Mindfulness for smoking cessation

Sarah Jackson, Jamie Brown, Emma Norris, Jonathan Livingstone-Banks, Emily Hayes, Nicola Lindson, Sarah Jackson, Jamie Brown, Emma Norris, Jonathan Livingstone-Banks, Emily Hayes, Nicola Lindson

Abstract

Background: Mindfulness-based smoking cessation interventions may aid smoking cessation by teaching individuals to pay attention to, and work mindfully with, negative affective states, cravings, and other symptoms of nicotine withdrawal. Types of mindfulness-based interventions include mindfulness training, which involves training in meditation; acceptance and commitment therapy (ACT); distress tolerance training; and yoga.

Objectives: To assess the efficacy of mindfulness-based interventions for smoking cessation among people who smoke, and whether these interventions have an effect on mental health outcomes.

Search methods: We searched the Cochrane Tobacco Addiction Group's specialised register, CENTRAL, MEDLINE, Embase, PsycINFO, and trial registries to 15 April 2021. We also employed an automated search strategy, developed as part of the Human Behaviour Change Project, using Microsoft Academic.

Selection criteria: We included randomised controlled trials (RCTs) and cluster-RCTs that compared a mindfulness-based intervention for smoking cessation with another smoking cessation programme or no treatment, and assessed smoking cessation at six months or longer. We excluded studies that solely recruited pregnant women.

Data collection and analysis: We followed standard Cochrane methods. We measured smoking cessation at the longest time point, using the most rigorous definition available, on an intention-to-treat basis. We calculated risk ratios (RRs) and 95% confidence intervals (CIs) for smoking cessation for each study, where possible. We grouped eligible studies according to the type of intervention and type of comparator. We carried out meta-analyses where appropriate, using Mantel-Haenszel random-effects models. We summarised mental health outcomes narratively.

Main results: We included 21 studies, with 8186 participants. Most recruited adults from the community, and the majority (15 studies) were conducted in the USA. We judged four of the studies to be at low risk of bias, nine at unclear risk, and eight at high risk. Mindfulness-based interventions varied considerably in design and content, as did comparators, therefore, we pooled small groups of relatively comparable studies. We did not detect a clear benefit or harm of mindfulness training interventions on quit rates compared with intensity-matched smoking cessation treatment (RR 0.99, 95% CI 0.67 to 1.46; I2 = 0%; 3 studies, 542 participants; low-certainty evidence), less intensive smoking cessation treatment (RR 1.19, 95% CI 0.65 to 2.19; I2 = 60%; 5 studies, 813 participants; very low-certainty evidence), or no treatment (RR 0.81, 95% CI 0.43 to 1.53; 1 study, 325 participants; low-certainty evidence). In each comparison, the 95% CI encompassed benefit (i.e. higher quit rates), harm (i.e. lower quit rates) and no difference. In one study of mindfulness-based relapse prevention, we did not detect a clear benefit or harm of the intervention over no treatment (RR 1.43, 95% CI 0.56 to 3.67; 86 participants; very low-certainty evidence). We did not detect a clear benefit or harm of ACT on quit rates compared with less intensive behavioural treatments, including nicotine replacement therapy alone (RR 1.27, 95% CI 0.53 to 3.02; 1 study, 102 participants; low-certainty evidence), brief advice (RR 1.27, 95% CI 0.59 to 2.75; 1 study, 144 participants; very low-certainty evidence), or less intensive ACT (RR 1.00, 95% CI 0.50 to 2.01; 1 study, 100 participants; low-certainty evidence). There was a high level of heterogeneity (I2 = 82%) across studies comparing ACT with intensity-matched smoking cessation treatments, meaning it was not appropriate to report a pooled result. We did not detect a clear benefit or harm of distress tolerance training on quit rates compared with intensity-matched smoking cessation treatment (RR 0.87, 95% CI 0.26 to 2.98; 1 study, 69 participants; low-certainty evidence) or less intensive smoking cessation treatment (RR 1.63, 95% CI 0.33 to 8.08; 1 study, 49 participants; low-certainty evidence). We did not detect a clear benefit or harm of yoga on quit rates compared with intensity-matched smoking cessation treatment (RR 1.44, 95% CI 0.40 to 5.16; 1 study, 55 participants; very low-certainty evidence). Excluding studies at high risk of bias did not substantially alter the results, nor did using complete case data as opposed to using data from all participants randomised. Nine studies reported on changes in mental health and well-being, including depression, anxiety, perceived stress, and negative and positive affect. Variation in measures and methodological differences between studies meant we could not meta-analyse these data. One study found a greater reduction in perceived stress in participants who received a face-to-face mindfulness training programme versus an intensity-matched programme. However, the remaining eight studies found no clinically meaningful differences in mental health and well-being between participants who received mindfulness-based treatments and participants who received another treatment or no treatment (very low-certainty evidence).

