Drug Alcohol Depend: Mindfulness Training For Smoking Cessation

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Drug Alcohol Depend. Author manuscript; available in PMC 2012 December 1.

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Published in final edited form as:
Drug Alcohol Depend. 2011 December 1; 119(1-2): 72–80. doi:10.1016/j.drugalcdep.2011.05.027.

Mindfulness Training for smoking cessation: results from a randomized controlled trial
Judson A. Brewer*, Sarah Mallik, Theresa A. Babuscio, Charla Nich, Hayley E. Johnson,
Cameron M. Deleone, Candace A. Minnix-Cotton, Shannon A. Byrne, Hedy Kober, Andrea
J. Weinstein, Kathleen M. Carroll, and Bruce J. Rounsaville
Department of Psychiatry, Yale University School of Medicine, New Haven, CT, 06510 USA


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Background—Cigarette smoking is the leading cause of preventable death in the world, and long-term abstinence rates remain modest. Mindfulness Training (MT) has begun to show benefits in a number of psychiatric disorders, including depression, anxiety and more recently, in addictions. However MT has not been evaluated for smoking cessation through randomized clinical trials.
Methods—88 treatment-seeking, nicotine-dependent adults who were smoking an average of 20 cigarettes/day were randomly assigned to receive MT or the American Lung Association’s
Freedom From Smoking (FFS) treatment. Both treatments were delivered twice weekly over four weeks (eight sessions total) in a group format. The primary outcomes were expired-air carbon monoxide-confirmed 7-day point prevalence abstinence and number of cigarettes/day at the end of the 4-week treatment and at a follow-up interview at week 17.
Results—88% of individuals who received MT and 84% of individuals who received FFS completed treatment. Compared to those randomized to the FFS intervention, individuals who received MT showed a greater rate of reduction in cigarette use during treatment and maintained these gains during follow-up (F=11.11, p = .001). They also exhibited a trend toward greater point prevalence abstinence rate at the end of treatment (36% vs. 15%, p = .063), which was significant at the 17-week follow-up (31% vs. 6%, p = .012).
Conclusions—This initial trial of Mindfulness Training may confer benefits greater than those associated with current standard treatments for smoking cessation.

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Tobacco; Nicotine Dependence; Mindfulness; behavioral treatment; addiction

1. Introduction
Cigarette smoking along with other tobacco use is the leading cause of preventable death in the world, associated with approximately five million people annually, and accounting for
10% of all deaths (Jha et al., 2006). In the US, smoking costs more than $193 billion in

© 2011 Elsevier Ireland Ltd. All rights reserved.
To whom correspondence should be addressed, Judson Brewer MD PhD, VA Connecticut Healthcare System, 950 Campbell Ave.,
Building 36, Room 142, West Haven, CT 06516, Ph: 203-937-4840, Fax: 203-937-3478, judson.brewer@yale.edu.
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Brewer et al.

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health care and lost productivity per year (Center for Disease Control, 2007). Although over
70% of smokers want to quit, fewer than 5% achieve this goal annually (Center for Disease
Control, 2007).

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As outlined in models previously (Baker et al., 2004; Curtin et al., 2006), acquisition and maintenance of nicotine dependence is a complex process, developed by associative learning mechanisms and perpetuated through positive and negative reinforcement. Habitual