Improve Smoking Abstinence with Mindfulness

July 25, 2020 psyjdc Leave a comment

By John M. de Castro, Ph.D.

“mindfulness training (MT) may decouple the association between craving and smoking, thus facilitating smoking cessation.” – J. Kim Pemberthy

“Tobacco use remains the single largest preventable cause of death and disease in the United States.” (Centers for Disease Control and Prevention). So, treating nicotine addiction and producing smoking cessation could greatly improve health. But smoking has proved devilishly difficult to treat. There are a wide variety of methods and strategies to quit smoking which are to only a very limited 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 nicotine is one of the most addictive substances known and withdrawal from nicotine is very stressful, producing many physical and psychological problems, including negative emotional states and depression. In essence, the addict feels miserable without the nicotine. This promotes relapse to relieve the discomfort. 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.

In today’s Research News article “Mechanisms linking mindfulness and early smoking abstinence: An ecological momentary assessment study.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6483850/), Spears and colleagues recruited adult smokers desiring to quit and provided them with “six smoking cessation counseling sessions (10–20 minutes each).” They completed questionnaires on demographics and mindfulness. They were also asked to complete assessments at baseline and for 4 weeks after cessation of smoking on a smartphone of positive and negative emotions, smoking urges, and expectancy of regulating emotions whenever they had an urge to smoke, smoked a cigarette, and 4 randomly selected times per day prompted on their smartphone.

Of the participants 63% achieved smoking abstinence after treatment and 41% remained abstinent 7 days later. They found that on the day of smoking cessation and 7 days later, the higher the levels of mindfulness the lower the levels of negative emotions, stress, smoking urges, and expectancies that smoking would improve mood and the higher the levels of positive emotions. They also found that lower smoking urges were associated with higher levels of abstinence when the participants were low in mindfulness but not when they were high in mindfulness. In addition, the higher the levels of mindfulness, the higher the levels of positive emotions and the lower the levels of negative emotions which were in turn associated with higher levels of smoking abstinence.

Even though the smoking cessation therapy did not include a mindfulness component, the participant’s level of mindfulness was an important contributor to successful smoking abstinence. Mindfulness appeared to be associated with improved mood and lower stress levels and urges to smoke which were in turn associated with improved outcomes. Hence, mood and stress appear to mediate the association of mindfulness with successfully quitting smoking. Mindful people appear to have more positive moods which works to improve the likelihood of quitting smoking.

So, improve smoking abstinence with mindfulness.

“stress is caused by craving. If you can let go of that craving, then your stress will dissolve, and practicing mindfulness is the way to do that.” – Judson Brewer

CMCS – Center for Mindfulness and Contemplative Studies

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

Study Summary

Spears, C. A., Li, L., Wu, C., Vinci, C., Heppner, W. L., Hoover, D. S., Lam, C., & Wetter, D. W. (2019). Mechanisms linking mindfulness and early smoking abstinence: An ecological momentary assessment study. Psychology of addictive behaviors : journal of the Society of Psychologists in Addictive Behaviors, 33(3), 197–207. https://doi.org/10.1037/adb0000451

Abstract

Research suggests that individuals with greater dispositional mindfulness (i.e., non-judgmental, present-focused attention) are more likely to quit smoking, but the underlying mechanisms are unclear. This study investigated mechanisms linking mindfulness and early smoking abstinence using ecological momentary assessment (EMA). Participants were 355 smokers (33% Caucasian, 33% African American, 32% Latino; 55% female) receiving smoking cessation treatment. Mindfulness was assessed at baseline and on the quit date. For 4 days pre-quit and 1 week post-quit, participants completed up to 4 EMAs per day indicating levels of negative affect (NA), positive affect (PA), smoking urges, and affect regulation expectancies. Mean, slope, and volatility were calculated for each pre-quit and post-quit EMA variable. Associations among mindfulness, EMA parameters, and abstinence on the quit day and 7 days post-quit, as well as indirect effects of mindfulness on abstinence through EMA parameters were examined. Mindfulness predicted higher odds of abstinence in unadjusted but not covariate-adjusted models. Mindfulness predicted lower NA, higher PA, and lower affective volatility. Lower stress mediated the association between mindfulness and quit-day abstinence. Higher ratings of happy and relaxed, and lower ratings of bored, sad and angry, mediated the association between mindfulness and post-quit abstinence. Mindfulness appeared to weaken the association between craving and post-quit abstinence. This study elucidates real-time, real-life mechanisms underlying dispositional mindfulness and smoking abstinence. During the early process of quitting smoking, more mindful individuals appear to have more favorable emotional profiles, which predicts higher likelihood of achieving abstinence 1 week after the quit date.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6483850/