Authors' conclusions: We did not detect a clear benefit of mindfulness-based smoking cessation interventions for increasing smoking quit rates or changing mental health and well-being. This was the case when compared with intensity-matched smoking cessation treatment, less intensive smoking cessation treatment, or no treatment. However, the evidence was of low and very low certainty due to risk of bias, inconsistency, and imprecision, meaning future evidence may very likely change our interpretation of the results. Further RCTs of mindfulness-based interventions for smoking cessation compared with active comparators are needed. There is also a need for more consistent reporting of mental health and well-being outcomes in studies of mindfulness-based interventions for smoking cessation.

Trial registration: ClinicalTrials.gov NCT00492310 NCT01525420 NCT01812278 NCT02724462 NCT01093599 NCT01299909 NCT02327104 NCT02134509 NCT02055326 NCT01652508 NCT01533974 NCT02901171 NCT02218281 NCT00297479 NCT02497339 NCT01098955 NCT01982110 NCT02037360 NCT02421991 NCT03253445.

Conflict of interest statement

All review authors declare no financial links with tobacco companies or e‐cigarette manufacturers or their representatives.

SJ: none reported

JB has undertaken research and consultancy for manufacturers of smoking cessation medications (Pfizer and Johnson & Johnson).

EN: none reported

JLB: none reported

EH: none reported

NL: none reported

Copyright © 2022 The Authors. Cochrane Database of Systematic Reviews published by John Wiley & Sons, Ltd. on behalf of The Cochrane Collaboration.

