Nicotine dependence is a tough addiction to beat. About half of current U.S. smokers actually gave up cigarettes for more than a day within the past year, but then relapsed. So it’s good news when a quit-smoking approach increases the odds of long-term success. And it’s great news when that approach blows the gold standard treatment out of the water.
That’s what happened in a recent study of mindfulness for smoking cessation. The study, published in Drug and Alcohol Dependence in 2011, included 88 adults who smoked at least half a pack per day and wanted to quit. Participants were randomly assigned to eight sessions of either mindfulness training or a standard quit-smoking program. The standard program focused on strategies such as avoiding smoking triggers and making lifestyle changes.
The mindfulness group showed a greater reduction rate in smoking, which lasted after the treatment was over. Four months later, 31% of those in the mindfulness group were smoke-free, compared to only 6% in the standard treatment group. This was the first randomized clinical trial to look at mindfulness training as a stand-alone approach for quitting smoking. More research is needed to confirm the results, but they certainly seem encouraging.
Recently, I had a chance to chat with lead researcher Judson Brewer, MD, PhD, medical director of the Yale Therapeutic Neuroscience Clinic. In our conversation below, he explains how practicing mindfulness might help you quit smoking for good.
How did you become interested in using mindfulness to help people break free from addiction?
Dr. Brewer: I noticed that people who have addictions and those who teach mindfulness speak the same language. Mindfulness teachers will tell you that stress is caused by craving. If you can let go of that craving, then your stress will dissolve, and practicing mindfulness is the way to do that.
People with addictions understand craving better than most of us. For them, craving is a very concrete, immediate problem that’s causing havoc in their lives, and they’re looking for a solution.
Were you surprised that, in your study, mindfulness training worked better than the standard behavioral approach to quitting smoking?
Dr. Brewer: Yes, pleasantly! I liken it to having weeds in your garden. Standard treatments—for example, avoiding triggers such as ashtrays and lighters or using substitutes such as eating carrot sticks and chewing on your pen—just pull the heads off the weeds, so they grow back. These treatments don’t uproot the craving itself. In contrast, mindfulness really gets in there and pulls up the roots.
Let’s talk specifics. How do you teach people to use mindfulness to manage a craving for nicotine?
Dr. Brewer: In my clinical practice, I use the acronym RAIN:
How does this process affect craving over time?
Dr. Brewer: Each time you ride out a craving, it gets weaker. Think of your craving as a screaming child in the grocery store. You could give your child a lollipop, but that’s only a temporary solution; he’ll start screaming again as soon as the lollipop is gone. You could clap your hand over your child’s mouth, but he’ll scream louder than ever as soon as you move your hand. In the same way, feeding a craving or trying to suppress it never works for long.
So what can you do instead? You can lovingly and patiently hold your child until the screaming stops. It might be uncomfortable for a while, but eventually your child will get tired and quit screaming. The next time your child screams, it won’t be as loud or as long. And the time after that, it will be less intense and shorter still, until eventually your child gives up screaming altogether. That’s how you train children—and how you tame cravings.