Mindfulness-Based Addiction Therapy (MBAT) Discussion

Mindfulness-Based Addiction Therapy (MBAT) Discussion

Mindfulness-Based Addiction Therapy (MBAT)—The MBAT manual (Wetter et al., 2009) created for this trial closely follows the content of Mindfulness-Based Cognitive

Therapy (MBCT; Segal, Williams, & Teasdale, 2002), but replaces depression-related

material with material pertinent to smoking cessation. The three primary aims of MBAT

(based on MBCT) are to: 1) increase attention to present-moment experience (e.g., thoughts,

feelings, physical sensations); 2) encourage nonjudgmental awareness of mental events (i.e.,

noticing thoughts as “just thoughts” without becoming caught up in their content); and 3)

foster the ability to acknowledge difficult sensations (e.g., cravings, maladaptive thoughts),

refocus attention on the present moment, and purposefully choose how to respond (rather

than impulsively react). MBAT sessions involved 30-45 minutes of formal mindfulness

practice per session (e.g., sitting meditation, yoga), as well as discussion. Participants were

encouraged to practice mindfulness formally (e.g., body scan, sitting meditation) six days

per week in addition to informal practice (e.g., mindfulness of routine activities) several

times each day. MBAT was delivered in eight two-hour in-person group counseling sessions,

and session 5 occurred on the quit date.

Cognitive Behavioral Treatment (CBT)—CBT taught problem-solving/coping skills for smoking cessation based on relapse prevention theory (Marlatt & Gordon, 1985) and the

Guideline (Fiore et al., 2008). Primary topics included: 1) planning to quit smoking (e.g., recognizing triggers); 2) learning about nicotine addiction; 3) practicing stress management

techniques; 4) preparing for quit day and using the nicotine patch; 5) learning skills to cope

with cravings and negative emotions; 6) enlisting social support; 7) managing nutrition and

exercise; and 8) reviewing skills and planning to maintain abstinence. Like MBAT, CBT

involved eight two-hour in-person group counseling sessions, and session 5 occurred on the

quit date.

Usual Care (UC) Intervention—The UC intervention taught coping and problem-solving strategies based on the Guideline (Fiore et al., 2008). UC was delivered in four 5- to 10- minute individual counseling sessions, with session 3 occurring on the quit date (i.e., week 5

of the protocol as in MBAT and CBT). UC, which was less intensive in terms of both time

and attention, was designed to be consistent with what smokers requesting help with

cessation might receive in a healthcare setting.

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