Figures

1
1
Figure 1: PRISMA flow diagram
2
2
Figure 2: risk of bias summary
1.1. Analysis
1.1. Analysis
Comparison 1: Mindfulness training, Outcome 1: Mindfulness training vs matched‐intensity smoking cessation treatment
1.2. Analysis
1.2. Analysis
Comparison 1: Mindfulness training, Outcome 2: Mindfulness training vs less intensive smoking cessation treatment
1.3. Analysis
1.3. Analysis
Comparison 1: Mindfulness training, Outcome 3: Mindfulness training vs no treatment
1.4. Analysis
1.4. Analysis
Comparison 1: Mindfulness training, Outcome 4: Mindfulness‐based relapse prevention vs no treatment
2.1. Analysis
2.1. Analysis
Comparison 2: Acceptance and commitment therapy (ACT), Outcome 1: ACT vs matched‐intensity smoking cessation treatment
2.2. Analysis
2.2. Analysis
Comparison 2: Acceptance and commitment therapy (ACT), Outcome 2: ACT vs NRT
2.3. Analysis
2.3. Analysis
Comparison 2: Acceptance and commitment therapy (ACT), Outcome 3: ACT vs brief advice
2.4. Analysis
2.4. Analysis
Comparison 2: Acceptance and commitment therapy (ACT), Outcome 4: ACT vs less intensive ACT
3.1. Analysis
3.1. Analysis
Comparison 3: Distress tolerance, Outcome 1: Distress tolerance vs matched‐intensity smoking cessation treatment
3.2. Analysis
3.2. Analysis
Comparison 3: Distress tolerance, Outcome 2: Distress tolerance vs less intensive smoking cessation treatment
4.1. Analysis
4.1. Analysis
Comparison 4: Yoga, Outcome 1: Yoga vs matched‐intensity smoking cessation treatment
5.1. Analysis
5.1. Analysis
Comparison 5: Sensitivity analysis ‐ excluding studies at high risk of bias, Outcome 1: Mindfulness training vs matched‐intensity smoking cessation treatment
5.2. Analysis
5.2. Analysis
Comparison 5: Sensitivity analysis ‐ excluding studies at high risk of bias, Outcome 2: Mindfulness training vs less intensive smoking cessation treatment
6.1. Analysis
6.1. Analysis
Comparison 6: Sensitivity analysis ‐ complete cases, Outcome 1: Mindfulness training vs matched‐intensity smoking cessation treatment
6.2. Analysis
6.2. Analysis
Comparison 6: Sensitivity analysis ‐ complete cases, Outcome 2: Mindfulness training vs less intensive smoking cessation treatment
6.3. Analysis
6.3. Analysis
Comparison 6: Sensitivity analysis ‐ complete cases, Outcome 3: Mindfulness training vs no treatment
6.4. Analysis
6.4. Analysis
Comparison 6: Sensitivity analysis ‐ complete cases, Outcome 4: Mindfulness‐based relapse prevention vs no treatment
6.5. Analysis
6.5. Analysis
Comparison 6: Sensitivity analysis ‐ complete cases, Outcome 5: ACT vs matched‐intensity smoking cessation treatment
6.6. Analysis
6.6. Analysis
Comparison 6: Sensitivity analysis ‐ complete cases, Outcome 6: ACT vs NRT
6.7. Analysis
6.7. Analysis
Comparison 6: Sensitivity analysis ‐ complete cases, Outcome 7: ACT vs brief advice
6.8. Analysis
6.8. Analysis
Comparison 6: Sensitivity analysis ‐ complete cases, Outcome 8: ACT vs less intensive ACT
6.9. Analysis
6.9. Analysis
Comparison 6: Sensitivity analysis ‐ complete cases, Outcome 9: Distress tolerance vs matched‐intensity smoking cessation treatment
6.10. Analysis
6.10. Analysis
Comparison 6: Sensitivity analysis ‐ complete cases, Outcome 10: Distress tolerance vs less intensive smoking cessation treatment
7.1. Analysis
7.1. Analysis
Comparison 7: Sensitivity analysis ‐ mindfulness training adjusting for clustering in Pbert 2020, Outcome 1: Mindfulness training vs matched‐intensity smoking cessation treatment
7.2. Analysis
7.2. Analysis
Comparison 7: Sensitivity analysis ‐ mindfulness training adjusting for clustering in Pbert 2020, Outcome 2: Mindfulness training vs less intensive smoking cessation treatment