Spirituality Improves Health Behaviors Particularly When Coupled with Religion

September 3, 2019 psyjdc Leave a comment

Spirituality Improves Health Behaviors Particularly When Coupled with Religion

By John M. de Castro, Ph.D.

“Spirituality is a universal phenomenon and an inherent aspect of human nature that unfolds during adolescence as the individual searches for transcendence, meaning, and purpose in life.” – Sangwon Kim

We tend to think that illness is produced by physical causes, disease, injury, viruses, bacteria, etc. But many health problems are behavioral problems or have their origins in maladaptive behavior. This is evident in car accident injuries that are frequently due to behaviors, such as texting while driving, driving too fast or aggressively, or driving drunk. Other problematic behaviors are cigarette smoking, alcoholism, drug use, or unprotected sex. It is well established that if patterns and habits of healthy behaviors can be established early in life, long-term health can be promoted and ill health can be prevented. Adolescence is a time when these behavioral causes of health problems usually develop.

Spirituality is defined as “one’s personal affirmation of and relationship to a higher power or to the sacred. There have been a number of studies of the influence of spirituality on the physical and psychological well-being of practitioners mostly showing positive benefits, with spirituality encouraging personal growth and mental health. Religiosity is also known to help with a wide range of physical and psychological problems. So, it would make sense to investigate the influence of spirituality and religiosity on the ability of adolescents to develop positive health behaviors.

In today’s Research News article “”I am spiritual, but not religious”: Does one without the other protect against adolescent health-risk behaviour?” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6353810/), Malinakova and colleagues obtained data from a Czechoslovakian survey of a representative sample of adolescents aged 11, 13, and 15 years. Among other measures the youths completed measures of religious attendance, spirituality, tobacco, alcohol, and cannabis use, drug use experience, and sexual intercourse.

They found that either religious attendance or high spirituality was associated with a lower risk of smoking while only high spirituality was associated with lower alcohol use and only religious attendance appeared to be associated with lower early sexual intercourse. But when the combination of religious attendance and high spirituality was looked at, there were large significantly lower levels of tobacco, alcohol, and cannabis use and lifetime drug use.

These results are interesting but correlational. So, caution must be exercised in making conclusions about causality. They suggest, though, that individually religious attendance and spirituality only have limited associations with lower levels of health risk behaviors in adolescents. But in combination they have a strong association with lower levels of these behaviors. This suggests that just attending religious services doesn’t impact health risk behaviors unless it is combined with spirituality. It would appear that when youths are religious and also spiritual, they are much less likely to engage in behaviors that may damage their health.

So, spirituality improves health behaviors particularly when coupled with religion.

“The results also showed a consistent relationship between high levels of spiritual health and positive overall self-rated health. Overall, while the perceived importance of spiritual health declined by age, for adolescents who maintain a strong sense of the importance of self-perceived spiritual health, the possible benefits are striking.” – HBSC News

CMCS – Center for Mindfulness and Contemplative Studies

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

Study Summary

Malinakova, K., Kopcakova, J., Madarasova Geckova, A., van Dijk, J. P., Furstova, J., Kalman, M., … Reijneveld, S. A. (2019). “I am spiritual, but not religious”: Does one without the other protect against adolescent health-risk behaviour?. International journal of public health, 64(1), 115–124. doi:10.1007/s00038-018-1116-4

Abstract

Objectives

Spirituality and religious attendance (RA) have been suggested to protect against adolescent health-risk behaviour (HRB). The aim of this study was to explore the interrelatedness of these two concepts in a secular environment.

