: 10.1016/j.physio.2014.04.008. Epub 2014 May 17.

    PubMed 25108641
  • Ben Saad H, Babba M, Boukamcha R, Ghannouchi I, Latiri I, Mezghenni S, Zedini C, Rouatbi S. Investigation of exclusive narghile smokers: deficiency and incapacity measured by spirometry and 6-minute walk test. Respir Care. 2014 Nov;59(11):1696-709. doi: 10.4187/respcare.03058. Epub 2014 Jul 8.

    PubMed 25006270
  • Kobayashi Y, Takeuchi T, Hosoi T, Loeppky JA. Effects of habitual smoking on cardiorespiratory responses to sub-maximal exercise. J Physiol Anthropol Appl Human Sci. 2004 Sep;23(5):163-9. doi: 10.2114/jpa.23.163.

    PubMed 15472461
  • Neves CD, Lacerda AC, Lage VK, Lima LP, Tossige-Gomes R, Fonseca SF, Rocha-Vieira E, Teixeira MM, Mendonca VA. Oxidative stress and skeletal muscle dysfunction are present in healthy smokers. Braz J Med Biol Res. 2016 Oct 24;49(11):e5512. doi: 10.1590/1414-431X20165512.

    PubMed 27783809
  • Morse CI, Wust RC, Jones DA, de Haan A, Degens H. Muscle fatigue resistance during stimulated contractions is reduced in young male smokers. Acta Physiol (Oxf). 2007 Oct;191(2):123-9. doi: 10.1111/j.1748-1716.2007.01721.x. Epub 2007 Jun 5.

    PubMed 17550408

Questions about this trial

What is this clinical trial studying?

An observational study of Cigarette Smoking, run by National Taiwan University Hospital at 1 site in Taiwan.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 3 inclusion and 4 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 24 Jan 2022. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Taiwan. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Maximal oxygen uptake (time frame: After finishing all the other measurement. The measurement will be lasted 15 minutes.). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT04688177, which also lists 57 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 24 Jan 2022.

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