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.

Background Smoking is the leading cause of preventable death in the US, while abstinence rates remain modest. Smoking has been shown to be perpetuated by operant conditioning, notably negative reinforcement (e.g., smoking to relieve negative affective states). Mindfulness training (MT) shows promise for smoking cessation, by potentially altering an individual’s tendency to smoke in response to craving. The purpose of this study was to examine the effects of MT and mindfulness practice on the relationship between smoking and craving after receiving four weeks of MT. Methods 33 adults received MT as part of a randomized trial for smoking cessation. Individuals in the MT condition recorded formal and informal mindfulness practice during treatment using daily diaries. Results Analyses showed that strong correlations between craving and smoking at baseline (r=0.582) were attenuated at the end of treatment (r=0.126). Mindfulness home practice significantly predicted cigarette use (formal: B=−1.21, p=0.007; informal: B=−1.52, p<0.0001) and informal practice moderated the relationship between craving and smoking at the end of treatment (B=0.52, p=0.03). Conclusions These findings suggest that MT may be effective as a treatment for smoking cessation and that informal mindfulness practice predicts a decoupling of the association between craving and smoking.

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