References

References to studies included in this review Bloom 2020 {published data only}

    1. Bloom EL, Ramsey SE, Abrantes AM, Hunt L, Wing RR, Kahler CW, et al.A pilot randomized controlled trial of distress tolerance treatment for weight concern in smoking cessation among women. Nicotine & Tobacco Research 2020;22(9):1578-86. [DOI: 10.1093/ntr/ntaa026] [PMID: ]
Bock 2012 {published data only}
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Bock 2019 {published data only}
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Bricker 2014a {published data only}
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Bricker 2018 {published data only}
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Bricker 2020 {published data only}
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Brown 2013 {published data only}
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Davis 2014a {published data only}
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Davis 2014b {published data only}
    1. Davis JM, Manley AR, Goldberg SB, Smith SS, Jorenby DE.Randomized trial comparing mindfulness training for smokers to a matched control. Journal of Substance Abuse Treatment 2014;47(3):213-21. [DOI: 10.1016/j.jsat.2014.04.005] [PMID: ]
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de Souza 2020 {published data only}
    1. Souza IC, Kozasa EH, Bowen S, Richter KP, Sartes LM, Colugnati FA, et al.Effectiveness of mindfulness-based relapse prevention program as an adjunct to the standard treatment for smoking: a pragmatic design pilot study. Nicotine & Tobacco Research 2020;22(9):1605-13. [DOI: 10.1093/ntr/ntaa057] [PMID: ]
Garrison 2020 {published data only}
    1. Garrison KA, Pal P, O'Malley SS, Pittman BP, Gueorguieva R, Rojiani R, et al.Craving to quit: a randomized controlled trial of smartphone app–based mindfulness training for smoking cessation. Nicotine & Tobacco Research 2020;22(3):324-31. [DOI: 10.1093/ntr/nty126] [PMID: ]
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Gaskins 2015 {published data only}
    1. Gaskins RB, Jennings EG, Thind H, Fava JL, Horowitz S, Lantini R, et al.Recruitment and initial interest of men in yoga for smoking cessation: QuitStrong, a randomized control pilot study. Translational Behavioral Medicine 2015;5(2):177-88. [DOI: 10.1007/s13142-014-0295-7] [PMID: ]
Gifford 2003 {published data only}
    1. Gifford ER.Acceptance -based treatment of regulatory internal stimuli in nicotine-dependent smokers: a controlled comparison with transdermal nicotine replacement [Dissertation]. ProQuest Dissertations Publishing, 2003. [ISBN: 978-0-496-38626-0] [URL: ]
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Mak 2020 {published data only}
    1. Mak YW, Leung DY, Loke AY.Effectiveness of an individual acceptance and commitment therapy for smoking cessation, delivered face-to-face and by telephone to adults recruited in primary health care settings: a randomized controlled trial. BMC Public Health 2020;20:1719. [DOI: 10.1186/s12889-020-09820-0] [PMID: ]
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    1. NCT01652508.Acceptance and commitment therapy for smoking cessation in the primary care setting. first received 30 July 2012. [URL: ]
McClure 2020 {published data only}
    1. McClure JB, Bricker J, Mull K, Heffner JL.Comparative effectiveness of group-delivered acceptance and commitment therapy versus cognitive behavioral therapy for smoking cessation: a randomized controlled trial. Nicotine & Tobacco Research 2020;22(3):354-62. [DOI: 10.1093/ntr/nty268] [PMID: ]
    1. NCT01533974.PATH partnering to achieve tobacco-free health (PATH). first received 16 February 2012. [URL: ]
O'Connor 2020 {published data only}
    1. NCT02901171.The contribution of a smartphone application to acceptance and commitment therapy group treatment for smoking cessation. first received 15 September 2016. [URL: ]
