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