Study provides insight into how mindfulness training works in the brain to help people quit smoking

New research provides evidence that a mindfulness-based app can help people stop smoking — and it appears to help by reducing brain reactivity to smoking cues. The study has been published in the journal Neuropsychopharmacology.

“Current programs to help people quit smoking are focused on cognitive control/will-power, which ironically depends on the weakest part of our brain,” said study author Judson Brewer, an associate professor and the director of research and innovation at Brown University Mindfulness Center.”Perhaps not surprisingly, their efficacy rates are suboptimal.”

“We did a study a few years back and found that mindfulness training was 5 times better than this ‘gold standard’ at helping people quit. We had also studied the brains of expert meditators and found that the same region that gets activated with craving gets deactivated during meditation,” Brewer said.

“We wanted to see if an app-based mindfulness training (Craving to Quit) could target that same brain region, which would be the first study to identify the neural mechanisms of mindfulness for smoking cessation.”

In a randomized controlled trial, Brewer and his colleagues compared 33 participants who used the mindfulness-based app to 34 participants who used a free smoking-cessation app from the National Cancer Institute (NCI).

The mindfulness app includes daily videos and activities to help users identify their smoking triggers, become more aware of cravings and learn mindfulness methods to ride out the cravings. The NCI app helps users track smoking triggers, provides inspirational messages and delivers distractions to help users deal with cravings.

All of the participants were smoking at least 10 cigarettes per day and were instructed to use their respective app to help them quit over the next 4-week period. The participants also underwent functional magnetic resonance imaging brain scans before and after the 4-week period.

The researchers found that participants who used the mindfulness app for a month reduced their self-reported daily cigarette consumption by 11 cigarettes per day on average. The NCI app users also reduced cigarette consumption by 9 cigarettes per day on average. Some participants in both groups reported smoking no cigarettes by the end of the month.

Brewer and his colleagues also found that posterior cingulate cortex reactivity predicted a reduction in cigarette smoking among those who used the mindfulness-based app. In other words, participants who had the greatest reduction in number of cigarettes per day also showed a significant reduction in brain reactivity to smoking images.

“We now know how mindfulness training works in the brain to help people quit smoking: it targets the same cue-reactive network (the default mode network), in a dose-dependent manner — the more modules people completed of the Craving to Quit app, the better they did (no correlations were found in the control group),” Brewer told PsyPost.

The long-term impact of the mindfulness-based app, however, is still unclear. “Future studies will need to replicate these results and look at later timepoints,” Brewer said.

The study, “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“, was authored by Amy C. Janes, Michael Datko, Alexandra Roy, Bruce Barton, Susan Druker, Carolyn Neal, Kyoko Ohashi, Hanif Benoit, Remko van Lutterveld, and Judson A. Brewer.