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Mindfulness training for smoking cessation: Results from a randomized controlled trial
Open accessAbstract
Background Cigarette smoking is the leading cause of preventable death in the world, and long-term abstinence rates remain modest. Mindfulness training (MT) has begun to show benefits in a number of psychiatric disorders, including depression, anxiety and more recently, in addictions. However, MT has not been evaluated for smoking cessation through randomized clinical trials.Methods 88 treatment-seeking, nicotine-dependent adults who were smoking an average of 20cigarettes/day were randomly assigned to receive MT or the American Lung Association's freedom from smoking (FFS) treatment. Both treatments were delivered twice weekly over 4 weeks (eight sessions total) in a group format. The primary outcomes were expired-air carbon monoxide-confirmed 7-day point prevalence abstinence and number of cigarettes/day at the end of the 4-week treatment and at a follow-up interview at week 17.Results 88% of individuals received MT and 84% of individuals received FFS completed treatment. Compared to those randomized to the FFS intervention, individuals who received MT showed a greater rate of reduction in cigarette use during treatment and maintained these gains during follow-up (F=11.11, p=.001). They also exhibited a trend toward greater point prevalence abstinence rate at the end of treatment (36% vs. 15%, p=.063), which was significant at the 17-week follow-up (31% vs. 6%, p=.012).Conclusions This initial trial of mindfulness training may confer benefits greater than those associated with current standard treatments for smoking cessation.
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“in studies of cigarette smoking and emotional eating, mindfulness training was found to mechanistically decouple cigarette or food craving from smoking or eating, with a subsequent fivefold increase in smoking cessation rates, and a 40% reduction in craving-related eating, respectively (Brewer et al., 2011; Elwafi, Witkiewitz, Mallik, Thornhill-IV, & Brewer, 2013; Ashley E. Mason, Jhaveri, Cohn, &”
From Can Mindfulness Mechanistically Target Worry to Improve Sleep Disturbances? Theory and Study Protocol for App-Based Anxiety Program. (2020) · cites this paper as Brewer et al., 2011
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In the citing paper
“contextual CBTs such as mindfulness-based therapy and ACT appear to demonstrate success in treating nicotine addiction and promoting smoking cessation with minimal or no reported increased risk of suicidality.76,78,88”
From Are smoking cessation treatments associated with suicidality risk? An overview (2016) · cites this paper as [78]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Brewer et al.78 concluded that mindfulness training is an effective method to help people quit smoking.”
From Are smoking cessation treatments associated with suicidality risk? An overview (2016) · cites this paper as [78]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“These authors further promote that the 17-week point prevalence odds ratio of 6.75 in their mindfulness-based intervention group was significantly larger than the average odds ratio of behavioral therapies as reported in the current clinical practice guidelines”
From Are smoking cessation treatments associated with suicidality risk? An overview (2016) · cites this paper as [78]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
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“recent reviews of the evidence indicate its efficacy for promoting abstinence and reducing cravings.51,78–80,95”
From Are smoking cessation treatments associated with suicidality risk? An overview (2016) · cites this paper as [78]
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“MBIs (e.g., MTS) showed significant improvements on self-reported measures of attentional control, emotion regulation, and mindfulness. Post-treatment, these measures were significantly correlated with meditation time and smoking abstinence versus Quit Line intervention or FFS (55, 73, 74).”
From Mindfulness-Based Interventions for the Treatment of Substance and Behavioral Addictions: A Systematic Review (2018) · cites this paper as [73]
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“Mindfulness-based interventions have demonstrated promise for supporting recovery and improving mental health for persons with substance use conditions (e.g. Refs. [11–21]).”
From Mindful moms: acceptability and impact of co-designed and digitally delivered video meditations for pregnant and parenting women with opioid use disorder (2025) · cites this paper as [13]
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“Brewer 2011 accounts for the difference between the conclusions of Oikonomou 2017's review and our review. Brewer 2011's results indicated a strong benefit of mindfulness training, albeit with high levels of imprecision (RR 4.97, 95% CI 1.52 to 16.22; 88 participants).”