    1. O'Connor M, Whelan R, Bricker J, McHugh L.Randomized controlled trial of a smartphone application as an adjunct to acceptance and commitment therapy for smoking cessation. Behavior Therapy 2020;51(1):162-77. [DOI: 10.1016/j.beth.2019.06.003] [PMID: ]
Pbert 2020 {published data only}
    1. NCT02218281.Developing a smartphone app With mindfulness training for teen smoking cessation. first received 18 August 2014. [URL: ]
    1. Pbert L, Druker S, Crawford S, Frisard C, Trivedi M, Osganian SK, et al.Feasibility of a smartphone app with mindfulness training for adolescent smoking cessation: Craving to Quit (C2Q)-Teen. Mindfulness 2020;11(3):720-33. [DOI: 10.1007/s12671-019-01273-w] [PMID: ]
Savvides 2014 {published data only}
    1. Savvides SN.Evaluating an acceptance and commitment therapy internet-based intervention for smoking cessation in young adults [Dissertation]. University of Cyprus, Faculty of Social Sciences and Education, 2014. [URL: ]
Singh 2014 {published data only}
    1. Singh NN, Lancioni GE, Myers RE, Karazsia BT, Winton AS, Singh J.A randomized controlled trial of a mindfulness-based smoking cessation program for individuals with mild intellectual disability. International Journal of Mental Health and Addiction 2014;12:153-68. [DOI: 10.1007/s11469-013-9471-0]
Vidrine 2016 {published data only}
    1. NCT00297479.Group therapy for nicotine dependence: mindfulness and smoking. first received 28 February 2006. [URL: ]
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Weng 2021 {published data only}
    1. NCT02497339.Mindfulness training for smoking cessation in women in workplaces. first received 14 July 2015. [URL: ]
    1. Weng X, Luk TT, Lau OS, Suen YN, Lee JJ, Li WH, et al.Brief mindfulness training for smoking cessation in Chinese women in workplaces: a pilot randomized controlled trial. Addictive Behaviors 2021;113:106677. [DOI: 10.1016/j.addbeh.2020.106677] [PMID: ]
References to studies excluded from this review Aggarwal 2017 {published data only}
    1. Aggarwal A, Kumar K.Yoga as a powerful tool for smoking cessation-convincing results of a community based randomised controlled trial. Journal of Thoracic Oncology 2017;12(S1):S1486-S1487.
Arcari 1997 {published data only}
    1. Arcari PM.Efficacy of a workplace smoking cessation program: Mindfulness meditation vs cognitive-behavioral interventions [Dissertation]. Dissertation Abstracts International: Section B: The Sciences and Engineering, 1997.
Arora 2013 {published data only}
    1. Arora M, Reddy KS, Sarkar BK, Shahab L, West R, Ahluwalia JS.Cluster randomised trial of a brief tobacco cessation intervention for low income communities, India. Respiratory Medicine 2013;107:S5.
Baruffi 2014 {published data only}
    1. Baruffi M, Spatola CA, Manzoni GM, Castelnuovo G, Molinari E, Malfatto G, et al.The ACTonHEART study: rationale and design of a randomized controlled clinical trial comparing a brief intervention based on acceptance and commitment therapy to usual secondary prevention care of coronary heart disease. Health and Quality of Life Outcomes 2014;12(1):22.
Bloom 2017 {published data only}
    1. Bloom EL, Wing RR, Kahler CW, Thompson JK, Meltzer S, Hecht J, et al.Distress tolerance treatment for weight concern in smoking cessation among women: the WE QUIT pilot study. Behavior Modification 2017;41(4):468-98.
Bowen 2009 {published data only}
    1. Bowen S, Marlatt A.Surfing the urge: brief mindfulness-based intervention for college student smokers. Psychology of Addictive Behaviors 2009;23(4):666-71. [DOI: 10.1037/a0017127] [PMID: ]
Brewer 2011 {published data only}
    1. Brewer JA, Mallik S, Babuscio TA, Nich C, Johnson HE, Deleone CM, et al.Mindfulness training for smoking cessation: results from a randomized controlled trial. Drug and Alcohol Dependence 2011;119(1):72-80. [DOI: 10.1016/j.drugalcdep.2011.05.027] [PMID: ]
Bricker 2014b {published data only}
