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

Journal of consulting and clinical psychology
November 1, 2017
Claire Adams Spears et al. (12 authors)
Journal ArticleRandomized Controlled TrialHuman StudyClinical
Study Details

Study Goal

The researchers aimed to compare the cognitive and affective mechanisms of mindfulness-based addiction treatment (MBAT) with cognitive-behavioral therapy (CBT) and usual care (UC) for smoking cessation.

Results Summary

MBAT participants showed greater volitional control over smoking and lower anger volatility compared to UC and CBT, but no other significant differences between MBAT and CBT were found. MBAT also reduced anxiety, craving, and dependence while increasing self-efficacy compared to UC, with indirect effects on abstinence through these mechanisms.

Population

412 participants (54.9% female; 48.2% African American, 41.5% non-Latino White, 5.4% Latino, 4.9% other; 57.6% annual income <$30,000) seeking smoking cessation.

Effective Dosage

Not specified

Duration

From quit date through 26 weeks postquit

Interactions

None mentioned

Extracted Claims (9)
InterventionDirectionEndpointPopulationDosageImpactClaim #
mindfulness-based addiction treatment (MBAT)
increase
volitional control over smoking
Participants in the parent study
-
perceived greater volitional control over smoking
#1
mindfulness-based addiction treatment (MBAT)
decrease
volatility of anger
Participants in the parent study
-
evidenced lower volatility of anger
#2
mindfulness-based addiction treatment (MBAT)
decrease
anxiety
Participants in the parent study
-
reported lower anxiety
#3
mindfulness-based addiction treatment (MBAT)
decrease
concentration difficulties
Participants in the parent study
-
reported lower concentration difficulties
#4
mindfulness-based addiction treatment (MBAT)
decrease
craving
Participants in the parent study
-
reported lower craving
#5
mindfulness-based addiction treatment (MBAT)
decrease
dependence
Participants in the parent study
-
reported lower dependence
#6
mindfulness-based addiction treatment (MBAT)
increase
self-efficacy for managing negative affect without smoking
Participants in the parent study
-
reported higher self-efficacy for managing negative affect without smoking
#7
mindfulness-based addiction treatment (MBAT)
no change
7-day smoking abstinence
Participants in the parent study
-
did not find a significant treatment effect on abstinence
#8
mindfulness-based addiction treatment (MBAT)
no change
psychosocial mechanisms implicated in tobacco dependence
Participants in the parent study
-
had similar effects on several of the psychosocial mechanisms
#9
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. (PsycINFO Database Record

Medical Subject Headings (MeSH)
AdultBehavior, AddictiveCognitive Behavioral TherapyCravingEmotionsFemaleHumansMaleMindfulnessSelf EfficacySmokingSmoking CessationTobacco Use DisorderTreatment Outcome
Study Links
Quality Scores
SafetyNot Assessed
Efficacy65/10
Quality80/10
Citation Metrics
Total Citations50
Citations/Year6.3
Relative Citation Ratio3.12
NIH Percentile85.8%
Research Impact Scores
APT Score0.95
Weight Score2.12
Normalized Score0.62
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