From Mindfulness for smoking cessation (2022) · cites this paper as Brewer 2011
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In the citing paper
“MT has been found to mechanistically break key links in the reinforcement pathway for other habitual behaviors such as smoking and emotional eating [29,30], with concomitant changes in related brain regions predicting clinical outcomes [31].”
From Clinical Efficacy and Psychological Mechanisms of an App-Based Digital Therapeutic for Generalized Anxiety Disorder: Randomized Controlled Trial (2021) · cites this paper as [29]
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“These researchers found that 36% of participants receiving mindfulness training achieved abstinence compared to 15% of participants in the alternative treatment group. After a 17-week follow-up, 31% of the mindfulness cohort remained abstinent compared to just 6% of participants receiving the alternative.”
From Are smoking cessation treatments associated with suicidality risk? An overview (2016) · cites this paper as [78]
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“Similar to Oikonomou 2017, this differs from our results because it included Brewer 2011, which showed a strong benefit of mindfulness on abstinence rates.”
From Mindfulness for smoking cessation (2022) · cites this paper as Brewer 2011
In the citing paper
“Several studies reported positive associations between the degree to which participants engaged in mindfulness homework exercises and changes in cigarette, marijuana, and alcohol use posttreatment (e.g., [68–70]).”
From Mindfulness-based treatment of addiction: current state of the field and envisioning the next wave of research (2018) · cites this paper as [68]
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Brewer, J. (2019) · Current Opinion in Psychology · doi:10.1016/j.copsyc.2019.01.014 · Cited by 58
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Meditation-induced changes in high-frequency heart rate variability predict smoking outcomes
Libby, D. J., Worhunsky, P. D., Pilver, C. E., & Brewer, J. A. (2012) · Frontiers in Human Neuroscience · doi:10.3389/fnhum.2012.00054 · Cited by 56
“Treatments for substance use disorders (Bowen et al., 2009; Brewer et al., 2009), and particularly smoking cessation (Cropley et al., 2007; Davis et al., 2007; Brewer et al., 2011), have integrated mindfulness meditation with promising results.”
BackgroundSelf-citationJanes, A. C., Datko, M., Roy, A., Barton, B., Druker, S., Neal, C., Ohashi, K., Benoit, H., van Lutterveld, R., & Brewer, J. A. (2019) · Neuropsychopharmacology · doi:10.1038/s41386-019-0403-y · Cited by 55
Self-citationSmoking and mental illness. An update for psychiatrists
Mendelsohn, C. P., Kirby, D. P., & Castle, D. J. (2014) · Australasian Psychiatry · doi:10.1177/1039856214562076 · Cited by 58
Gratitude facilitates healthy eating behavior in adolescents and young adults
Fritz, M. M., Armenta, C. N., Walsh, L. C., & Lyubomirsky, S. (2018) · Journal of Experimental Social Psychology · doi:10.1016/j.jesp.2018.08.011 · Cited by 60
Mindfulness changes construal level: An experimental investigation.
Chan, E. Y., & Wang, Y. (2019) · Journal of Experimental Psychology General · doi:10.1037/xge0000654 · Cited by 54
Wupperman, P., Fickling, M. J., Klemanski, D. H., Berking, M., & Whitman, J. B. (2013) · Journal of Clinical Psychology · doi:10.1002/jclp.21969 · Cited by 57
An exploratory study of Mindfulness Based Stress Reduction for emotional eating
Levoy, E., Lazaridou, A., Brewer, J. A., & Fulwiler, C. (2016) · Appetite · doi:10.1016/j.appet.2016.11.029 · Cited by 56
Self-citationTaheri, M. A., Semsarha, F., & Modarresi-Asem, F. (2020) · Preprints.org · doi:10.20944/preprints202009.0679.v1 · Cited by 46
Singh, N. N., Lancioni, G. E., Myers, R. E., Karazsia, B. T., Winton, A. S. W., & Singh, J. (2014) · International Journal of Mental Health and Addiction · doi:10.1007/s11469-013-9471-0 · Cited by 49