Methods

A nationally representative sample (n = 4566, 14.4 ± 1.1 years, 48.8% boys) of adolescents participated in the 2014 Health Behaviour in School-aged Children cross-sectional study. RA, spirituality (modified version of the Spiritual Well-Being Scale), tobacco, alcohol, cannabis and drug use and the prevalence of sexual intercourse were measured.

Results

RA and spirituality were associated with a lower chance of weekly smoking, with odds ratios (OR) 0.57 [95% confidence interval (CI) 0.36–0.88] for RA and 0.88 (0.80–0.97) for spirituality. Higher spirituality was also associated with a lower risk of weekly drinking [OR (95% CI) 0.91 (0.83–0.995)]. The multiplicative interaction of RA and spirituality was associated with less risky behaviour for four of five explored HRB. RA was not a significant mediator for the association of spirituality with HRB.

Conclusions

Our findings suggest that high spirituality only protects adolescents from HRB if combined with RA.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6353810/

Improve Response Inhibition to Quit Smoking with Mindfulness

January 15, 2019May 22, 2020 psyjdc Leave a comment

Improve Response Inhibition to Quit Smoking with Mindfulness

By John M. de Castro, Ph.D.

“mindfulness home practice significantly predicted reduced smoking behavior, even after controlling for initial craving and cigarette use. In fact, every day the participants meditated meant 1.2 fewer cigarettes, and every day they were mindful with their cravings and in everyday activities meant 1.52 fewer cigarettes.” – Mayo Clinic

“Tobacco use remains the single largest preventable cause of death and disease in the United States.” (Centers for Disease Control and Prevention). So, treating nicotine addiction and producing smoking cessation could greatly improve health. But smoking has proved devilishly difficult to treat. There are a wide variety of methods and strategies to quit smoking which are to only a very limited 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.

In today’s Research News article “Effects of a brief mindfulness-meditation intervention on neural measures of response inhibition in cigarette smokers.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5784955/ ), Andreu and colleagues explore a possible mechanism by which mindfulness may affect smoking cessation; improved response inhibition. This is the ability to stop or withhold a behavior that may be highly motivated. Obviously, smoking is strongly motivated and a behavior that is very hard to stop or withhold.

They recruited adult smokers and exposed them to a cigarette and either provided them with a recorded mindfulness instruction or were told to cope with their urge to smoke in any way they could. They then had the Electroencephalogram (EEG) recorded while performing a smoking go/no-go task in which they pushed a button each time a picture was presented with a particularly colored frame on a computer screen and did not press the button when the picture had a different colored frame. The pictures were either smoking related or neutral. The go-no-go task is a standard test for response inhibition.

They found that there were no significant differences between the error rates or response speeds between the mindfulness or no instruction groups on the go/no-go task. But there were differences in the EEG. During the task the changes in the electrical activity that occur in response to the pictures was recorded. These event-related potentials or ERPs are the fluctuations of the signal after specific periods of time which are thought to measure different aspects of the nervous system’s processing of the stimulus. The P3 response in the evoked potential (ERP) is a positive going electrical response occurring between a 3 to 5 tenths of a second following the target stimulus presentation. These responses were significantly larger with the smoking related than neutral pictures. Importantly, the mindfulness instruction group had significantly smaller P3 responses on the no-go trials than the no-instruction group.

The P3 component is thought to reflect response inhibition. The lower P3 response after mindfulness instruction suggests that mindfulness reduces the effort needed to withhold a response when needed (no-go trials). By paying closer attention in the present moment, detection of the no-go stimulus may be enhanced making it easier to withhold responding. Hence, the results suggest that mindfulness improves response inhibition in smokers. This may be, in part, the mechanism by which mindfulness training improves smoking cessation and reduces relapse. It makes it easier to not respond to smoking related situation with smoking.

