Mindful attention reduces neural and self-reported cue-induced craving in smokers
Open accessAbstract
An emerging body of research suggests that mindfulness-based interventions may be beneficial for smoking cessation and the treatment of other addictive disorders. One way that mindfulness may facilitate smoking cessation is through the reduction of craving to smoking cues. The present work considers whether mindful attention can reduce self-reported and neural markers of cue-induced craving in treatment seeking smokers. Forty-seven (n = 47) meditation-naïve treatment-seeking smokers (12-h abstinent from smoking) viewed and made ratings of smoking and neutral images while undergoing functional magnetic resonance imaging (fMRI). Participants were trained and instructed to view these images passively or with mindful attention. Results indicated that mindful attention reduced self-reported craving to smoking images, and reduced neural activity in a craving-related region of subgenual anterior cingulate cortex (sgACC). Moreover, a psychophysiological interaction analysis revealed that mindful attention reduced functional connectivity between sgACC and other craving-related regions compared to passively viewing smoking images, suggesting that mindfulness may decouple craving neurocircuitry when viewing smoking cues. These results provide an initial indication that mindful attention may describe a 'bottom-up' attention to one's present moment experience in ways that can help reduce subjective and neural reactivity to smoking cues in smokers.
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Accumulating evidence from neuroimaging studies mostly supports the idea of bottom-up processing.
“Accumulating evidence from neuroimaging studies mostly support this idea (Westbrook et al., 2013).”
From Enhanced Resting-State Functional Connectivity With Decreased Amplitude of Low-Frequency Fluctuations of the Salience Network in Mindfulness Novices (2022) · cites this paper as Westbrook et al., 2013
In “Mindful attention and reduced reactivity to craving” (page unavailable), the authors say their fMRI findings support a bottom-up, reduced-reactivity account in meditation-naïve smokers. But “Neural pathways linking mindful attention to reduced craving” also describes evidence for top-down regulation, including a neuroimaging review. The paper supports bottom-up processing in this study, not the broader claim that neuroimaging evidence mostly supports it. (LLM, conf=0.84)
Experimental — accuracy not yet measuredMindfulness effects are detected with decoupling of resting-state FC between subgenual ACC and amygdala or other craving-related regions.
“Mindfulness effects were detected with the decoupling of resting-state FC (rs-FC) between subgenual ACC and amygdala (Taren et al., 2015) or other craving-related regions (caudate, ventral striatum, premotor cortex, and insula) (Westbrook et al., 2013).”
From Enhanced Resting-State Functional Connectivity With Decreased Amplitude of Low-Frequency Fluctuations of the Salience Network in Mindfulness Novices (2022) · cites this paper as Westbrook et al., 2013
The ‘Mindful attention and reduced reactivity to craving’ section reports decreased functional connectivity between sgACC and caudate, ventral striatum, premotor cortex, and insula. But the ‘fMRI analyses’ section identifies this as a comparison of mindful attention with passive viewing of smoking images, not resting-state functional connectivity. The amygdala portion of the citing sentence is attributed to Taren et al., not Westbrook et al. (LLM, conf=0.91)
Experimental — accuracy not yet measuredIn a lab-based brief mindfulness induction, mindful attention to smoking cues significantly reduced craving coupled with decreased activation in a craving-related region of the subgenual ACC.
“in a lab-based brief mindfulness induction, mindful attention to smoking cues significantly reduced craving coupled with decreased activation in a craving-related region of the subgenual ACC [53].”
From Mindfulness-based treatment of addiction: current state of the field and envisioning the next wave of research (2018) · cites this paper as [53]
In mindfulness-naive smokers, one study found lower connectivity between craving-related brain areas during mindfulness than during passive viewing of smoking cues while craving.
“one study of mindfulness-naive smokers demonstrated reduced connectivity between craving-related brain regions during a mindfulness condition compared to passive viewing of smoking-related images during cigarette craving [53]”
From A translational neuroscience perspective on mindfulness meditation as a prevention strategy (2016) · cites this paper as [53]
When applying mindful attention in smokers viewing craving-inducing images during fMRI, subjects reported less craving impulse and presented decreased activation in the subgenual ACC and reduced functional connectivity between this region and bilateral AI and VS, with no involvement of the PFC.
“When applying “mindful attention,” subjects reported less craving impulse; additionally, they presented decreased activation in the subgenual ACC (sg-ACC), and reduced functional connectivity between this same region and bilateral AI and VS. At the same time, no involvement of the PFC was detected (Westbrook et al., 2013).”
From Mindfulness and Emotion Regulation: Insights from Neurobiological, Psychological, and Clinical Studies (2017) · cites this paper as Westbrook et al., 2013
In three studies, strategy instructions were judged not to be matched with regards to the use of smoking-relevant words.
“In three studies, strategy instructions were judged not to be matched with regards to the use of smoking-relevant words (Litvin et al. 2012; Szasz et al. 2012; Westbrook et al. 2013)”
From Mindfulness, Acceptance and Defusion Strategies in Smokers: A Systematic Review of Laboratory Studies (2018) · cites this paper as Westbrook et al. 2013
With the exception of Westbrook et al. (2013) and Ruscio et al. (2016), all studies relied primarily on self-reporting of smoking-related outcomes.
