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.

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.

College is a stressful time for many students, including student-athletes, who may benefit from mindfulness interventions focusing on present-moment awareness and nonjudgmental acceptance. Mindful sport performance enhancement (MSPE) has shown promise in previous open trials for promoting both athlete well-being and psychological factors related to sport performance, and this first randomized controlled trial of MSPE was conducted with mixed-sport groups of 52 NCAA Division III student-athletes. Each of the six sessions included educational, discussion-based, experiential, and home practice components, with meditation exercises progressing from sedentary mindfulness to mindfulness in motion. Whereas wait-list controls showed significant increases in depressive symptoms, those who received MSPE evidenced non-significant reductions in depressive symptoms over the course of treatment. Furthermore, once controls had also received MSPE, treatment completers (the 41% who attended at least five of six MSPE sessions) demonstrated significant increases in flow, trait mindfulness, satisfaction with life, and self-rated sport performance, along with reductions in worry, with medium to large effect sizes. There were no significant changes for treatment completers from post-treatment to 6-month follow-up, suggesting that improvements were maintained over time.

BackgroundNearly half of U.S. adults have difficulties with health literacy (HL), which is defined as the ability to adequately obtain, process, and understand basic health information. Lower HL is associated with negative health behaviors and poor health outcomes. Racial/ethnic minorities and those with low socioeconomic status (SES) are disproportionately affected by poor HL. They also have higher smoking prevalence and more difficulty quitting smoking. Thus, lower HL may be uniquely associated with poorer cessation outcomes in this population.MethodsThis study investigated the association between HL and smoking cessation outcomes among 200, low-SES, racially/ethnically diverse smokers enrolled in smoking cessation treatment. Logistic regression analyses adjusted for demographics (i.e., age, gender, race/ethnicity, relationship status), SES-related characteristics (i.e., education, income), and nicotine dependence were conducted to investigate associations between HL and smoking relapse at the end of treatment (3 weeks post quit day).ResultsResults indicated that smokers with lower HL (score of < 64.5 on the Rapid Estimate of Adult Literacy in Medicine [REALM]) were significantly more likely than those with higher HL (score of ≥ 64.5 on the REALM) to relapse by the end of treatment, even after controlling for established predictors of cessation including demographics, SES, and nicotine dependence (OR = 3.26; 95% CI = 1.14, 9.26).ConclusionsFindings suggest that lower HL may serve as an independent risk factor for smoking relapse among low-SES, racially/ethnically diverse smokers enrolled in treatment. Future research is needed to investigate longitudinal relations between HL and cessation outcomes and potential mechanisms of this relationship.