Neural stress reactivity relates to smoking outcomes and differentiates between mindfulness and cognitive-behavioral treatments

Kober, Hedy; Brewer, Judson A.; Height, Keri L.; Sinha, Rajita

doi:10.1016/j.neuroimage.2016.09.042

Cited by 75Smoking Behavior and CessationMindfulness and Compassion InterventionsSubstance Abuse Treatment and Outcomes

Neural stress reactivity relates to smoking outcomes and differentiates between mindfulness and cognitive-behavioral treatments

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Kober, Hedy, Brewer, Judson A., Height, Keri L., Sinha, Rajita·2017·NeuroImage

DOI 10.1016/j.neuroimage.2016.09.042PMC PMC5373945

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Abstract

Stress and negative affect are known contributors to drug use and relapse, and several known treatments for addictions include strategies for managing them. In the current study, we administered a well-established stress provocation during functional magnetic resonance imaging (fMRI) to 23 participants who completed either mindfulness training (MT; N=11) or the American Lung Association's Freedom From Smoking (FFS; N=12), which is a cognitive-behavioral treatment (CBT) for smoking cessation. Across the entire sample, we found that stress reactivity in several brain regions including the amygdala and anterior/mid insula was related to reductions in smoking after treatment, as well as at 3-month post-treatment follow-up. Moreover, conjunction analysis revealed that these same regions also differentiated between treatment groups such that the MT group showed lower stress-reactivity compared to the FFS/CBT group. This suggests that reduction in stress reactivity may be one of the mechanisms that underlie the efficacy of MT in reducing smoking over time. The findings have important implications for our understanding of stress, the neural and psychological mechanisms that underlie mindfulness-based treatments, and for smoking cessation treatments more broadly.

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In a RCT, an 8-week MBI for smoking cessation was associated with significantly less amygdala and insula activation during stress exposure relative to an active control condition, and reduced activity in these brain regions was associated with decreased smoking by follow-up.
“in a RCT, an 8-week MBI for smoking cessation was associated with significantly less amygdala and insula activation during stress exposure relative to an active control condition, and reduced activity in these brain regions was associated with decreased smoking by follow-up [51].”
From Mindfulness-based treatment of addiction: current state of the field and envisioning the next wave of research (2018) · cites this paper as [51]

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Mindfulness Meditation and Psychopathology
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“Cognitive Behavioral Treatment (19), Health Education [HE (66, 72, 76, 80)], Freedom from Smoking [FFS (73, 75)], Quit Line (74), Interactive Learning for Smokers [ILS (50)], Support Group [SG (20, 30, 56, 57)], a QuitGuide app (64), Physical Education (47), relaxation (34), medication treatment (naltrexone or others)…”
Background
Mindfulness-based programs for substance use disorders: a systematic review of manualized treatments
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“Moreover, these changes were greater in participants that received MBI [96].”
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Authors: Kober, H., Brewer, J. A., Height, K. L., & Sinha, R.
Affiliations: University of Massachusetts Chan Medical School (US)
Yale University (US)
ORCID: Brewer, Judson A.
Sinha, Rajita
Venue: NeuroImage
Publisher: Elsevier BV
Published: 2017-05
Volume: 151
Pages: 4-13
ISSN: 1053-8119 (ISSN-L)
DOI: 10.1016/j.neuroimage.2016.09.042
PMC: PMC5373945
OpenAlex: W2526221569
Cited by: 75
References: 156
Citations by year: 2026: 5 · 2025: 3 · 2024: 7 · 2023: 6 · 2022: 10 · 2021: 11 · 2020: 12 · 2019: 11 · 2018: 8 · 2017: 2
FWCI: 5.63
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: NeuroImage (publishedVersion)
PubMed (publishedVersion)
Europe PMC (PubMed Central) (acceptedVersion)
PubMed Central (acceptedVersion)
The Journal of the American Medical Association (JAMA) Network (American Medical Association) (submittedVersion)
Funders: National Institutes of Health (UL1TR001863)
National Institute on Drug Abuse (P50DA009241, PL1DA024859, K12DA000167)
National Institute of Dental and Craniofacial Research (UL1DE019586)
National Center for Advancing Translational Sciences
Topics: Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
Keywords: stress reactivity, smoking cessation, mindfulness training, cognitive behavioral therapy, amygdala, insula, treatment response mechanisms, relapse, addiction treatment
MeSH terms: Cigarette Smoking, Brain, Brain Mapping, Female, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Stress, Psychological, Cognitive Behavioral Therapy, Smoking Cessation, Treatment Outcome, Mindfulness

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Neural stress reactivity relates to smoking outcomes and differentiates between mindfulness and cognitive-behavioral treatments

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