So, improve response inhibition to quit smoking with mindfulness.

“mindfulness training may actually target the addictive loop, breaking the relationship between craving and smoking and resulting in greater smoking cessation.” – Lori Pbert

CMCS – Center for Mindfulness and Contemplative Studies

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

Study Summary

Andreu, C. I., Cosmelli, D., Slagter, H. A., & Franken, I. (2018). Effects of a brief mindfulness-meditation intervention on neural measures of response inhibition in cigarette smokers. PloS one, 13(1), e0191661. doi:10.1371/journal.pone.0191661

Abstract

Research suggests that mindfulness-practices may aid smoking cessation. Yet, the neural mechanisms underlying the effects of mindfulness-practices on smoking are unclear. Response inhibition is a main deficit in addiction, is associated with relapse, and could therefore be a candidate target for mindfulness-based practices. The current study hence investigated the effects of a brief mindfulness-practice on response inhibition in smokers using behavioral and electroencephalography (EEG) measures. Fifty participants (33 females, mean age 20 years old) underwent a protocol of cigarette exposure to induce craving (cue-exposure) and were then randomly assigned to a group receiving mindfulness-instructions or control-instructions (for 15 minutes approximately). Immediately after this, they performed a smoking Go/NoGo task, while their brain activity was recorded. At the behavioral level, no group differences were observed. However, EEG analyses revealed a decrease in P3 amplitude during NoGo vs. Go trials in the mindfulness versus control group. The lower P3 amplitude might indicate less-effortful response inhibition after the mindfulness-practice, and suggest that enhanced response inhibition underlies observed positive effects of mindfulness on smoking behavior.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5784955/

Reduce Substance Abuse with Yoga

April 4, 2018 psyjdc Leave a comment

Reduce Substance Abuse with Yoga

By John M. de Castro, Ph.D.

“When people take substances, they’re seeking a certain experience, whether it’s escapist or transcendental or just wanting a different psychological state, to get away from whatever is making them unhappy. Yoga is an alternative, a positive way to generate a change in consciousness that, instead of providing an escape, empowers people with the ability to access a peaceful, restorative inner state that integrates mind, body, and spirit.” – Sat Bir Khalsa

Substance abuse is a major health and social problem. There are estimated 22.2 million people in the U.S. with substance dependence. It is estimated that worldwide there are nearly ¼ million deaths yearly as a result of illicit drug use which includes unintentional overdoses, suicides, HIV and AIDS, and trauma. In the U.S. about 17 million people abuse alcohol. Drunk driving fatalities accounted for over 10,000 deaths annually. “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).

Obviously, there is a need to find effective methods to prevent and treat substance abuse. There are a number of programs that are successful at stopping the drug abuse, including the classic 12-step program emblematic of Alcoholics Anonymous. Unfortunately, the majority of drug and/or alcohol abusers relapse and return to substance abuse. Hence, it is important to find an effective method to both treat substance abuse disorders and to prevent relapses. Mindfulness practices have been shown to improve recovery from various addictions. Yoga is a mindfulness practice that has documented benefits for the individual’s psychological and physical health and well-being. There has been a paucity of studies, however, on the use of yoga practice to treat substance abuse.

In today’s Research News article “Role of Yoga in Management of Substance-use Disorders: A Narrative Review.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5812135/ ), Kuppili and colleagues review and summarize the published research literature on the application of yoga practice for the treatment of substance abuse. They found 16 studies, 12 of which were randomized controlled trials.

