By John M. de Castro, Ph.D.
“smoking is a form of insanity that the logical mind and our own better judgment cannot solve. Many smokers have been helped by mindfulness meditation, a means of slowing down the action and beginning to penetrate the experience of the addiction. Once it is better understood, a rational choice can be made (of whether to continue smoking or not).” – Lawrence Peltz
“Tobacco use remains the single largest preventable cause of death and disease in the United States. Cigarette smoking kills more than 480,000 Americans each year, with more than 41,000 of these deaths from exposure to secondhand smoke. In addition, smoking-related illness in the United States costs more than $300 billion a year. In 2013, an estimated 17.8% (42.1 million) U.S. adults were current cigarette smokers.” (Centers for Disease Control and Prevention).
Nicotine is one of the most addictive substances known. But, its addictiveness is not just due to its pharmacological properties. Addiction to smoking also involves learned or conditioned factors, genetics, and social and environmental factors. This makes it easy to become addicted and very difficult to stop. To some extent this is why there still are high rates of smoking even though mostly everyone understands that it has very negative effects on health and longevity.
There are a wide variety of methods and strategies to quit smoking which are to some extent effective. According to the National Institutes of Health, about 40% of smokers who want to quit make a serious attempt to do so each year, but fewer than 5% actually succeed. Most people require three or four failed attempts before being successful. One problem is that after quitting if a single cigarette is smoked, going back to regular smoking is almost assured. As John Polito wrote “nicotine dependency recovery is one of the few challenges in life where being 99% successful all but assures 100% defeat.”
So, better methods to quit which can not only promote quitting but also prevent relapse are badly needed. Mindfulness practices have been found to be helpful in treating addictions, including nicotine addiction, and reducing the risk of relapse. But, it is not known what aspects of mindfulness are responsible for the beneficial effects. In today’s Research News article “Nonjudging Facet of Mindfulness Predicts Enhanced Smoking Cessation in Hispanics.” See:
or below or view the full text of the study at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4641832/
Spears and colleagues recruited current smokers and measured the Five Facets of Mindfulness Scale (FFMQ). They then applied a quitting smoking treatment program “including nicotine patch therapy, self-help materials, and six brief in-person and telephone counseling sessions.”
The FFMQ measures observing, describing, acting with awareness, non-judging, and non-reactivity facets of mindfulness. They found that the non-judging was the sole facet of mindfulness that predicted successful abstinence from smoking. It significantly predicted abstinence even when its relationship with reduced depression and with demographic variables were accounted for. Of the participants who were high in non-judging 54% were abstinent from smoking 3 weeks after the end of treatment versus 23% of those low in non-judging, while a half year after treatment ceased 23% versus 5% of high versus low non-judging participants were still abstinent. Although 23% success after 6 months may seem low, relative to other programs with about a 5% success rate and low non-judging participants, also with a 5% success rate, the results for high non-judging participants are quite high.
The results clearly demonstrate that non-judging is importantly related to successful smoking cessation and continued abstinence. Non-judging involves being aware of thoughts and feelings but accepting them and not placing value judgements on them. This skill may be helpful in remaining abstinent from smoking as it allows the individual to recognize their thoughts about cigarettes and their cravings simply as they are and not as an indicator that they are failing, that they are weak, or that they shouldn’t be feeling this way. That acceptance may go a long way to helping the individual cope with the cravings and successfully restrain themselves from acting on them and return to smoking. The individuals don’t deny how they’re feeling and accept their feelings, allowing them to better cope with the feelings and remain abstinent.
It should be noted that these results were correlational, not manipulating mindfulness, just simply measuring the levels present. As a result it can’t be concluded that non-judging is the cause of great success in smoking cessation. It could well be that there is something else about the individual that both makes them non-judging and better at quitting. It remains for future studies to manipulate non-judging facet of mindfulness and determine if it produces greater success. Regardless, is an interesting and potentially important observation that could lead to better treatments for quitting smoking.
“Early evidence suggests that exercises aimed at increasing self-control, such as mindfulness meditation, can decrease the unconscious influences that motivate a person to smoke.” – Dr. Nora Volkow
CMCS – Center for Mindfulness and Contemplative Studies
Study Summary
Spears, C. A., Houchins, S. C., Stewart, D. W., Chen, M., Correa-Fernández, V., Cano, M. Á., … Wetter, D. W. (2015). Nonjudging Facet of Mindfulness Predicts Enhanced Smoking Cessation in Hispanics. Psychology of Addictive Behaviors : Journal of the Society of Psychologists in Addictive Behaviors,29(4), 918–923. http://doi.org/10.1037/adb0000087
Abstract
Although most smokers express interest in quitting, actual quit rates are low. Identifying strategies to enhance smoking cessation is critical, particularly among underserved populations including Hispanics, for whom many of the leading causes of death are related to smoking. Mindfulness (purposeful, non-judgmental attention to the present moment) has been linked to increased likelihood of cessation. Given that mindfulness is multifaceted, determining which aspects of mindfulness predict cessation could help to inform interventions. This study examined whether facets of mindfulness predict cessation in 199 Spanish-speaking smokers of Mexican heritage (63.3% male, mean age=39, 77.9% ≤ high school education) receiving smoking cessation treatment. Primary outcomes were 7-day abstinence at weeks 3 and 26 post-quit (biochemically-confirmed and determined using an intent-to-treat approach). Logistic random coefficients regression models were utilized to examine the relationship between mindfulness facets and abstinence over time. Independent variables were subscales of the Five Facet Mindfulness Questionnaire (Observing, Describing, Acting with Awareness, Nonjudging, Nonreactivity). The Nonjudging subscale (i.e., accepting thoughts and feelings without evaluating them) uniquely predicted better odds of abstinence up to 26 weeks post-quit. This is the first known study to examine whether specific facets of mindfulness predict smoking cessation. The ability to experience thoughts, emotions, and withdrawal symptoms without judging them may be critical in the process of quitting smoking. Results indicate potential benefits of mindfulness among smokers of Mexican heritage and suggest that smoking cessation interventions might be enhanced by central focus on the Nonjudging aspect of mindfulness.