Abstract

Background: Current management strategies for tobacco cessation, including pharmacological interventions, and other supportive therapies have limitations. Emerging evidence suggests that alternate therapies, particularly yoga, may play a significant role. This study was conducted to evaluate the role of yoga in tobacco cessation among adult tobacco users.
Methods: A prospective randomised, open, blinded end-point trial was conducted among healthy adult tobacco users. Participants were randomly assigned to either yoga  (n=64) or exercise (n=66). The primary outcome measure was 7-day Point Prevalence Abstinence (7-PPA) validated by salivary cotinine levels, at 6 months. Secondary outcomes included Quality of Life (QoL), assessed using the World Health Organization Quality of Life-brief (WHOQOL-BREF), and psychological health outcomes using the Depression, Anxiety and Stress Scale (DASS) at 6 months. 
Results: Between December 2021 to June 2023, 910 adult tobacco users were screened. A total of 130 eligible participants (96.9%male) were included, of which 51 (39.3%) were smoking and 79 (60.7%) were smokeless tobacco users. At the final follow-up, 14 (22%) participants in the yoga group achieved 7-PPA, compared to 6 (9.1%) participants in the exercise group, (p = .043) (OR: 2.8, 95% CI:1.04-8.40).  There were significant differences between the groups in quality of life (p < .05), psychological health outcomes including stress and anxiety (p  < .001) and depression (p = .008)) at 6 months.
Conclusion: Yoga was found to be more effective than exercise in achieving tobacco abstinence, among both smoking and smokeless tobacco users, along with improvements in quality of life and psychological health outcomes.