Top

International Journal of Mental Health and Addiction

Published in:

01-04-2014

A Randomized Controlled Trial of a Mindfulness-Based Smoking Cessation Program for Individuals with Mild Intellectual Disability

Authors: Nirbhay N. Singh, Giulio E. Lancioni, Rachel E. Myers, Bryan T. Karazsia, Alan S. W. Winton, Judy Singh

Published in: International Journal of Mental Health and Addiction | Issue 2/2014

Abstract

Smoking is a risk factor for death and dying for individuals who smoke and for those who inhale second hand smoke. Smokers struggle to quit smoking because of the negative affect associated with nicotine withdrawal. We assessed the efficacy of a mindfulness-based intervention for smoking cessation in individuals with mild intellectual disabilities. In addition to the basic concentration meditation, the mindfulness-based smoking cessation program included daily intention, mindful observation of thoughts, and Meditation on the Soles of the Feet. In a two-group randomized controlled trial, 51 protocol-eligible participants were randomly assigned to either the experimental group (mindfulness-based intervention) or the control group (treatment as usual). Results showed a statistically significant reduction in smoking commensurate with mindfulness-based training when compared to the treatment as usual condition. This finding was evident regardless of whether the analysis included only those who completed the study or the total sample in an intent-to-treat analysis. Furthermore, those receiving the mindfulness-based intervention were significantly more successful in abstaining from smoking during a 1-year follow-up than the treatment as usual group. These results suggest mindfulness-based interventions may be effective treatments for smoking cessation in individuals with mild intellectual disabilities.

Abrantes, A. M., Strong, D. R., Lejuez, C. W., Kahler, C. W., Carpenter, L. L., Price, L. H., Niaura, R., & Brown, R. A. (2008). The role of negative affect in risk for early lapse among low distress tolerance smokers. Addictive Behaviors, 33, 1394–1401.PubMedCentralPubMedCrossRef

Adams, C. E., Heppner, W. L., Houchins, S., Stewart, D. W., Vidrine, J. I., & Wetter, D. W. (2014). Mindfulness meditation and addictive behaviors. In N. N. Singh (Ed.), Psychology of meditation (pp. 311–343). New York: Nova Science.

Baer, R. A., Smith, G., Hopkins, J., Krietemeyer, J., & Toney, L. (2006). Using self-report assessment methods to explore facets of mindfulness. Assessment, 13, 27–45.PubMedCrossRef

Barlow, D. H., Nock, M. K., & Hersen, M. (2009). Single case experimental designs: strategies for studying behavior change (3rd ed.). Boston, MA: Allyn & Bacon.

Behan, D. F., Eriksen, M. P., & Lin, Y. (2005). Economic effects of environmental tobacco smoke report. Schaumburg, IL: Society of Actuaries.

Bowen, S., & Marlatt, A. (2009). Surfing the urge: brief mindfulness-based intervention for college student smokers. Psychology of Addictive Behaviors, 23, 666–671.PubMedCrossRef

Bowen, S., Chawla, N., Collins, S. E., Witkiewitz, K., Hsu, S., Grow, J., Clifasefi, S., Garner, M., Douglass, A., Larimer, M. E., & Marlatt, A. (2009). Mindfulness-based relapse prevention for substance use disorders: a pilot efficacy trial. Substance Abuse, 30, 295–305.PubMedCentralPubMedCrossRef

Brewer, J. A., Sinha, R., Chen, J. A., Michalsen, R. N., Babuscio, T. A., Nich, C., Grier, A., Bergquist, K. L., Reis, D. L., Potenza, M. N., Carroll, K. M., & Rounsaville, B. J. (2009). Mindfulness training and stress reactivity in substance abuse: results from a randomized, controlled stage I pilot study. Substance Abuse, 30, 306–317.PubMedCentralPubMedCrossRef

Brewer, J. A., Mallik, S., Babuscio, T. A., Nich, C., Johnson, H. E., Deleone, C. M., Minnix-Cotton, C. A., Byrne, S. A., Kober, H., Weinstein, A. J., Carroll, K. M., & Rounsaville, B. J. (2011). Mindfulness training for smoking cessation: results from a randomized controlled trial. Drug and Alcohol Dependence, 119, 72–80.PubMedCentralPubMedCrossRef

Brown, R. A., Lejuez, C. W., Kahler, C. W., Strong, D. R., & Zvolensky, M. J. (2005). Distress tolerance and early smoking lapse. Clinical Psychology Review, 25, 713–733.PubMedCentralPubMedCrossRef

Carim-Todd, L., Mitchell, S. H., & Oken, B. S. (2013). Mind-body practices: an alternative, drug-free treatment for smoking cessation? A systematic review of the literature. Drug and Alcohol Dependence, 132, 399–410.PubMedCrossRef

Centers for Disease Control and Prevention. (2008). Smoking attributable mortality, years of potential life lost, and productivity losses—United States, 2000-2004. Morbidity and Mortality Weekly Report, 57, 1226–1228.

