By John M. de Castro, Ph.D.
“Mindfulness, which is commonly described as present-moment, nonjudgmental awareness, can be an effective tool for riding out cravings and “sitting with” the distress associated with the quitting process. Furthermore, mindfulness can help foster an attitude of acceptance of present-moment challenges and thoughts (such as, “Quitting feels extremely difficult, and sometimes I worry I can’t do this.”). Acceptance can help one to ride out these moments, understanding them as temporary, rather than being overwhelmed by them.” – Traci Stein
“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 are badly needed. Mindfulness training has been shown to be helpful in treatment for addiction and prevention of relapse after recovery. In today’s Research News article “Effect of Brief Mindfulness Practice on Self-Reported Affect, Craving, and Smoking: A Pilot Randomized Controlled Trial Using Ecological Momentary Assessment.” See:
or see summary below, Ruscio and colleagues test the effectiveness of brief meditation in real life situations to assist in reducing smoking. They recruited a community sample of adult cigarette smokers and randomly assigned them to either a brief (2 week) meditation or sham meditation condition. Meditation group participants were instructed in meditation and required to meditate once per day for at least 20 minutes at a time and place of their choosing with pre-recorded guided meditations. The control group also “sham meditated” once a day with a recording that guided them to let their minds wander and judge experience. Both groups were given a Personal Digital Assistant (PDA) that was programmed to prompt them at four random times during each day to complete assessments of smoking, craving, and positive and negative feelings.
They found that the meditation group reported significantly lower cravings after meditation and fewer negative emotions. Importantly, the meditation group significantly and progressively decreased the number of cigarettes smoked per day over the 2 weeks while the sham meditation group did not. These findings are particularly striking because real-world smoking was followed and assessed and there was a truly comparable control condition. Hence, the findings are not due to experimental contamination and are applicable to the kinds of situations where smoking normally occurs. The importance of this should not be underestimated. The lab or the clinic is not the real world. Smoking is prompted by many situations and signals present in the everyday environment that are not present in the lab. So, it is particularly important to test potential therapies against real world smoking behavior.
These are interesting and potentially important findings. A brief daily meditation is capable of reducing craving to smoke and the number of cigarettes smoked per day. If this could be maintained for longer periods it might lead to complete cessation of smoking and possibly prevention of relapse. It will require future research to examine these possibilities. Regardless meditation appears to reduce smoking over the short-term.
So, reduce cigarette smoking and cravings with mindfulness.
“With mindful awareness, patients are no longer at the mercy of their cravings. Instead, they can build awareness for their cravings and choose how to respond.. . mindfulness may also allow patients to build healthier behaviors. . . everyone knows smoking and eating too much is bad for them, but mere knowledge doesn’t change behavior. It’s when they actually begin to pay attention to how smoking tastes, they want to change on a visceral level.” – Jamie Zimmerman
CMCS – Center for Mindfulness and Contemplative Studies
This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts
Study Summary
Ruscio AC, Muench C, Brede E, Waters AJ. Effect of Brief Mindfulness Practice on Self-Reported Affect, Craving, and Smoking: A Pilot Randomized Controlled Trial Using Ecological Momentary Assessment. Nicotine Tob Res. 2016 Jan;18(1):64-73. doi: 10.1093/ntr/ntv074.
Abstract
Introduction: Despite efficacious pharmacological and behavioral treatments, most smokers attempt to quit without assistance and fail to quit. Mindfulness practice may be useful in smoking cessation.
Methods: This ecological momentary assessment (EMA) study was a pilot parallel group randomized controlled trial of a brief mindfulness practice (Brief-MP) intervention on self-reported smoking behavior delivered to smokers on a Personal Digital Assistant (PDA) in the field. Adult community smokers (N = 44) were randomly assigned to a Brief-MP (n = 24) or Control (sham meditation; n = 20) group. Participants were instructed to smoke as much or as little as they liked. Participants carried a PDA for 2 weeks and were instructed to initiate 20 minutes of meditation (or control) training on the PDA daily, completing an assessment of cognitive and affective processes immediately afterwards. Additionally, they completed assessments at random times up to four times per day. Primary outcome variables were negative affect, craving, and cigarettes smoked per day, all self-reported.
Results: Thirty-seven participants provided EMA data totaling 1874 assessments. Linear Mixed Model analyses on EMA data revealed that Brief-MP (vs. Control) reduced overall negative affect, F(1, 1798) = 13.8, P= .0002; reduced craving immediately post-meditation, (Group × Assessment Type interaction, F(2, 1796) = 12.3, P = .0001); and reduced cigarettes smoked per day over time (Group × Day interaction, F(1, 436) = 5.50, P = .01).
Conclusions: Brief-MP administered in the field reduced negative affect, craving, and cigarette use, suggesting it may be a useful treatment.