Journal Article

Craving to Quit: A Randomized Controlled Trial of Smartphone App–Based Mindfulness Training for Smoking Cessation

Garrison, Kathleen A, Rojiani, Rahil, O’Malley, Stephanie S, Pal, Prasanta, Dallery, Jesse, Pittman, Brian P, Brewer, Judson A, Scheinost, Dustin, Gueorguieva, Ralitza

2020

Overview

Abstract Introduction Mindfulness training may reduce smoking rates and lessen the association between craving and smoking. This trial tested the efficacy of mindfulness training via smartphone app to reduce smoking. Experience sampling (ES) was used to measure real-time craving, smoking, and mindfulness. Methods A researcher-blind, parallel randomized controlled trial compared the efficacy of mobile mindfulness training with experience sampling (MMT-ES; Craving to Quit) versus experience sampling only (ES) to (1) increase 1-week point-prevalence abstinence rates at 6 months, and (2) lessen the association between craving and smoking. A modified intent-to-treat approach was used for treatment starters (MMT-ES n = 143; ES n = 182; 72% female, 81% white, age 41 ± 12 year). Results No group difference was found in smoking abstinence at 6 months (overall, 11.1%; MMT-ES, 9.8%; ES, 12.1%; χ2(1) = 0.43, p = .51). From baseline to 6 months, both groups showed a reduction in cigarettes per day (p < .0001), craving strength (p < .0001) and frequency (p < .0001), and an increase in mindfulness (p < .05). Using ES data, a craving by group interaction was observed (F(1,3785) = 3.71, p = .05) driven by a stronger positive association between craving and cigarettes per day for ES (t = 4.96, p < .0001) versus MMT-ES (t = 2.03, p = .04). Within MMT-ES, the relationship between craving and cigarettes per day decreased as treatment completion increased (F(1,104) = 4.44, p = .04). Conclusions Although mindfulness training via smartphone app did not lead to reduced smoking rates compared with control, our findings provide preliminary evidence that mindfulness training via smartphone app may help lessen the association between craving and smoking, an effect that may be meaningful to support quitting in the longer term. Implications This is the first reported full-scale randomized controlled trial of any smartphone app for smoking cessation. Findings provide preliminary evidence that smartphone app-based MMT-ES may lessen the association between craving and smoking. Trial registration Clinicaltrials.gov NCT02134509.

• Publisher: Oxford University Press
• Subject: Adult / Craving / Ecological Momentary Assessment - statistics & numerical data / Female / Health Behavior / Humans / Male / Mindfulness - methods / Mobile Applications - statistics & numerical data / Original Investigations / Smartphone - statistics & numerical data / Smoking - psychology / Smoking - therapy / Smoking Cessation - methods / Smoking Cessation - psychology