Skip to main content

Advertisement

SpringerLink
Log in

Coping with Cigarette Cravings: Comparison of Suppression Versus Mindfulness-Based Strategies

  • ORIGINAL PAPER
  • Published:
Mindfulness Aims and scope Submit manuscript

Abstract

Mindfulness- and acceptance-based therapies have been explored within the context of addiction treatment, with some preliminary success. The current empirical study investigated the effectiveness of a brief suppression versus mindfulness-based strategy for coping with cigarette cravings. Participants (N = 61; M age = 40.34 years, SD = 12.42) were randomly assigned to using one of the two coping strategies to help them manage cravings during an experimental cue exposure to cigarettes. Participants completed self-report measures of self-efficacy, craving, negative affect, depression, and nicotine dependence before and after the cue exposure and at a 7-day follow-up assessment session. Participants in both conditions reported significantly reduced amount of smoking and increased self-efficacy in coping with smoking urges at the 7-day follow-up. However, only participants in the mindfulness condition demonstrated reductions in negative affect, depressive symptoms, and marginal reductions in their level of nicotine dependence. These findings suggest that, although both conditions were associated with improvements on smoking relevant outcomes, only mindfulness had beneficial effects on reported nicotine dependence and emotional functioning over the course of the study. These findings provide preliminary support for the use of mindfulness-based strategies for coping with smoking urges, as these strategies appear to provide some additional benefits not obtained when coping with smoking cravings through suppression.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Anda, R. F., Croft, J. B., Felitti, V. J., Nordenberg, D., Giles, W. H., Williamson, D. F., et al. (1999). Adverse childhood experiences and smoking during adolescence and adulthood. Journal of the American Medical Association, 282, 1652–1658.

    Article  PubMed  Google Scholar 

  • Arch, J. J., & Craske, M. G. (2006). Mechanisms of mindfulness: Emotion regulation following a focused breathing induction. Behaviour Research and Therapy, 44, 1849–1858.

    Article  PubMed  Google Scholar 

  • Baer, J. (2002). Student factors: Understanding individual variation in college drinking. Journal of Studies on Alcohol, 14, 40–53.

    Google Scholar 

  • Baer, R. A. (2003). Mindfulness training as a clinical intervention: A conceptual and empirical review. Clinical Psychology: Science and Practice, 10, 125–143.

    Article  Google Scholar 

  • Baer, J. S., Holt, C. S., & Lichtenstein, E. (1986). Self-efficacy and smoking reexamined: Construct validity and clinical utility. Journal of Consulting and Clinical Psychology, 54, 846–852.

    Article  PubMed  Google Scholar 

  • Bagot, K. S., Heishman, S. J., & Moolchan, E. T. (2007). Tobacco craving predicts lapse to smoking among adolescent smokers in cessation treatment. Nicotine & Tobacco Research, 9, 647–652.

    Article  Google Scholar 

  • Baker, T. B., Morse, E., & Sherman, J. E. (1986). The motivation to use drugs: a psychobiological analysis of urges. Nebraska Symposium on Motivation, 34, 257–323.

    PubMed  Google Scholar 

  • Barnier, A. J., Levin, K., & Maher, A. (2004). Suppressing thoughts of past events: are repressive copers good suppressors? Cognition and Emotion, 18, 513–531.

    Article  Google Scholar 

  • Bishop, S. R. (2002). What do we really know about mindfulness-based stress reduction? Psychosomatic Medicine, 64, 71–83.

    PubMed  Google Scholar 

  • Bowen, S., & Marlatt, G. A. (2007, November). Effects of mindfulness-based strategies on urges, negative affect, and smoking. Paper presented at the meeting of the Association for Behavioral and Cognitive Therapies, Philadelphia, PA.

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

    Article  PubMed  Google Scholar 

  • Bowen, S., Witkiewitz, K., Dillworth, T. M., & Marlatt, G. A. (2007). The role of thought suppression in the relationship between mindfulness meditation and alcohol use. Addictive Behaviors, 32, 2324–2328.

    Article  PubMed  Google Scholar 

  • Brandon, T. H., Tiffany, S. T., Obremski, K. M., & Baker, T. B. (1990). Postcessation cigarette use: the process of relapse. Addictive Behaviors, 15, 105–114.