There were 9 studies of yoga practice as a treatment for nicotine (smoking) addiction. These studies reported that yoga practice increased the desire to quit smoking, reduced cravings for cigarettes, and assisted in quitting. There were, however, mixed findings on the duration of these effects. There were 3 studies of yoga practice as a treatment for alcohol use disorders. These studies reported that yoga practice was helpful in reducing alcohol intake and depression. There were 3 studies of yoga practice as a treatment for opioid use disorders. These studies reported that yoga practice for patients undergoing treatment improved mood states and quality of life. There was only 1 study of yoga practice as a treatment for cocaine use disorder and reported improvements in perceived stress and quality of life.

The studies reviewed suggest that yoga practice may be of use in the treatment of substance use disorders particularly in improving the psychological state of patients under treatment and perhaps reducing cravings. There is obviously, though, a need for more studies with larger samples and with long-term follow-up. Yoga practice does not appear to a magical cure for substance abuse but may be helpful to the patient in kicking the habit. Clearly yoga practice has substantial psychological and physical benefits for practitioners and these in combination with its helpfulness for the treatment of substance abuse make it a reasonable choice for improving he well-being of patients with these disorders.

“Yoga is a complementary, or adjunct, health practice that is often considered a natural form of medicine. Adjunct means “in addition to,” and not “in place of.” Yoga is often beneficial when used in tandem with other traditional substance abuse treatment methods.” – American Addiction Centers

CMCS – Center for Mindfulness and Contemplative Studies

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

Study Summary

Pooja Patnaik Kuppili, Arpit Parmar, Ankit Gupta, Yatan Pal Singh Balhara. Role of Yoga in Management of Substance-use Disorders: A Narrative Review. J Neurosci Rural Pract. 2018 Jan-Mar; 9(1): 117–122. doi: 10.4103/jnrp.jnrp_243_17

Abstract

Substance use disorders are comparable to chronic medical illnesses and have a chronic relapsing course. Despite being significant contributors to morbidity and mortality, limited treatment options exist. The current narrative review was aimed at providing an overview of yoga therapy in substance-use disorders and discuss the relevant methodological issues. Articles published in English language till May 2017 indexed with PubMed, PubMed central, and Google Scholar were searched using search terms “Yoga,” “Substance use,” “Drug dependence,” “Nicotine,” “Tobacco,” “Alcohol,” “Opioids,” “Cannabis,” “Cocaine,” “Stimulants,” “Sedative hypnotics,” “Inhalants,” and “Hallucinogens” for inclusion in the review. A total of 314 studies were found fulfilling the stated criteria. Out of which, 16 studies were found to fulfill the inclusion and exclusion criteria and 12 were randomized control trials. The majority of studies were available on the role of yoga in management of nicotine dependence. Sample size of these studies ranged from 18 to 624. The majority of studies suggested the role of yoga in reducing substance use as well as substance-related craving (especially in nicotine-use disorders) in short term. However, more studies are required for demonstrating the long-term effects of yoga therapy in substance-use disorder.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5812135/

Depressions Interferes with Mindfulness’ Relationship to Smoking

January 13, 2018 psyjdc Leave a comment

Depressions Interferes with Mindfulness’ Relationship to Smoking

By John M. de Castro, Ph.D.

“There’s lots of self-judgment that goes on when you’re trying to do something difficult, like trying to quit smoking. Also, if we judge others, that can get us riled up, which can lead to smoking. We teach it as a way to learn to concentrate more but also to let go of judgment. When people have a craving, they can notice if they’re resisting or beating themselves up.” – Judson Brewer

“Tobacco use remains the single largest preventable cause of death and disease in the United States.” (Centers for Disease Control and Prevention). So, treating nicotine addiction and producing smoking cessation could greatly improve health. But, smoking has proved devilishly difficult to treat. There are a wide variety of methods and strategies to quit smoking which are to only a very limited 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.

Cigarette smoking is highly related to depression. In addition, mindfulness has been shown to be negatively related to depression and is also effective in assisting smokers in quitting. Hence, examining the relationships between mindfulness, depression, and cigarette smoking may lead to better methods to quit smoking and prevent relapse. In today’s Research News article “Facets of Mindfulness Mediate the Relationship between Depressive Symptoms and Smoking Behavior.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5222556/ ), Vinci and colleagues investigate the relationships of the facets of mindfulness of observing, describing, acting with awareness, and accepting without judging, with depression and cigarette smoking.

