Awareness, affect, and craving during smoking cessation: An experience sampling study

Abstract

Objective: Mindfulness has received attention in smoking cessation research, yet the mechanisms by which mindfulness may promote smoking cessation are not well understood. Mindfulness training may help individuals increase awareness and respond skillfully to processes that contribute to smoking, such as affective states and craving. This study used experience sampling (ES) to test how awareness was related to craving, positive and negative affect and smoking, in the moment, among smokers in treatment for smoking cessation.

Method: Participants (N = 228) were part of a clinical trial evaluating Craving to Quit, a smartphone app for mindfulness training for smoking cessation, compared to an app delivering only ES. All participants were asked to complete 22 days of ES, with up to 6 ES surveys per day, measuring awareness, craving, positive and negative affect and smoking. Data were analyzed using multilevel linear modeling.

Results: Both at the within and between-person level, higher awareness was associated with higher positive affect, lower craving and lower negative affect. Lower within-person craving was associated with lower smoking. Within-person awareness, positive and negative affect were not significantly associated with smoking. At the between-person level, higher awareness and higher positive affect, and lower negative affect and lower craving were associated with lower smoking.

Conclusions: Awareness of current experience was related to key psychological variables linked to behavior change in smoking cessation, namely positive and negative affect and craving, among smokers trying to quit. Future studies should test whether learning to increase awareness, such as through mindfulness training, may benefit smokers in treatment. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Trial registration: ClinicalTrials.gov NCT02134509.

Conflict of interest statement

Conflicts of Interest

Dr. Brewer is the founder of MindSciences, the company that developed the mindfulness app used in this study. He owns stock in, serves as a non-compensated scientist for the company and has previously served on the board of directors. This financial interest has been disclosed to and is being managed by Brown University, in accordance with its Conflict of Interest and Conflict of Commitment policies. All other authors report no biomedical financial interests or potential conflicts of interest.