Yoga for Tobacco Cessation: A Randomized Controlled Trial (QUIT-SMART)

BACKGROUND: Current tobacco cessation strategies, including pharmacological interventions and supportive therapies, have limitations related to adherence and relapse. Emerging evidence suggests that yoga plays a significant role in tobacco cessation through psycho-behavioral mechanisms. This study was conducted to evaluate the role of yoga among adults who used both smoking and smokeless forms (SLT) of tobacco. METHODS: A prospective, randomized, open-label, blinded endpoint trial was conducted among adult tobacco users. Participants were randomly assigned to either the yoga (n = 64) or the exercise (n = 66). The primary outcome was 7-day point prevalence abstinence (7-PPA) validated by salivary cotinine, at 6 months. Secondary outcomes included quality of life (QoL), assessed using WHOQOL-BREF, and psychological health was assessed using DASS-21. RESULTS: Between December 2021 and June 2023, 910 adult tobacco users were screened. A total of 130 participants (96.9% male) were enrolled, including 51 (39.3%) who used smoking tobacco and 79 (60.7%) who used smokeless tobacco. At 6 months, 14 (22%) participants in the yoga group achieved 7-PPA, compared to 6 (9.1%) in the exercise group (p = 0.043) (OR: 2.8, 95% CI: 1.04-8.40). The yoga group demonstrated greater improvements in QoL (p < 0.05), and psychological health outcomes, including stress and anxiety (p < 0.001) and depression (p = 0.008). CONCLUSION: Yoga demonstrated a significantly higher rate of 7-PPA compared with exercise. The yoga group also showed greater improvements in QoL and psychological outcomes. These findings suggest that yoga may serve as a feasible complementary intervention for tobacco cessation among adult tobacco users. TRIAL REGISTRATION: Clinical Trial Registry India number; CTRI/2021/12/038745. Date of Registration - Dec 20, 2021.