They recruited undergraduate students who smoked cigarettes and had them complete online measures of mindfulness, cigarette use, smoking consequences, and depression. They found that the higher the students’ levels of depression the more cigarettes they smoked per day. They also found that the higher the level of mindfulness accepting without judging the fewer cigarettes they smoked per day and the lower the expectation that smoking would decrease negative emotions like depression.

Applying a sophisticated multiple mediation statistical method to the data they found that depression increased mindful observing which in turn increased the expectation that smoking would improve negative emotions. In addition, they found that depression decreased mindfully accepting without judging which in turn decreased the expectation that smoking would improve negative emotions. In other words, depression worked through mindfulness facets to alter the students’ expectation that they would feel emotionally better after smoking.

The results suggest that the greater the students’ levels of mindful accepting without judging the lower the expectation that smoking would make them feel better and the lower their cigarette consumption. This suggests that improving the students’ abilities to accept things as they are without judgement would lower their beliefs that smoking a cigarette will make them feel emotionally better which would act, in turn, to decrease cigarette consumption. They also suggest that depression interferes with this by lowering the ability of accepting without judging and thereby increase the expectation of feeling better. In other words, depression interferes with mindfulness’ ability to lower expectations and cigarette smoking.

This study is correlative, so causal relationships cannot be concluded. But, the fact that mindfulness training has been found previously to both lower depression and cigarette smoking, suggests that the relationships discovered in the present study reflect underlying causal connections. These results provide a clearer perspective on how mindfulness training may improve the ability to overcome drug addictions, doing so by reducing the expectation that the drug will help them feel better emotionally.

So, increase mindfulness and reduce smoking.

“I noticed that people who have addictions and those who teach mindfulness speak the same language. Mindfulness teachers will tell you that stress is caused by craving. If you can let go of that craving, then your stress will dissolve, and practicing mindfulness is the way to do that.” – Judson Brewer

CMCS – Center for Mindfulness and Contemplative Studies

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

Study Summary

Vinci, C., Spears, C. A., Peltier, M. R., & Copeland, A. L. (2016). Facets of Mindfulness Mediate the Relationship between Depressive Symptoms and Smoking Behavior. Mindfulness, 7(6), 1408–1415. http://doi.org/10.1007/s12671-016-0582-0

Abstract

The relationship between cigarette smoking and depressive symptoms is well-established. Dispositional mindfulness has been associated with lower depressive symptoms, lower smoking dependence, and higher odds of smoking cessation. Given that mindfulness is multi-faceted, the current study examined which facets of mindfulness might mediate the relationship between depressive symptoms and smoking behavior. Participants (n = 72) completed the Smoking Consequences Questionnaire (SCQ), Center for Epidemiologic Studies Depression Scale (CESD), and Kentucky Inventory of Mindfulness Skills (KIMS; subscales-Observe, Describe, Acting with Awareness, Accepting without Judgment), and indicated number of cigarettes smoked per day (CPD). Simple mediation models (followed by multiple mediation when more than one facet was significant) tested whether mindfulness facets mediated the relationship between CESD and smoking behavior (CPD and SCQ subscales). Results indicated that 1) lower depressive symptoms were associated with higher Accepting without Judgment, which was related to lower Negative Reinforcement expectancies, 2) lower depressive symptoms were associated with increased Describe, which was associated with greater perceived Negative Consequences, 3) lower depressive symptoms were associated with higher Accepting without Judgment, which was associated with lower Negative Consequences expectancies, and 4) higher depressive symptoms were associated with higher scores on Observe, which related to both greater Positive Reinforcement and Negative Consequences expectancies. Greater Accepting without Judgment and Describe aspects of mindfulness may serve as protective factors in the relationship of depressive symptoms and smoking.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5222556/

Stay Abstinent from Smoking Mindfully

July 17, 2017 psyjdc Leave a comment

Stay Abstinent from Smoking Mindfully

By John M. de Castro, Ph.D.

