Mechanisms underlying mindfulness-based addiction treatment versus cognitive behavioral therapy and usual care for smoking cessation

Claire Adams Spears, Donald Hedeker, Liang Li, Cai Wu, Natalie K. Anderson, Sean C. Houchins, Christine Vinci, Diana Stewart Hoover, Jennifer Irvin Vidrine, Paul M. Cinciripini, Andrew J. Waters, David W. Wetter

Research output: Contribution to journalArticlepeer-review

53 Scopus citations

Abstract

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 postquit, 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 postquit. 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 with 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.

Original languageEnglish (US)
Pages (from-to)1029-1040
Number of pages12
JournalJournal of Consulting and Clinical Psychology
Volume85
Issue number11
DOIs
StatePublished - Nov 2017

Keywords

  • Mechanisms
  • Mindfulness
  • Nicotine dependence
  • Smoking cessation

ASJC Scopus subject areas

  • Clinical Psychology
  • Psychiatry and Mental health

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