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

Abstract

Mindfulness is a skill of intentionally directing one's attention to emotions, thoughts, or physical sensations with an open-minded, non-judgmental attitude. Mindfulness can enable a person to experience challenging feelings or situations without reacting impulsively or automatically. Mindfulness training may be provided to smokers to help them manage smoking triggers, urges, stress, or negative emotions without smoking. Randomized controlled trials have now shown that mindfulness training for smokers (MTS) yields smoking abstinence rates that are equal to or higher than matched behavioral treatments. We describe a comparative observational study on MTS within an ongoing clinical program. The study was conducted with a naturalistic design and utilized no procedures or evaluations beyond those already employed in clinical practice. All participants were advised to use FDA-approved smoking cessation medications and were provided with a choice of two behavioral treatments-MTS (selfpay) or the Wisconsin Tobacco Quit Line (WTQL) (free). Over a 12-month study period, 181 clinic patients enrolled; 65.75% (119) choose MTS and 34.25% (62) choose WTQL. MTS compared to WTQL treatment initiators showed significantly higher biochemically confirmed 7-day point prevalence smoking abstinence at 2 weeks postquit attempt (MTS = 47.00%, QL = 24.52%, p = .011, OR = 2.71). Intent-to-treat analysis showed similar outcomes (p = .019, OR = 2.45). The study provides evidence that MTS provided within clinical program leads to similar outcomes as found in randomized controlled trials. The strategic use of MTS within a smoking cessation program is discussed.

Is mindfulness research methodology improving over time? A systematic review

“…Lastly, the reporting of ITT analyses involves including individuals who may have dropped out of the study and/or did not complete their assigned intervention [ 12 ]. Generally speaking, ITT analyses are viewed to be more conservative estimates of treatment effects [ 19 , 20 ], and are preferred for this reason.…”

Health benefits and economic advantages associated with increased utilization of a smoking cessation program

“…Each year, 80% of all smokers see a medical provider [23] and each of these contacts is an opportunity to provide treatment or referral to evidence-based tobacco treatment services. Smoking abstinence rates for specialized treatment programs (e.g., Mayo Clinic, MD Anderson, Duke) are in the range of 27-39% -nine-to ten-times that of an unassisted quit attempt [24][25][26].…”

“…Using Markov modeling, the increase in DSCP utilization resulted in an improvement in health outcomes and a decrease in medical costs. Across both clinic types and sex, the addition of new referral methods -BPA and Population Outreach -to Traditional Referral resulted in per person QALY gains of 0.07-0.08 (26)(27)(28) seen in the two Primary Care and two Disadvantaged Care clinics, the addition of BPA and Population Outreach to Traditional Referral was associated with 27 quality-adjusted days per person and 408 QALYs gained.…”