“With the exception of Westbrook et al. (2013) and Ruscio et al. (2016), all studies relied primarily on self-reporting of smoking-related outcomes.”
From Mindfulness, Acceptance and Defusion Strategies in Smokers: A Systematic Review of Laboratory Studies (2018) · cites this paper as Westbrook et al. 2013
Of the six studies comparing the effects of a PFM strategy to an inactive control, three reported a larger within-session reduction in negative affect in the PFM group.
“Of the six studies comparing the effects of a PFM strategy to an inactive control (Cropley et al. 2007; Litvin et al. 2012; Ruscio et al. 2016; Ussher et al. 2009; Ussher et al. 2006; Westbrook et al. 2013), three reported a larger within-session reduction in negative affect in the PFM group (Litvin et al. 2012; Ussher et al. 2009; Westbrook et al. 2013).”
From Mindfulness, Acceptance and Defusion Strategies in Smokers: A Systematic Review of Laboratory Studies (2018) · cites this paper as Westbrook et al. 2013
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The Neuroscience of Mindfulness Meditation
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“In line with this literature, Westbrook et al. (2013) demonstrated how just the briefest training in mindfulness can have important effects on the experience of craving, and activation of craving-related brain regions in smokers actively desiring to quit.”
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“At the same time, no involvement of the PFC was detected (Westbrook et al., 2013).”
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Mindfulness and Behavior Change
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Association of Drug Cues and Craving With Drug Use and Relapse
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Mindfulness-Based Relapse Prevention for substance craving
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Metacognitive model of mindfulness
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“First, mindfulness training may decrease bottom-up reactivity to drug-related stimuli, as mediated by reduced activation in the subgenual anterior cingulate cortex and striatum during exposure to substance cues (105).”
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Effects of Brief Mindfulness-Based Interventions on Health-Related Outcomes: a Systematic Review
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A Triadic Neurocognitive Approach to Addiction for Clinical Interventions
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Follow your breath: respiratory interoceptive accuracy in experienced meditators
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Addiction and the Brain-Disease Fallacy
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Let it be: mindful acceptance down-regulates pain and negative emotion
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The effects of three mindfulness skills on chocolate cravings
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Self-citationMindfulness training and the cultivation of secure, satisfying couple relationships.
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Mechanisms of Behavior Change in Substance Use Disorder With and Without Formal Treatment
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Randomized trial on mindfulness training for smokers targeted to a disadvantaged population
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Randomized trial comparing mindfulness training for smokers to a matched control
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Treatment approaches for interoceptive dysfunctions in drug addiction
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Adolescent brain development, substance use, and psychotherapeutic change.
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“[53] found that mindful attention during the exposure to cigarette-related images reduced self-reported as well as neuronal measures of cue-induced craving in treatment-seeking smokers.”
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Biomarkers for Smoking Cessation
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The Emerging Neurobiology of Mindfulness and Emotion Processing
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Mindfulness Reduces Reactivity to Food Cues: Underlying Mechanisms and Applications in Daily Life
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Neural Mechanisms Underlying Craving and the Regulation of Craving
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- Authors
- Westbrook, C., Creswell, J. D., Tabibnia, G., Julson, E., Kober, H., & Tindle, H. A.
- Affiliations
- University of Wisconsin–Madison (US)
- University of Wisconsin, School of Medicine and Public Health, Madison, Wisconsin, USA, 2Department of Psychology, Carnegie Mellon University, Pittsburgh, PA, USA, 3Department of Psychiatry, Yale University, New Haven, CT, USA, and 4University of Pittsburgh, Medical Center, Pittsburgh, PA, USA
- Venue
- Social Cognitive and Affective Neuroscience
- Publisher
- Oxford University Press (OUP)
- Published
- 2011-11-22
- Volume
- 8
- Issue
- 1
- Pages
- 73-84
- ISSN
- 1749-5016 (ISSN-L)
- 1749-5024
- PMC
- PMC3541484
- OpenAlex
- W2160305908
- Cited by
- 278
- References
- 103
- Citations by year
- 2026: 8 · 2025: 12 · 2024: 14 · 2023: 16 · 2022: 20 · 2021: 24 · 2020: 22 · 2019: 23 · 2018: 23 · 2017: 18 · 2016: 17 · 2015: 28 · 2014: 29 · 2013: 15 · 2012: 9
- FWCI
- 11.56
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Social Cognitive and Affective Neuroscience (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- KiltHub Repository (submittedVersion)
- Figshare (submittedVersion, cc-by)
- KiltHub Repository
- Funders
- Mind and Life Institute
- National Institutes of Health
- National Institute of Mental Health (T-32-MH17140, T32MH017140)
- National Center for Research Resources (RR024154, KL2RR024154, K12 RR024154)
- 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
- mindful attention, cigarette craving, smoking cues, smoking cessation, mindfulness-based interventions, subgenual anterior cingulate cortex, functional connectivity, psychophysiological interaction, treatment-seeking smokers, cue reactivity, addiction treatment
- MeSH terms
- Adult, Attention, Awareness, Female, Gyrus Cinguli, Humans, Male, Middle Aged, Neural Pathways, Smoking, Smoking Cessation, Behavior, Addictive, Meditation, Functional Neuroimaging
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