Levit‐Binnun, N., Arbel, K., & Dorjee, D. (2021) · Frontiers in Psychology · doi:10.3389/fpsyg.2021.727857 · Cited by 57
Yang, M.-J., Sutton, S. K., Hernandez, L. M., Jones, S. R., Wetter, D. W., Kumar, S., & Vinci, C. (2022) · Addictive Behaviors · doi:10.1016/j.addbeh.2022.107467 · Cited by 48
Andreu, C. I., Cosmelli, D., Slagter, H. A., & Franken, I. H. A. (2018) · PLOS ONE · doi:10.1371/journal.pone.0191661 · Cited by 47
Smoking Cessation in a Chronic Pancreatitis Population
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Childhood maltreatment and amygdala connectivity in methamphetamine dependence: a pilot study
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Dispositional Mindfulness Predicts Enhanced Smoking Cessation and Smoking Lapse Recovery
Heppner, W. L., Spears, C. A., Correa-Fernández, V., Castro, Y., Li, Y., Guo, B., Reitzel, L. R., Vidrine, J. I., Mazas, C. A., Cofta-Woerpel, L. M., et al. (2016) · Annals of Behavioral Medicine · doi:10.1007/s12160-015-9759-3 · Cited by 46
Roy, A., Hoge, E. A., Abrante, P., Druker, S., Liu, T., & Brewer, J. A. (2021) · Journal of Medical Internet Research · doi:10.2196/26987 · Cited by 41
Self-citationKamboj, S. K., Irez, D., Serfaty, S., Thomas, E., Das, R. K., & Freeman, T. P. (2017) · International Journal of Neuropsychopharmacology · doi:10.1093/ijnp/pyx064 · Cited by 41
Mindfulness-Based Stress Reduction and Change in Health-Related Behaviors
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Roche, A. I., Kroska, E. B., & Denburg, N. L. (2019) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2019.06.002 · Cited by 41
Overall and differential attrition in mindfulness-based interventions: A meta-analysis
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Dill, B., & Holton, R. (2014) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2014.00139 · Cited by 40
A Mindfulness-Based Smoking Cessation Program for Individuals with Mild Intellectual Disability
Singh, N. N., Lancioni, G. E., Winton, A. S. W., Karazsia, B. T., Singh, A. D. A., Singh, A. N. A., & Singh, J. (2012) · Mindfulness · doi:10.1007/s12671-012-0148-8 · Cited by 39
Considering Drug-Associated Contexts in Substance Use Disorders and Treatment Development
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Metadata
- Authors
- Brewer, J. A., Mallik, S., Babuscio, T. A., Nich, C., Johnson, H. E., Deleone, C. M., Minnix-Cotton, C. A., Byrne, S. A., Kober, H., Weinstein, A. J., Carroll, K. M., & Rounsaville, B. J.
- Affiliations
- Yale University (US)
- Corresponding author
- Brewer, Judson A.
- Venue
- Drug and Alcohol Dependence
- Publisher
- Elsevier BV
- Published
- 2011-12
- Volume
- 119
- Issue
- 1-2
- Pages
- 72-80
- ISSN
- 0376-8716 (ISSN-L)
- PMC
- PMC3191261
- OpenAlex
- W2089965180
- Cited by
- 383
- References
- 92
- Citations by year
- 2026: 11 · 2025: 16 · 2024: 14 · 2023: 23 · 2022: 27 · 2021: 21 · 2020: 35 · 2019: 34 · 2018: 39 · 2017: 20 · 2016: 31 · 2015: 33 · 2014: 37 · 2013: 27 · 2012: 13
- FWCI
- 17.23
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Drug and Alcohol Dependence (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Yale University
- National Institute on Drug Abuse (K05-DA00457, K05DA000089, K05DA00089, P50DA009241, K05DA000457, K12 DA00167, R03DA029163, P50-DA-0-9241, K12DA000167)
- National Institute of Dental and Craniofacial Research (UL1DE019586)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Smoking Behavior and Cessation
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Keywords
- mindfulness training, smoking cessation, nicotine dependence, smoking abstinence, group intervention, addiction treatment
- MeSH terms
- Adult, Carbon Monoxide, Female, Follow-Up Studies, Humans, Health Knowledge, Attitudes, Practice, Male, Middle Aged, Nicotine, Smoking, Tobacco Use Disorder, Smoking Cessation, Treatment Outcome, Nicotinic Agonists, Young Adult
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