Centers for Disease Control and Prevention. (2012). Current cigarette smoking among adults—United States, 2011. Morbidity and Mortality Weekly Report, 61, 889–894.

Davis, J. M., Fleming, M. F., Bonus, K. A., & Baker, T. B. (2007). A pilot study on mindfulness based stress reduction for smokers. BMC Complementary and Alternative Medicine, 7, 2. doi:10.1186/1472-6882-7-2.PubMedCentralPubMedCrossRef

Emerson, E., & Turnbull, L. (2005). Self-reported smoking and alcohol use among adolescents with intellectual disabilities. Journal of Intellectual Disabilities, 9, 58–69.PubMedCrossRef

Foerde, K., Knowlton, B. J., & Poldrack, R. A. (2006). Modulation of competing memory systems by distraction. Proceedings of the National Academy of Sciences, 103, 11778–11783.CrossRef

Gonzalez, A., Zvolensky, M. J., Vujanovic, A., Leyro, T. M., & Marshall, E. C. (2008). An evaluation of anxiety sensitivity, emotional dysregulation, and negative affectivity among daily cigarette smokers: relation to smoking motives and barriers to quitting. Journal of Psychiatric Research, 43, 138–147.PubMedCentralPubMedCrossRef

Harper, S. K., Webb, T. L., & Rayner, K. (2013). The effectiveness of mindfulness-based interventions for supporting people with intellectual disabilities: a narrative review. Behavior Modification, 37, 431–453.PubMedCrossRef

Hwang, Y.-S., & Kearney, P. (2013). A systematic review of mindfulness intervention for individuals with developmental disabilities: long-term practice and long lasting effects. Research in Developmental Disabilities, 34, 314–326.PubMedCrossRef

Jha, P., Ramasundarahettige, C., Landsman, V., Rostron, B., Thun, M., Anderson, R. N., McAfee, T., & Peto, R. (2013). 21st century hazards of smoking and benefits of cessation in the United States. New England Journal of Medicine, 36, 341–350.CrossRef

Kabat-Zinn, J. (1990). Full catastrophe living: how to cope with stress, pain and illness using mindfulness meditation. New York: Dell.

Kalyva, E. (2007). Prevalence and influences on self-reported smoking among adolescents with mild learning disabilities, attention deficit hyperactivity disorder, and their typically developing peers. Journal of Intellectual Disabilities, 11, 267–279.PubMedCrossRef

Katz, R. C., & Singh, N. N. (1986). Reflections on the ex-smoker: some findings on successful quitters. Journal of Behavioral Medicine, 9, 191–202.PubMedCrossRef

Marlatt, G. A., & Gordon, J. R. (1985). Relapse prevention: maintenance strategies in the treatment of addictive behaviors. New York: Guilford Press.

Mazumdar, S., Liu, K. S., Houck, P. R., & Reynolds, C. F. (1999). Intent-to-treat analysis for longitudinal clinical trials: coping with the challenge of missing values. Journal of Psychiatric Research, 33, 87–96.PubMedCrossRef

McDonald, K. (2005). How to meditate. Boston, MA: Wisdom Publications.

Michael, R. B., Garry, M., & Kirsch, I. (2012). Suggestion, cognition, and behavior. Current Directions in Psychological Science, 21, 151–156.CrossRef

Myers, R. E., Winton, A. S. W., Lancioni, G. E., & Singh, N. N. (2014). Mindfulness in developmental disabilities. In N. N. Singh (Ed.), Psychology of meditation (pp. 209–240). New York: Nova Science.

Peine, H. A., Darvish, R., Blakelock, H., Osborne, J. G., & Jenson, W. R. (1998). Non-aversive reduction of cigarette smoking in two adult men in a residential setting. Journal of Behavior Therapy and Experimental Psychiatry, 29, 55–65.PubMedCrossRef

Robertson, J., Emerson, E., Gregory, N., Hatton, C., Turner, S., Kessissoglou, S., & Hallam, A. (2000). Lifestyle related risk factors for poor health in residential settings for people with intellectual disabilities. Research in Developmental Disabilities, 21, 469–486.PubMedCrossRef

Rogojanski, J., Vettese, L. C., & Antony, M. M. (2011). Coping with cigarette cravings: comparison of suppression versus mindfulness-based strategies. Mindfulness, 2, 14–26.CrossRef