    1. Bricker JB, Mull KE, Kientz JA, Vilardaga R, Mercer LD, Akioka KJ, et al.Randomized, controlled pilot trial of a smartphone app for smoking cessation using acceptance and commitment therapy. Drug and Alcohol Dependence 2014;143:87-4.
Chirikos 2004 {published data only}
    1. Chirikos TN, Herzog TA, Meade CD, Webb MS, Brandon TH.Cost-effectiveness analysis of a complementary health intervention: the case of smoking relapse prevention. International Journal of Technology Assessment in Health Care 2004;20(4):475-80.
Cropley 2007 {published data only}
    1. Cropley M, Ussher M, Charitou E.Acute effects of a guided relaxation routine (body scan) on tobacco withdrawal symptoms and cravings in abstinent smokers. Addiction 2007;102(6):989-93. [DOI: 10.1111/j.1360-0443.2007.01832.x] [PMID: ]
Davis 2013 {published data only}
    1. Davis JM, Mills DM, Stankevitz KA, Manley AR, Majeskie MR, Smith SS.Pilot randomized trial on mindfulness training for smokers in young adult binge drinkers. BMC Complementary and Alternative Medicine 2013;13:215.
Davoudi 2017 {published data only}
    1. Davoudi M, Omidi A, Sehat M, Sepehrmanesh Z.The effects of acceptance and commitment therapy on man smokers' comorbid depression and anxiety symptoms and smoking cessation: a randomized controlled trial. Addiction and Health 2017;9(3):129-38.
Elibero 2011 {published data only}
    1. Elibero A, Van Rensburg KJ, Drobes DJ.Acute effects of aerobic exercise and Hatha yoga on craving to smoke. Nicotine & Tobacco Research 2011;13(11):1140-8. [DOI: 10.1093/ntr/ntr163] [PMID: ]
Elwafi 2013 {published data only}
    1. Elwafi HM, Witkiewitz K, Mallik S, Thornhill TA, Brewer JA.Mindfulness training for smoking cessation: moderation of the relationship between craving and cigarette use. Drug and Alcohol Dependence 2013;130:222-9.
Gifford 2011 {published data only}
    1. Gifford EV, Kohlenberg BS, Hayes SC, Pierson HM, Piasecki MP, Antonuccio DO, et al.Does acceptance and relationship focused behavior therapy contribute to bupropion outcomes? A randomized controlled trial of functional analytic psychotherapy and acceptance and commitment therapy for smoking cessation. Behavior Therapy 2011;42(4):700-15.
Heffner 2013 {published data only}
    1. Heffner JL, Wyszynski CM, Comstock B, Mercer LD, Bricker J.Overcoming recruitment challenges of web-based interventions for tobacco use: the case of web-based acceptance and commitment therapy for smoking cessation. Addictive Behaviors 2013;38(10):2473-6.
Hemenway 2021 {published data only}
    1. Hemenway M, Witkiewitz K, Unrod M, Brandon KO, Brandom TH, Wetter DW, et al.Development of a mindfulness-based treatment for smoking cessation and the modification of alcohol use: a protocol for a randomized controlled trial and pilot study findings. Contemporary Clinical Trials 2021;100:106218.
Hernandez‐Lopez 2009 {published data only}
    1. Hernandez-Lopez M, Luciano MC, Bricker JB, Roales-Nieto JG, Montesinos F.Acceptance and commitment therapy for smoking cessation: a preliminary study of its effectiveness in comparison with cognitive behavioral therapy. Psychology of Addictive Behaviors 2009;23(4):723-30.
Janes 2019 {published data only}
    1. Janes AC, Datko M, Roy A, Barton B, Druker S, Neal C, et al.Quitting starts in the brain: a randomized controlled trial of app-based mindfulness shows decreases in neural responses to smoking cues that predict reductions in smoking. Neuropsychopharmacology 2019;44(9):1631-8.
Jang 2019 {published data only}
    1. Jan S, Lee JA, Jang BH, Shin YC, Ko SG, Park S.Clinical effectiveness of traditional and complementary medicine interventions in combination with nicotine replacement therapy on smoking cessation: a randomized controlled pilot trial. Journal of Alternative and Complementary Medicine 2019;25(5):526-34.
Jones 2015 {published data only}
    1. Jones HA, Heffner JL, Mercer L, Wyszynski CM, Vilardaga R, Bricker JB.Web-based acceptance and commitment therapy smoking cessation treatment for smokers with depressive symptoms. Journal of Dual Diagnosis 2015;11(1):56-62.
