Mechanisms Underlying Mindfulness-Based Addiction Treatment
Mechanisms Underlying Mindfulness-Based Addiction Treatment versus Cognitive Behavioral Therapy and Usual Care for Smoking Cessation
Claire Adams Spears1, Donald Hedeker2, Liang Li3, Cai Wu3, Natalie K. Anderson4, Sean C. Houchins4, Christine Vinci5, Diana Stewart Hoover3, Jennifer Irvin Vidrine6, Paul M. Cinciripini3, Andrew J. Waters7, and David W. Wetter8
1Georgia State University School of Public Health, Atlanta, GA
2The University of Chicago, Chicago, IL
3The University of Texas MD Anderson Cancer Center, Houston, TX
4The Catholic University of America, Washington, DC
5Rice University, Houston, TX
6Stephenson Cancer Center and The University of Oklahoma Health Sciences Center, Oklahoma City, OK
7Uniformed Services University of the Health Sciences, Washington, DC
8University of Utah and the Huntsman Cancer Institute, Salt Lake City, UT
Abstract
Objective—To examine cognitive and affective mechanisms underlying Mindfulness-Based Addiction Treatment (MBAT) versus Cognitive Behavioral Therapy (CBT) and Usual Care (UC)
for smoking cessation.
Method—Participants in the parent study from which data were drawn (N = 412; 54.9% female; 48.2% African-American, 41.5% non-Latino White, 5.4% Latino, 4.9% other; 57.6% annual
income < $30,000) were randomized to MBAT (n = 154), CBT (n = 155), or UC (n = 103). From quit date through 26 weeks post-quit, participants completed measures of emotions, craving,
dependence, withdrawal, self-efficacy, and attentional bias. Biochemically-confirmed 7-day
smoking abstinence was assessed at 4 and 26 weeks post-quit. Although the parent study did not
find a significant treatment effect on abstinence, mixed-effects regression models were conducted
to examine treatment effects on hypothesized mechanisms, and indirect effects of treatments on
abstinence were tested.
Results—Participants receiving MBAT perceived greater volitional control over smoking and evidenced lower volatility of anger than participants in both other treatments. However, there were
no other significant differences between MBAT and CBT. Compared to those receiving UC,
MBAT participants reported lower anxiety, concentration difficulties, craving, and dependence, as
Corresponding Author: Claire Adams Spears, Ph.D., Assistant Professor, Division of Health Promotion & Behavior, School of Public Health, Georgia State University; cspears@gsu.edu; Phone: 404.413.9335.
HHS Public Access Author manuscript J Consult Clin Psychol. Author manuscript; available in PMC 2018 November 01.
Published in final edited form as: J Consult Clin Psychol. 2017 November ; 85(11): 1029–1040. doi:10.1037/ccp0000229.