Mindfulness training for smoking cessation: Moderation of the relationship between craving and cigarette use

Hani M. Elwafi, Katie Witkiewitz, Sarah Mallik, Thomas A.Thornhill IV, Judson A. Brewer

Research output: Contribution to journalArticlepeer-review

112 Scopus citations


Background: Smoking is the leading cause of preventable death in the US, while abstinence rates remain modest. Smoking has been shown to be perpetuated by operant conditioning, notably negative reinforcement (e.g., smoking to relieve negative affective states). Mindfulness training (MT) shows promise for smoking cessation, by potentially altering an individual's tendency to smoke in response to craving. The purpose of this study was to examine the effects of MT and mindfulness practice on the relationship between smoking and craving after receiving four weeks of MT. Methods: 33 adults received MT as part of a randomized trial for smoking cessation. Individuals in the MT condition recorded formal and informal mindfulness practice during treatment using daily diaries. Results: Analyses showed that strong correlations between craving and smoking at baseline (r=0.582) were attenuated at the end of treatment (r=0.126). Mindfulness home practice significantly predicted cigarette use (formal: B=-1.21, p=0.007; informal: B=-1.52, p<0.0001) and informal practice moderated the relationship between craving and smoking at the end of treatment (B=0.52, p=0.03). Conclusions: These findings suggest that MT may be effective as a treatment for smoking cessation and that informal mindfulness practice predicts a decoupling of the association between craving and smoking.

Original languageEnglish (US)
Pages (from-to)222-229
Number of pages8
JournalDrug and Alcohol Dependence
Issue number1-3
StatePublished - Jun 1 2013
Externally publishedYes


  • Addiction
  • Associative learning
  • Craving
  • Incentive salience
  • Mindfulness
  • Negative reinforcement
  • Nicotine dependence
  • Tobacco

ASJC Scopus subject areas

  • Toxicology
  • Pharmacology
  • Psychiatry and Mental health
  • Pharmacology (medical)


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