Jones 2017 {published data only}
    1. Jones C, Bennett B.Smoking cessation using group auricular acupuncture and mindfulness. Journal of Spinal Cord Medicine 2017;40(5):623-4.
Karelka 2020 {published data only}
    1. Karelka M, Savvides SN, Gloster avatar-led intervention promotes smoking cessation in young adults: a pilot randomized clinical trial. Annals of Behavioral Medicine 2020;54(10):747-60.
Kochupillai 2005 {published data only}
    1. Kochupillai V, Kumar P, Singh D, Aggarwal D, Bhardwaj N, Bhutani M, et al.Effect of rhythmic breathing (Sudarshan Kriya and Pranayam) on immune functions and tobacco addiction. Annals of the New York Academy of Sciences 2005;1056:242-52.
Luberto 2016 {published data only}
    1. Luberto C, McLeish A.The effects of a brief mindfulness exercise on state mindfulness, smoking, and affective outcomes among adult smokers. Journal of Alternative and Complementary Medicine (New York, N.Y.) 2016;22(6):A82-A83.
Luk 2019 {published data only}
    1. Luk TT, Li WHC, Cheung DY, Wong SW, Kwont AC, Lai VW, et al.Chat-based instant messaging support combined with brief smoking cessation interventions for Chinese community smokers in Hong Kong: rationale and study protocol for a pragmatic, cluster-randomized controlled trial. Contemporary Clinical Trials 2019;77:70-5.
Luo 2018 {published data only}
    1. Luo M, Gardiner P, D'Amico S, Charlot M, Lasser KE, Kathuria H.Feasibility, acceptability, and effectiveness of a mindfulness-based smoking cessation program for cancer patients. Global Advances in Health and Medicine 2018;7:170.
Minami 2018 {published data only}
    1. Minami H, Brinkman HR, Nahvi S, Arnsten JH, Rivera-Mindt M, Wetter DW, et al.Rationale, design and pilot feasibility results of a smartphone-assisted, mindfulness-based intervention for smokers with mood disorders: Project mSMART MIND. Contemporary Clinical Trials 2018;66:36-44.
Mineyama 2019 {published data only}
    1. Mineyama Y, Hyder Ferry L, Arechiga A, Dos Santos H, Berk L.The effect of a tobacco dependence treatment program with stress management through mindfulness technique training in US veterans. Advances in Mind-body Medicine 2019;33(2):12-17.
Mujcic 2018 {published data only}
    1. Mujcic A, Blankers M, Boon B, Engels R, Van Laar M.Internet-based self-help smoking cessation and alcohol moderation interventions for cancer survivors: a study protocol of two RCTs. BMC Cancer 2018;18(1):364.
NCT01314378 {published data only}
    1. NCT01314378.Effects of intensive behavioral training program on impulsivity and inhibitory control in smokers (IBTP). first received 14 March 2011. [URL: ]
NCT04038255 {published data only}
    1. NCT04038255.Mindfulness based smoking cessation among cancer survivors. first received 30 July 2019. [URL: ]
Otto 2020 {published data only}
    1. Otto MW, Zvolensky MJ, Rosenfield D, Hoyt DL, Witkiewitz K, McKee SA, et al.A randomized controlled trial protocol for engaging distress tolerance and working memory to aid smoking cessation in low socioeconomic status (SES) adults. Health Psychology 2020;39(9):815-25.
Pakhale 2014 {published data only}
    1. Pakhale S, Armstrong MA, Garde A, Reid B, Aitken D, Mullen KA, et al.A pilot implementation of Buddhist mindfulness training, combined with the Ottawa model for smoking cessation in an out-patient respirology clinic setting. American Journal of Respiratory and Critical Care Medicine 2014;189:A2796.
Rogojanski 2011a {published data only}
    1. Rogojanski J, Vettese LC, Antony MM.Coping with cigarette cravings: comparison of suppression versus mindfulness-based strategies. Mindfulness 2011;2(1):14-26. [DOI: ]
Rogojanski 2011b {published data only}
    1. Rogojanski J, Vettese LC, Antony MM.Role of sensitivity to anxiety symptoms in responsiveness to mindfulness versus suppression strategies for coping with smoking cravings. Journal of Clinical Psychology 2011;67(4):439-45. [DOI: 10.1002/jclp.20774] [PMID: ]
