Craving to Quit: A Randomized Controlled Trial of Smartphone App–Based Mindfulness Training for Smoking Cessation

Garrison, Kathleen A.; Pal, Prasanta; O’Malley, Stephanie S.; Pittman, Brian; Gueorguieva, Ralitza; Rojiani, Rahil; Mayes, Linda C.; Dallery, Jesse; Brewer, Judson A.

doi:10.1093/ntr/nty126

Cited by 124 publications

(133 citation statements)

References 48 publications

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“…Given interest in internet- and app-delivered mindfulness interventions, research is needed to determine whether the low dose, brief format of these delivery systems is sufficient to intervene in the chronically relapsing symptoms of SUD. 107 , 108 However, if long-term MBIs are shown to produce the greatest clinical benefit, their implementation would require significant change in the current addiction treatment system. Yet, the emerging global emphasis on integrative health supports a holistic approach toward wellness by providing treatment for psychiatric and SUDs in community-based medical settings.…”

Section: Discussionmentioning

confidence: 99%

Mindfulness meditation in the treatment of substance use disorders and preventing future relapse: neurocognitive mechanisms and clinical implications

Priddy¹,

Howard²,

Hanley³

et al. 2018

SAR

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Substance use disorders (SUDs) are a pervasive public health problem with deleterious consequences for individuals, families, and society. Furthermore, SUD intervention is complicated by the continuous possibility of relapse. Despite decades of research, SUD relapse rates remain high, underscoring the need for more effective treatments. Scientific findings indicate that SUDs are driven by dysregulation of neural processes underlying reward learning and executive functioning. Emerging evidence suggests that mindfulness training can target these neurocognitive mechanisms to produce significant therapeutic effects on SUDs and prevent relapse. The purpose of this manuscript is to review the cognitive, affective, and neural mechanisms underlying the effects of mindfulness-based interventions (MBIs) on SUDs. We discuss the etiology of addiction and neurocognitive processes related to the development and maintenance of SUDs. We then explore evidence supporting use of MBIs for intervening in SUDs and preventing relapse. Finally, we provide clinical recommendations about how these therapeutic mechanisms might be applied to intervening in SUDs and preventing relapse.

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Section: Discussionmentioning

confidence: 99%

Mindfulness meditation in the treatment of substance use disorders and preventing future relapse: neurocognitive mechanisms and clinical implications

Priddy¹,

Howard²,

Hanley³

et al. 2018

SAR

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“… 368 As treatment has moved digital, app-based paradigms have been tested, reporting similar decoupling mechanisms. 369 , 370 Recent work demonstrated that app-based mindfulness training serves to target DMN brain networks involved in “getting caught up” in craving 206 , 371 in a dose-dependent manner, with the degree of brain activity reduction in the posterior cingulate cortex predicting smoking reductions, especially among women. 372 More work is needed to replicate and extend findings.…”

Section: Mbis’ Effects On Psychiatrically Relevant Behavior Changementioning

confidence: 99%

Mindfulness and Behavior Change

Schuman‐Olivier

Trombka

Lovas

et al. 2020

Harv Rev Psychiatry

181

102

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Initiating and maintaining behavior change is key to the prevention and treatment of most preventable chronic medical and psychiatric illnesses. The cultivation of mindfulness, involving acceptance and nonjudgment of present-moment experience, often results in transformative health behavior change. Neural systems involved in motivation and learning have an important role to play. A theoretical model of mindfulness that integrates these mechanisms with the cognitive, emotional, and self-related processes commonly described, while applying an integrated model to health behavior change, is needed. This integrative review (1) defines mindfulness and describes the mindfulness-based intervention movement, (2) synthesizes the neuroscience of mindfulness and integrates motivation and learning mechanisms within a mindful self-regulation model for understanding the complex effects of mindfulness on behavior change, and (3) synthesizes current clinical research evaluating the effects of mindfulness-based interventions targeting health behaviors relevant to psychiatric care. The review provides insight into the limitations of current research and proposes potential mechanisms to be tested in future research and targeted in clinical practice to enhance the impact of mindfulness on behavior change.

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“…It reported continuous abstinence at 6 months was not significantly different at 7.8% for the smartphone app versus 9.2% the self-help guide (odds ratio = 0.83, 95% confidence interval [CI] 0.59-1.18). A third RCT was conducted in the US and involved mindfulness training via a smartphone app with experience sampling vs a control of experience sampling only [9] (this experience sampling involved a component of the app which queried smoking, craving, and mindfulness in real time). It reported no group difference in smoking abstinence at 6 months (9.8% vs 12.1% in the two groups respectively, p = 0.51).…”

Section: Introductionmentioning

confidence: 99%

Mass media promotion of a smartphone smoking cessation app: modelled health and cost-saving impacts

et al. 2019

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Background: Smartphones are increasingly available and some high quality apps are available for smoking cessation. However, the cost-effectiveness of promoting such apps has never been studied. We therefore aimed to estimate the health gain, inequality impacts and cost-utility from a five-year promotion campaign of a smoking cessation smartphone app compared to business-as-usual (no app use for quitting). Methods: A well-established Markov macro-simulation model utilising a multi-state life-table was adapted to the intervention (lifetime horizon, 3% discount rate). The setting was the New Zealand (NZ) population (N = 4.4 million). The intervention effect size was from a multi-country randomised trial: relative risk for quitting at 6 months = 2.23 (95%CI: 1.08 to 4.77), albeit subsequently adjusted to consider long-term relapse. Intervention costs were based on NZ mass media promotion data and the NZ cost of attracting a smoker to smoking cessation services (NZ$64 per person). Results: The five-year intervention was estimated to generate 6760 QALYs (95%UI: 5420 to 8420) over the remaining lifetime of the population. For Māori (Indigenous population) there was 2.8 times the per capita age-standardised QALY gain relative to non-Māori. The intervention was also estimated to be cost-saving to the health system (saving NZ$115 million [m], 95%UI: 72.5m to 171m; US$81.8m). The cost-saving aspect of the intervention was maintained in scenario and sensitivity analyses where the discount rate was doubled to 6%, the effect size halved, and the intervention run for just 1 year. Conclusions: This study provides modelling-level evidence that mass-media promotion of a smartphone app for smoking cessation could generate health gain, reduce ethnic inequalities in health and save health system costs. Nevertheless, there are other tobacco control measures which generate considerably larger health gains and cost-savings such as raising tobacco taxes.

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Craving to Quit: A Randomized Controlled Trial of Smartphone App–Based Mindfulness Training for Smoking Cessation

Cited by 124 publications

References 48 publications

Mindfulness meditation in the treatment of substance use disorders and preventing future relapse: neurocognitive mechanisms and clinical implications

Mindfulness meditation in the treatment of substance use disorders and preventing future relapse: neurocognitive mechanisms and clinical implications

Mindfulness and Behavior Change

Mass media promotion of a smartphone smoking cessation app: modelled health and cost-saving impacts

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