    Article  PubMed  Google Scholar 

  • Breslau, N., Kilbey, M. M., & Andreski, P. (1992). Nicotine withdrawal symptoms and psychiatric disorders: Findings from an epidemiologic study of young adults. The American Journal of Psychiatry, 149, 464–469.

    PubMed  Google Scholar 

  • Breslin, F., Zack, M., & McMain, S. (2002). An information-processing analysis of mindfulness: implications for relapse prevention in the treatment of substance abuse. Clinical Psychology: Science and Practice, 9, 275–299.

    Article  Google Scholar 

  • Brown, R. A., Lewinsohn, P. M., Seeley, J. R., & Wagner, E. F. (1996). Cigarette smoking, major depression, and other psychiatric disorders among adolescents. Journal of the American Academy of Child and Adolescent Psychiatry, 35, 1602–1610.

    Article  PubMed  Google Scholar 

  • Brown, R. A., Burgess, E. S., Sales, S. D., Evans, D. M., & Miller, I. W. (1998). Reliability and validity of a smoking timeline follow-back interview. Psychology of Addictive Behaviors, 12, 101–112.

    Article  Google Scholar 

  • Carmody, T. P., Vieten, C., & Astin, J. A. (2007). Negative affect, emotional acceptance, and smoking cessation. Journal of Psychoactive Drugs, 39, 499–508.

    PubMed  Google Scholar 

  • Centers for Disease Control and Prevention. (2005). Smoking—attributable mortality, years of potential life lost, and economic costs—United States, 1997–2001. Washington, DC: CDC.

    Google Scholar 

  • Clark, D. M., Ball, S., & Pape, D. (1991). An experimental investigation of thought suppression. Behaviour Research and Therapy, 29, 253–257.

    Article  PubMed  Google Scholar 

  • Covey, L. S., Glassman, A. H., & Stetner, F. (1990). Depression and depressive symptoms in smoking cessation. Comprehensive Psychiatry, 31, 350–354.

    Article  PubMed  Google Scholar 

  • Covey, L. S., Glassman, A. H., & Stetner, F. (1997). Major depression following smoking cessation. The American Journal of Psychiatry, 154, 263–265.

    PubMed  Google Scholar 

  • Davidson, R. J., Kabat-Zinn, J., Schumacher, J., Rosenkranz, M., Muller, D., Santorelli, S. F., et al. (2003). Alterations in brain and immune function produced by mindfulness meditation. Psychosomatic Medicine, 65, 564–570.

    Article  PubMed  Google Scholar 

  • 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, 1–7.

    Article  Google Scholar 

  • Devilly, G. J., & Borkovec, T. D. (2000). Psychometric properties of the credibility/expectancy questionnaire. Journal of Behavior Therapy and Experimental Psychiatry, 31, 73–86.

    Article  PubMed  Google Scholar 

  • DiFranza, J. R., & Wellman, R. J. (2005). A sensitization-homeostasis model of nicotine craving, withdrawal, and tolerance: Integrating the clinical and basic science literature. Nicotine & Tobacco Research, 7, 9–26.

    Article  Google Scholar 

  • Ellison, L. F., Mao, Y., & Gibbons, L. (1995). Projected smoking-attributable mortality in Canada, 1991–2000. Chronic Diseases in Canada, 16, 84–89.

    Google Scholar 

  • Erblich, J., & Bovbjerg, D. H. (2004). In vivo versus imaginal smoking cue exposures: Is seeing believing? Experimental and Clinical Psychopharmacology, 12, 208–215.

    Article  PubMed  Google Scholar 

  • Fagerstrom, K. O., & Schneider, N. G. (1989). Measuring nicotine dependence: a review of the Fagerstrom Tolerance Questionnaire. Journal of Behavioral Medicine, 12, 159–182.

    Article  PubMed  Google Scholar 

  • Fagerstrom, K. O., Heatherton, T. F., & Kozlowski, L. T. (1991). Nicotine addiction and its assessment. Ear, Nose, & Throat Journal, 69, 763–765.

    Google Scholar 

  • Feldman, G., Hayes, A., Kumar, S., Greeson, J., & Laurenceau, J. (2007). Mindfulness and emotion regulation: the development and initial validation of the Cognitive and Affective Mindfulness Scale—revised (CAMS-R). Journal of Psychopathology and Behavioral Assessment, 29, 177–190.