Ruscio 2016 {published data only}
    1. Ruscio AC, Muench C, Brede E, Waters AJ.Effect of brief mindfulness practice on self-reported affect, craving, and smoking: a pilot randomized controlled trial using ecological momentary assessment. Nicotine & Tobacco Research 2016;18(1):64-73.
Sarkar 2017 {published data only}
    1. Sarkar BK, West R, Arora M, Ahluwalia JS, Reddy KS, Shahab L.Effectiveness of a brief community outreach tobacco cessation intervention in India: a cluster-randomised controlled trial (the BABEX Trial). Thorax 2017;72(2):167-73.
Schuman‐Olivier 2014 {published data only}
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Shahab 2013 {published data only}
    1. Shahab L, Sarkar BY, West R.The acute effects of yogic breathing exercises on craving and withdrawal symptoms in abstaining smokers. Psychopharmacology 2013;225(4):875-82. [DOI: 10.1007/s00213-012-2876-9] [PMID: ]
Sharma 2013 {published data only}
    1. Sharma MP, Sharma MK.Mindfulness, an integrated approach for cessation of smoking in workplace. International Journal of Yoga 2013;6(1):80.
Sidhu 2016 {published data only}
    1. Sidhu AK, Sussman S, Tewari A, Bassi S, Arora M.Project EX-India: a classroom-based tobacco use prevention and cessation intervention program. Addictive Behaviors 2016;53:53-7.
Spears 2019 {published data only}
    1. Spears CA, Abroms LC, Glass CR, Hedeker D, Eriksen MP, Cottrell-Daniels C, et al.Mindfulness- based smoking cessation enhanced with mobile technology (iquit mindfully): pilot randomized controlled trial. JMIR mHealth and uHealth 2019;7(6):e13059.
Sussman 2004 {published data only}
    1. Sussman S, McCuller WJ, Zheng H, Pfingston YM, Miyano J, Dent CW.Project EX: a program of empirical research on adolescent tobacco use cessation. Tobacco Induced Diseases 2004;2(3):119-32.
Tang 2013 {published data only}
    1. Tang YY, Tang R, Posner MI.Brief meditation training induces smoking reduction. Proceedings of the National Academy of Sciences of the United States of America 2013;110(34):13971-5. [DOI: ]
Ussher 2009 {published data only}
    1. Ussher M, Cropley M, Playle S, Mohidin R, West R.Effect of isometric exercise and body scanning on cigarette cravings and withdrawal symptoms. Addiction 2009;104(7):1251-7. [DOI: 10.1111/j.1360-0443.2009.02605.x] [PMID: ]
Zeng 2016 {published data only}
    1. Zeng EY, Heffner JL, Copeland WK, Mull KE, Bricker JB.Get with the program: adherence to a smartphone app for smoking cessation. Addictive Behaviors 2016;63:120-4.
References to studies awaiting assessment Pumariega 2020 {published data only}
    1. Pumariega YN, Calheiros PR, Cardenas RN, Farias ED, Torres CD.Relapse prevention based on mindfulness in the treatment of tobacco dependence - Brazil [Prevenção de recaídas baseada em mindfulness no tratamento do tabagismo – Brasil]. CES Psicología 2020;13(2):129-43. [DOI: ]
References to ongoing studies CTRI/2020/01/022692 {published data only}CTRI/2020/01/022692
    1. CTRI/2020/01/022692.Yoga as a complementary intervention for tobacco cessation: a PROBE trial. first received 10 January 2020. [URL: ]
NCT01098955 {published data only}
    1. NCT01098955.Smoking cessation treatment for head & neck cancer patients. first received 5 April 2010. []
NCT01982110 {published data only}
    1. NCT01982110.A mindfulness based application for smoking cessation (MBSC). first received 13 November 2013. [URL: ]
NCT02037360 {published data only}
    1. NCT02037360.Mobile mindfulness training for smoking cessation. first received 15 January 2014. [URL: ]
NCT02421991 {published data only}
    1. NCT02421991.Telephone-delivered interventions for smoking cessation (TALK). first received 21 April 2015.
NCT03253445 {published data only}
    1. NCT03253445.Individual Acceptance and Commitment Therapy (ACT) for smoking cessation for schizophrenic patients. first received 17 August 2017.
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