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 well as higher self-efficacy for managing negative affect without smoking. 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.