Effects of aerobic exercise on approach–avoidance responses and prefrontal activity in individuals with tobacco dependence

Objective: This study examined whether smokers exhibit an approach bias toward smoking-related cues and investigated the effects of acute aerobic exercise on modifying this behavioral tendency and its associated prefrontal cortical activity. Methods: = 40) under smoking-related and neutral cue conditions. Experiment 2 adopted a randomized controlled design in which 60 smokers were assigned to moderate-intensity exercise, high-intensity exercise, or a resting control group. Participants completed the stimulus-response compatibility task before and after intervention, while prefrontal oxygenated hemoglobin was recorded using fNIRS. Results: Smokers demonstrated a significant approach bias toward smoking-related cues, and the magnitude of this bias was positively associated with nicotine dependence levels. Acute aerobic exercise significantly altered the cognitive processing underlying this bias, evidenced by reduced behavioral approach bias scores and decreased prefrontal activation in response to smoking cues. Conclusion: Acute aerobic exercise temporarily strengthens smokers' cognitive control over smoking-related cues, attenuates approach bias, and improves prefrontal cortical function. These findings provide empirical support for incorporating aerobic exercise into smoking cessation interventions.