Improve Smoking Abstinence with Mindfulness
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
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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
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.