What Is Mindfulness And How Can It Help You To Quit Smoking?

There is a thing that we sometimes forget that accompanies us from life to death, breaths. The dazzling attractiveness of mindfulness meditation in our fast-paced society is not surprising as it helps us to come back to the essential, just breathing and enjoying the present moment for a happier life. How simple can that seem? If you have already tried it, then you know that it is not as simple as that, and that there are many kinds of meditation out there. We will answer a few questions that you might have: Where did it come from? What kind is best for me? Do I have to believe in some sort of spiritual spirit? And how can it help to prevent a relapse during a smoking cessation?

Before we start, how about we give it a try?

Stand, sit or lay comfortably upright and place one hand on your stomach and the other one on your chest. If you feel comfortable, you can close your eyes to better concentrate. Pay attention to your breathing without trying to control it. Simply feel the cold air coming in through your nose and coming out warmer. After each exhalation, feel the relaxation that gradually settles in your whole body. If you notice that you get lost in your thoughts, observe what is happening without judgment and return peacefully to the breath.
Continue for as long as you like, and when you stop, think about how you feel in the present moment.

Soothing, right?

Western origins and its development

Mindfulness based interventions (MBIs) in the West have been influenced by ancient Buddhist practices without integrating the spiritual aspect. It is therefore a laic practice adapted to our current society. A commonly used definition of mindfulness is intentionally paying attention to the present moment by accepting the experience lived without judgment¹. It is the ability to disconnect from draining day-to-day activities that consist of planning, problem-solving, forward thinking and more in order to truly experience what we refer to as the “present moment”. By acknowledging without judgment our body position, our breath, our feelings, thoughts and emotions, we are able to reduce distress and foster well-being^2,6.

The first evidence-based program, Mindfulness-Based Stress Reduction (MBSR), was developed at the University of Massachusetts Medical Center in the 1970s by Professor Jon Kabat-Zinn. It was first designed to be a non-invasive intervention for people with chronic pain. Having observed numerous benefits on health, anxiety and depression, this 8-week meditation program was then used to reduce anxiety, stress, depression and pain among healthy people^2,3,4. Its ingredients are a combination of mindfulness meditation, body awareness and yoga along with an exploration of different behavioral patterns such as thinking, feeling and taking action^2,5.

Subsequently, a group of researchers who wanted to find a solution to prevent relapses in patients who had experienced several depressions turned to mindfulness. They noticed that psychiatric treatments at the time were not able to offer tools to prevent relapses and that it was generally the negative thoughts in spiral that precipitated relapses. Thus, they developed Mindfulness-Based Cognitive Therapy (MBCT)⁷ influenced by the MBSR program of Professor Kabat-Zinn. Therefore, MBCT uses both aspects of mindfulness and Cognitive Behavioral Therapy. Since then, several researches have shown its effectiveness in relapse prevention of depression⁸ and anxiety^9,10. Other psychological interventions, such as Acceptance and Commitment Therapy or Dialectical Behavioral Therapy, have subsequently incorporated mindfulness into their interventions.

About addiction relapse prevention

A group of researchers in Portland, U.S.A., have created a mindfulness-based intervention that incorporates Relapse Prevention Therapy, Mindfulness-Based Relapse Prevention (MBRP). Relapse Prevention is a traditional cognitive behavioral therapy that aims to prevent or manage behaviors that lead to relapse. The addition of mindfulness brings a caring and nonjudgmental side to one's addiction. Instead of trying to escape or control one's behaviors, MBRP teaches participants to observe their experiences in the present moment, detach and accept them without judgment. People struggling with addictions often feel shame or guilt and the practice of mindfulness helps to detach from these unrealistic thoughts, increasing self-kindness and one's tolerance for discomfort¹¹.

MBRP is especially well known for it’s Urge Surfing technique which is designed to change the relationship with an intense craving. Normally, people tend to either try to fight the urge to smoke or try to ignore it and hope it goes away. On the contrary, Urge Surfing involves not considering the urge to smoke as a threat, but to stay with it in a curious and compassionate way. Participants are then taught to ride the urge to smoke like a wave that increases in intensity, but will eventually decrease. The urge to smoke will inevitably come back like a wave, but as you practice more and more surfing you become more adept at controlling it¹¹. Just like surfing, you might fall. But it is acceptable because you will learn from it and get better after all.

