Efficacy of mindfulness-based addiction treatment (MBAT) for smoking cessation and lapse recovery: A randomized clinical trial.

Abstract

Objective To compare the efficacy of Mindfulness-Based Addiction Treatment (MBAT) to a Cognitive Behavioral Treatment (CBT) that matched MBAT on treatment contact time, and a Usual Care (UC) condition that comprised brief individual counseling. Method Participants (N=412) were 48.2% African-American, 41.5% non-Latino White, 5.4% Latino and 4.9% other, and 57.6% reported a total annual household income < $30,000. The majority of participants were female (54.9%). Mean cigarettes per day was 19.9 (SD= 10.1). Following the baseline visit, participants were randomized to UC (n = 103), CBT (n = 155), or MBAT (n = 154). All participants were given self-help materials and nicotine patch therapy. CBT and MBAT groups received eight two-hour in person group counseling sessions. UC participants received four brief individual counseling sessions. Biochemically verified smoking abstinence was assessed 4 and 26 weeks after the quit date. Results Logistic random effects model analyses over time indicated no overall significant treatment effects, (completers only: F(2,236) = 0.29, p=.749; intent-to-treat: F(2,401) = 0.9, p=.407). Among participants classified as smoking at the last treatment session, analyses examining the recovery of abstinence revealed a significant overall treatment effect, F(2,103)=4.41, p=.015 (MBAT vs. CBT: OR=4.94, 95% CI: 1.47 to 16.59, p=.010, Effect Size =.88; MBAT vs. UC: OR=4.18, 95% CI: 1.04 to 16.75, p=.043, Effect Size =.79). Conclusions Although there were no overall significant effects of treatment on abstinence, MBAT may be more effective than CBT or UC in promoting recovery from lapses.

POINT: Are Advanced Practice Professionals More Likely to Achieve Better Tobacco Cessation Results than Physicians? Yes

“…For these patients, optimal treatment may require longer duration treatment or adjunctive behavioral treatments that target smoking behavior in the context of psychological distress. 12,13 Third, APPs may be more likely than physicians to be able to link behaviors that cluster together to enhance readiness to quit smoking. For example, strategies for stress, weight, and fatigue management include healthy eating and walking and other forms of exercise, all of which dovetail into M A N U S C R I P T A C C E P T E D ACCEPTED MANUSCRIPT 5 treatment strategies for COPD and smoking cessation.…”

Observational Study on a Mindfulness Training for Smokers within a Smoking Cessation Program

“…These differences introduce multiple potential biases related to financial ability, medical literacy, time flexibility, understanding of treatments and make a fair comparison between MTS and WTQL interventions impossible. For a comparison between MTS and various controls (including WTQL), please see randomized trials already conducted on these interventions (Brewer et al, 2011; Davis, Goldberg, et al, 2014; Davis, Manley, et al, 2014; Davis et al, 2013; Vidrine et al, 2016). This trial provides a different perspective through its naturalistic design with more robust ecological validity.…”

“…Since then, Mindfulness Training for Smokers (MTS) and similar interventions have been evaluated in a number of randomized controlled trials (RCTs) (Brewer et al, 2011; Davis, Goldberg, et al, 2014; Davis et al, 2014; Davis et al, 2013; Vidrine et al, 2016). A recent meta-analysis across multiple RCTs showed that abstinence rates for MTS were almost twice that of matched behavioral controls (RR = 1.88 (95% CI: 1.04–3.40)) (Oikonomou, Arvanitis, & Sokolove, 2016).…”

Tobacco Cessation in Oncology Care

“…Mindfulness practices, which are centered on teaching awareness and nonreactivity toward craving states, are especially relevant in the treatment of addictive behaviors [42]. Patients practice and learn specific interventions such as breath meditation, mindful eating, and urge surfing, a mindfulness practice applied specifically to cravings [42,43]. In one study, patients who were randomized to mindfulness training for tobacco cessation achieved abstinence rates of 31% at the 17-week follow-up, compared to only 6% of those in the American Lung Association's Freedom from Smoking program [44].…”

“…Mindfulness practices teach patients to take a nonjudgmental, nonreactive stance toward present-moment experiences [41]. Mindfulness practices, which are centered on teaching awareness and nonreactivity toward craving states, are especially relevant in the treatment of addictive behaviors [42]. Patients practice and learn specific interventions such as breath meditation, mindful eating, and urge surfing, a mindfulness practice applied specifically to cravings [42,43].…”