Schnoll, R. A., Patterson, F., Wileyto, E. P., Tyndale, R. F., Benowitz, N., & Lerman, C. (2009). Nicotine metabolic rate predicts successful smoking cessation with transdermal nicotine: a validation study. Pharmacology, Biochemistry and Behavior, 92, 6–11.PubMedCentralPubMedCrossRef

Shapiro, S. L., & Carlson, L. E. (2009). The art and science of mindfulness: integrating mindfulness into psychology and the helping professions. Washington: American Psychological Association.CrossRef

Singh, N. N., & Leung, J. P. (1988). Smoking cessation through cigarette-fading, self-recording, and contracting: treatment, maintenance and long-term follow-up. Addictive Behaviors, 13, 101–105.PubMedCrossRef

Singh, N. N., Lancioni, G. E., Winton, A. S. W., Singh, A. N. A., Singh, J., & Singh, A. D. A. (2011a). Effects of a mindfulness-based smoking cessation program for an adult with mild intellectual disability. Research in Developmental Disabilities, 32, 1180–1185.CrossRef

Singh, N. N., Singh, J., Adkins, A. D., Singh, A. N., & Winton, A. S. W. (2011b). Meditation on the soles of the feet: a trainer’s manual. Raleigh: Fernleaf (www.fernleafpub.com).

Singh, N. N., Lancioni, G. E., Winton, A. S. W., Singh, A. N., Adkins, A. D., & Singh, J. (2011c). Can adult offenders with intellectual disabilities use mindfulness-based procedures to control their deviant sexual arousal? Psychology, Crime and Law, 17, 165–179.CrossRef

Singh, N. N., Lancioni, G. E., Winton, A. S. W., Karazsia, B. T., Singh, A. D. A., Singh, J., Singh, A. N. A., & Singh, J. (2013a). A mindfulness-based smoking cessation program for individuals with mild intellectual disability. Mindfulness, 4, 148–157.CrossRef

Singh, N. N., Lancioni, G. E., Karazsia, B. T., Winton, A. S. W., Myers, R. E., Singh, A. N. A., Singh, A. D. A., & Singh, J. (2013b). Mindfulness-based treatment of aggression in individuals with intellectual disabilities: a waiting-list control study. Mindfulness, 4, 158–167.CrossRef

The Cochrane Collaboration (2002). Intent to treat issues. Retrieved from: http://www.cochrane-net.org/openlearning/html/mod14–4.htm.

Tracy, J., & Hosken, R. (1997). The importance of smoking education and preventive health strategies for people with intellectual disability. Journal of Intellectual Disability Research, 41, 416–421.PubMedCrossRef

Tsering, T. G. (2005). The four noble truths. Boston, MA: Wisdom.

Tsering, T. G. (2006). Buddhist psychology. Boston, MA: Wisdom.

U.S. Department of Health and Human Services. (2010). How tobacco smoke causes disease: the biology and behavioral basis for smoking-attributable disease. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health.

West, R., Hajek, P., Stead, L., & Stapleton, J. (2005). Outcome criteria in smoking cessation trials: proposal for a common standard. Addiction, 100, 299–303.PubMedCrossRef

Title: A Randomized Controlled Trial of a Mindfulness-Based Smoking Cessation Program for Individuals with Mild Intellectual Disability
Authors: Nirbhay N. Singh
Giulio E. Lancioni
Rachel E. Myers
Bryan T. Karazsia
Alan S. W. Winton
Judy Singh
Publication date: 01-04-2014
Publisher: Springer US
Published in: International Journal of Mental Health and Addiction / Issue 2/2014
Print ISSN: 1557-1874
Electronic ISSN: 1557-1882
DOI: https://doi.org/10.1007/s11469-013-9471-0

Keynote webinar | Spotlight on medication adherence

Springer Medicine

A Randomized Controlled Trial of a Mindfulness-Based Smoking Cessation Program for Individuals with Mild Intellectual Disability

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 2/2014

Foundations of Mindfulness and Contemplation: Traditional and Contemporary Perspectives

Mindfulness-Enhanced Cognitive Behavior Therapy for Problem Gambling: A Controlled Pilot Study

A Trial of Mindfulness Meditation to Reduce Anger and Violence in Thai Youth

Mechanisms of Action in the Relationship between Mindfulness and Problem Gambling Behaviour

Cognitive Behavioral Therapy (CBT) and Meditation Awareness Training (MAT) for the Treatment of Co-occurring Schizophrenia and Pathological Gambling: A Case Study

Shenpa and Compassionate Abiding: Mindfulness-Based Practices for Anger and Aggression by Individuals with Schizophrenia