Through the practice of mindfulness, people with intense cravings to smoke might be able to take a moment to detach from the cravings, observe them without judgment and without getting carried away, then surf with the craving instead of reproducing their habitual behaviors by lighting a cigarette. This 8 weeks group therapy brings people to a better quality of life, less anxiety and depression as well as preventing relapses for many types of addictions¹².

As more recent research has been done on online or digitized mindfulness-based intervention¹³, Ditch Labs seeks to develop a brief online MBRP in its self-help application. These tools have been proven by several researches to prevent relapse of several addictions such as alcohol, tobacco, drugs¹¹, and will definitely come in handy to manage an urge to smoke during the smoking cessation process.

References

¹Kabat-Zinn, J. (1994) Wherever you go, there you are: Mindfulness meditation in everyday life. Hyperion Books: New York.

²Kabat-Zinn, J. (2013). Full Catastrophe Living: Using the Wisdom of Your Body and Mind to Face Stress, Pain, and Illness. New York: Bantam Dell. ISBN 978-0345539724.

³Creswell, J. D. & Khoury, B. (2019, October 30). Mindfulness meditation: A research-proven way to reduce stress. American Psychological Association. https://www.apa.org/topics/mindfulness/meditation.

⁴Paulus, M. P. (2016). Neural Basis of Mindfulness Interventions that Moderate the Impact of Stress on the Brain. Neuropsychopharmacology: Official Publication of the American College of Neuropsychopharmacology, 41(1), 373. https://doi.org/10.1038/npp.2015.239.

⁵Kabat-Zinn, J. (2003). Mindfulness-based interventions in context: Past, present, and future. Clinical Psychology: Science and Practice, 10(2), 144–156. https://doi.org/10.1093/clipsy.bpg016.

⁶Creswell, J. D. (2017). Mindfulness Interventions. Annual Review of Psychology, 68, 491–516. https://doi.org/10.1146/annurev-psych-042716-051139.

⁷Segal, Z. V., Williams, J. M. G., & Teasdale, J. D. (2002). Mindfulness Based cognitive therapy for depression: A new approach to preventing relapse. New York: Guilford Press.

⁸Kuyken, W., Warren, F. C., Taylor, R. S., Whalley, B., Crane, C., Bondolfi, G., Hayes, R., Huijbers, M., Ma, H., Schweizer, S., Segal, Z., Speckens, A., Teasdale, J. D., Van Heeringen, K., Williams, M., Byford, S., Byng, R., & Dalgleish, T. (2016). Efficacy of Mindfulness-Based Cognitive Therapy in Prevention of Depressive Relapse: An Individual Patient Data Meta-analysis From Randomized Trials. JAMA Psychiatry, 73(6), 565–574. https://doi.org/10.1001/jamapsychiatry.2016.0076.

⁹Kim, Y. W., Lee, S.-H., Choi, T. K., Suh, S. Y., Kim, B., Kim, C. M., Cho, S. J., Kim, M. J., Yook, K., Ryu, M., Song, S. K., & Yook, K.-H. (2009). Effectiveness of mindfulness-based cognitive therapy as an adjuvant to pharmacotherapy in patients with panic disorder or generalized anxiety disorder. Depression and Anxiety, 26(7), 601–606. https://doi.org/10.1002/da.20552.

¹⁰Marchand, W. R. (2012). Mindfulness-based stress reduction, mindfulness-based cognitive therapy, and Zen meditation for depression, anxiety, pain, and psychological distress. Journal of Psychiatric Practice, 18(4), 233–252. https://doi.org/10.1097/01.pra.0000416014.53215.86.

¹¹Bowen, S., Chawla, N., Grow, N. & Marlatt, G.A. (2021). Mindfulness-Based Relapse Prevention for Addictive Behaviors. A Clinician’s Guide (2nd ed.). Guilford Press: New York.

¹²Grant, S., Colaiaco, B., Motala, A., Shanman, R., Booth, M., Sorbero, M., & Hempel, S. (2017). Mindfulness-based Relapse Prevention for Substance Use Disorders: A Systematic Review and Meta-analysis. Journal of Addiction Medicine, 11(5), 386–396. https://doi.org/10.1097/ADM.0000000000000338.

¹³Apolinário-Hagen, J., Drüge, M., & Fritsche, L. (2020). Cognitive Behavioral Therapy, Mindfulness-Based Cognitive Therapy and Acceptance Commitment Therapy for Anxiety Disorders: Integrating Traditional with Digital Treatment Approaches. Advances in Experimental Medicine and Biology, 1191, 291–329. https://doi.org/10.1007/978-981-32-9705-0_17.