    Article  Google Scholar 

  • Fiore, M. C., Bailey, W. C., Cohen, S. J., Dorfman, S. F., Gritz, E. R., Heyman, R. B., et al. (2000). Treating tobacco use and dependence. Clinical practice guideline. Rockville, MD: United States Department of Health and Human Services, Public Health Service.

    Google Scholar 

  • Fonder, M. A., Sacco, K. A., Termine, A., Boland, B. S., Seyal, A. A., Dudas, M. M., et al. (2005). Smoking cue reactivity in schizophrenia: effects of a nicotinic receptor antagonist. Biological Psychiatry, 57, 802–808.

    Article  PubMed  Google Scholar 

  • Garvey, A. J., Bliss, R. E., Hitchcock, J. L., Heinold, J. W., & Rosner, B. (1992). Predictors of smoking relapse among self-quitters: a report from the normative aging study. Addictive Behaviors, 17, 367–377.

    Article  PubMed  Google Scholar 

  • Ghadirian, P. (2004). Sleeping with a killer: The effect of smoking on human health. A report from Tobacco Control Programme, Health Canada

  • Glassman, A. H. (1993). Cigarette smoking: Implications for psychiatric illness. The American Journal of Psychiatry, 150, 546–553.

    PubMed  Google Scholar 

  • Glassman, A. H., Helzer, J. E., Covey, L. S., Cottler, L. B., Stetner, F., Tipp, J. E., et al. (1990). Smoking, smoking cessation, and major depression. Journal of the American Medical Association, 12, 1546–1549.

    Article  Google Scholar 

  • Gonzalez, A., Vujanovic, A. A., Johnson, K. A., Leyro, T. M., & Zvolensky, M. J. (2009). The role of mindful attention in regard to the relation between negative affect reduction outcome expectancies and emotional vulnerability among adult cigarette smokers. Cognitive Therapy Research, 33, 645–656.

    Article  Google Scholar 

  • Gross, J. J., & John, O. P. (2003). Individual differences in two emotion regulation processes: Implications for affect, relationships, and well-being. Journal of Personality and Social Psychology, 85, 348–362.

    Article  PubMed  Google Scholar 

  • Gwaltney, C. J., Shiffman, S., Norman, G. J., Paty, J. A., Kassel, J. D., Gnys, M., et al. (2001). Does smoking abstinence self-efficacy vary across situations? Identifying context-specificity within the relapse situation efficacy questionnaire. Journal of Consulting and Clinical Psychology, 69, 516–527.

    Article  PubMed  Google Scholar 

  • Haaga, D. A. F., & Allison, M. L. (1994). Thought suppression and smoking relapse: a secondary analysis of Haaga (1989). The British Journal of Clinical Psychology, 33, 327–331.

    PubMed  Google Scholar 

  • Hall, S. M., Munoz, R. F., Reus, V. I., & Sees, K. L. (1993). Nicotine, negative affect, and depression. Journal of Consulting and Clinical Psychology, 61, 761–767.

    Article  PubMed  Google Scholar 

  • Havermans, R. C., Debaere, S., Smulders, F. T. Y., Wiers, R. W., & Jansen, A. T. M. (2003). Effects of cue exposure, urge to smoke, and nicotine deprivation on cognitive performance in smokers. Psychology of Addictive Behaviors, 17, 336–339.

    Article  PubMed  Google Scholar 

  • Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (1999). Acceptance and commitment therapy: An experiential approach to behaviour change. New York, NY: Guilford Press.

    Google Scholar 

  • Heatherton, T. F., Kozlowski, L. T., Frecker, R. C., & Fagerstrom, K. (1991). The fagerstrom test for nicotine dependence: a revision of the fagerstrom tolerance questionnaire. British Journal of Addiction, 86, 1119–1127.

    Article  PubMed  Google Scholar 

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

    Google Scholar 

  • Kabat-Zinn, J. (2005). Full catastrophe living: Using the wisdom of your body and mind to face stress, pain, and illness: 15th Anniversary. New York, NY: Delta Trade Paperback/Bantam Dell.

    Google Scholar 

  • