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.
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 “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
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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
Although mindfulness has been hypothesized to promote health behaviors, no research has examined how dispositional mindfulness might influence the process of smoking cessation.
The current study investigated dispositional mindfulness, smoking abstinence, and recovery from a lapse among African American smokers.
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.
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.
Results suggest that mindfulness might enhance smoking cessation among African American smokers by operating on mechanisms posited by prominent models of addiction.