MBAT Versus UC On Abstinence Assignment
Indirect effects of
MBAT versus UC on abstinence occurred through each of these mechanisms.
Conclusions—Whereas several differences emerged between MBAT and UC, MBAT and CBT had similar effects on several of the psychosocial mechanisms implicated in tobacco dependence.
Results help to shed light on similarities and differences between mindfulness-based and other
active smoking cessation treatments.
Keywords
mindfulness; mechanisms; smoking cessation; nicotine dependence
Tobacco use is the leading preventable cause of illness and premature mortality in the U.S.
(USDHHS, 2014), and quitting smoking significantly increases life expectancy (Jha et al.,2013). Although most smokers express interest in quitting, the vast majority are unsuccessful in their quit attempts (CDC, 2011). Mindfulness (defined as “paying attention in a particular way: on purpose, in the present moment, and nonjudgmentally;” Kabat-Zinn, 1994, p. 4) shows promise for improving psychological health (e.g., Gotink et al., 2015; Khoury et al., 2013) and has been incorporated into smoking cessation treatments with initial success (e.g., Brewer et al., 2011).
However, the mechanisms underlying mindfulness- based interventions versus more traditional approaches for smoking cessation are unclear.
The purpose of the present study was to investigate cognitive and affective mechanisms underlying mindfulness-based versus cognitive-behavioral and usual care smoking cessation treatments in a racially/ethnically diverse sample.
Mindfulness-based Treatments for Smoking Cessation At least six trials support the use of in-person, multi-session mindfulness-based interventions for smoking cessation (Brewer et al., 2011; Davis, Fleming, Bonus, & Baker,
2007; Davis, Goldberg, et al., 2014; Davis, Manley, Goldberg, Smith, & Jorenby, 2014; Davis et al., 2013; Vidrine et al., 2016). Mindfulness-based programs have produced significantly higher abstinence rates than standard treatment (Brewer et al., 2011) and Quitline delivered treatment (Davis, Goldberg, et al., 2014). In the largest known trial of
mindfulness treatment for smoking cessation, Vidrine et al. (2016) compared mindfulness- based addiction treatment (MBAT) to cognitive-behavioral therapy (CBT) and usual care
(UC). MBAT did not differ significantly from CBT or UC in terms of post-treatment abstinence rates. However, mindfulness was superior in promoting lapse recovery. That is, among participants who were not abstinent at the end of treatment, those who received mindfulness-based treatment were more likely to regain abstinence at later time points (versus CBT or UC). The potential for mindfulness to promote lapse recovery is critical given that most smokers lapse early in the quit attempt (Hughes et al., 1992), and the majority of these lapses lead to full-blown relapse (Kenford et al., 1994).
Although mindfulness-based smoking cessation treatments show promise, the underlying mechanisms are yet to be well delineated. Investigating why and how treatments for addictive behaviors work is a critical question (Witkiewitz & Marlatt, 2008), and a number of researchers have called for studies to elucidate the mechanisms through which
Spears et al. Page 2 J Consult Clin Psychol. Author manuscript; available in PMC 2018 November 01.