“I liken it to having weeds in your garden. Standard treatments—for example, avoiding triggers such as ashtrays and lighters or using substitutes such as eating carrot sticks and chewing on your pen—just pull the heads off the weeds, so they grow back. These treatments don’t uproot the craving itself. In contrast, mindfulness really gets in there and pulls up the roots.” – Judson Brewer

“Tobacco use remains the single largest preventable cause of death and disease in the United States.” (Centers for Disease Control and Prevention). So, treating nicotine addiction and producing smoking cessation could greatly improve health. But, smoking has proved devilishly difficult to treat. There are a wide variety of methods and strategies to quit smoking which are to only a very limited 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.

In today’s Research News article “Dispositional Mindfulness Predicts Enhanced Smoking Cessation and Smoking Lapse Recovery.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4867253/, Heppner and colleagues recruited African American smokers who smoked at least 5 cigarettes per day for at least one year and enrolled in a smoking cessation treatment program. They were measured 19 and 5 days before quitting smoking and 3 days, 31 days, and 26 weeks after quitting for cigarettes smoked per day, smoking abstinence, mindfulness, positive and negative emotions, dependence and withdrawal symptoms, self-efficacy, and social support.

They found that the number of participants remaining abstinent dropped precipitously over 26 weeks but mindfulness mattered. Abstinence dropped to around 7% of participants who were low in mindfulness but to only 14% of participants who were high in mindfulness. Of those participants who relapsed at day 3 after treatment high mindfulness participants were significantly more likely to recover abstinence by day 31 and week 26. They also found that the improvement in abstinence at day 3 produced by mindfulness occurred primarily as a result of mindfulness producing lower levels of sadness, anger, and depression, lower use of smoking to control emotions, and more social support which in turn were associated with better abstinence rates.

These results are interesting but correlational, so causation cannot be determined. But, prior research has shown that mindfulness training improves treatment for nicotine addiction. So, it is likely that the relationships between mindfulness and smoking cessation observed in the present study were due to mindfulness causing the improved abstinence. Mindfulness acted through intermediaries of improved emotion regulation and improved social support to support abstinence. These results suggest that mindfulness is very helpful in remaining abstinent after quitting smoking and should become a component of all smoking cessation treatment packages.

So, stay abstinent from smoking mindfully.

“each time the individual does not succumb to the craving, the craving becomes weaker until eventually it no longer gets triggered. Moreover, with each moment of mindfulness, the smoker regains a sense of control and understanding regarding their mind and body, which can be empowering.” – Azadeh Aalai

CMCS – Center for Mindfulness and Contemplative Studies

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

Study Summary

Heppner, W. L., Spears, C. A., Correa-Fernández, V., Castro, Y., Li, Y., Guo, B., … Wetter, D. W. (2016). Dispositional Mindfulness Predicts Enhanced Smoking Cessation and Smoking Lapse Recovery. Annals of Behavioral Medicine : A Publication of the Society of Behavioral Medicine, 50(3), 337–347. http://doi.org/10.1007/s12160-015-9759-3

Abstract

Background

Although mindfulness has been hypothesized to promote health behaviors, no research has examined how dispositional mindfulness might influence the process of smoking cessation.

Purpose

The current study investigated dispositional mindfulness, smoking abstinence, and recovery from a lapse among African American smokers.

Methods

Participants were 399 African Americans seeking smoking cessation treatment (treatments did not include any components related to mindfulness). Dispositional mindfulness and other psychosocial measures were obtained pre-quit; smoking abstinence was assessed 3 days, 31 days, and 26 weeks post-quit.

Results

Individuals higher in dispositional mindfulness were more likely to quit smoking both initially and over time. Moreover, among individuals who had lapsed at day 3, those higher in mindfulness were more likely to recover abstinence by the later time points. The mindfulness-early abstinence association was mediated by lower negative affect, lower expectancies to regulate affect via smoking, and higher perceived social support.

Conclusions

Results suggest that mindfulness might enhance smoking cessation among African American smokers by operating on mechanisms posited by prominent models of addiction.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4867253/

Reduce Cigarette Smoking and Cravings with Mindfulness

December 19, 2016February 10, 2017 psyjdc Leave a comment

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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:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1425084614182127/?type=3&theater

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

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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.

Kick the Smoking Habit with Mindfulness

May 7, 2016February 10, 2017 psyjdc Leave a comment

Kick the Smoking Habit with Mindfulness

By John M. de Castro, Ph.D.

“There’s lots of self-judgment that goes on when you’re trying to do something difficult, like trying to quit smoking. Also if we judge others, that can get us riled up, which can lead to smoking. We teach it as a way to learn to concentrate more but also to let go of judgment. When people have a craving, they can notice if they’re resisting or beating themselves up.” – Judson Brewer

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 training has been shown to be helpful in treatment for addiction and prevention of relapse after recovery. In today’s Research News article “Mindfulness training for smoking cessation: A meta-analysis of randomized-controlled trials.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1224395630917694/?type=3&theater

or below

Oikonomou and colleagues review the published randomized controlled trials on the use of mindfulness training as a treatment for quitting cigarette smoking. They found, not surprising, that the training was successful in increasing mindfulness. More importantly, they found that although mindfulness training did not produce significantly different cigarette abstinence rates at 4 to 6 weeks following training, it did at 17 to 24 weeks, where 25.2% of mindfulness trained participants were abstinent while only 13.6% of usual treatment participants were.

These results are encouraging as the reviewed studies were high quality, well controlled, and designed trials. They suggest that mindfulness training is effective in promoting the long-term cessation of cigarette smoking. It is not known exactly what it is about mindfulness training that assists with cessation of smoking. But, it can be speculated that since quitting smoking is very stressful, mindfulness training might help because it reduces the psychological and physical responses to stress, thus making it easier for the individual to withstand the stress of nicotine withdrawal. The fact, however, that mindfulness training did not improve cessation rates at 4 weeks after treatment and it is during this time that nicotine withdrawal effects are present, that it is unlikely that this is the mechanism of action.

Staying abstinent from smoking over the long-term requires that the individual be able to refrain from responding to the myriad of social, environmental, and physical triggers that signal cigarette smoking. By increasing mindfulness, the training may make it easier for the individual to be aware of these triggers and thus be better able to prevent responding to them. Regardless of the mechanism, it is clear that mindfulness training is effective in promoting abstinence from cigarette smoking following successful quitting. This is an important advance in the fight against this major threat to health.

So, kick the smoking habit with mindfulness.

“evidence suggests that exercises aimed at increasing self-control, such as mindfulness meditation, can decrease the unconscious influences that motivate a person to smoke,” – Nora Volkow

CMCS – Center for Mindfulness and Contemplative Studies

Study Summary

Oikonomou MT, Arvanitis M, Sokolove RL. Mindfulness training for smoking cessation: A meta-analysis of randomized-controlled trials. J Health Psychol. 2016 Apr 4. pii: 1359105316637667. [Epub ahead of print]

Abstract

Recent studies have shown that mindfulness training has a promising potential for smoking treatment. In order to examine the efficacy of mindfulness training in smoking cessation, we performed a systematic review of the literature and meta-analysis of randomized controlled trials. Four randomized controlled trials with 474 patients were included in our analysis. The results showed that 25.2 percent of participants remained abstinent for more than 4 months in the mindfulness group compared to 13.6 percent of those who received usual care therapy (relative risk, 1.88; 95 percent confidence interval, 1.04–3.40). Our results suggest that mindfulness training may have an important role to play in efforts to lower cigarette smoking rates.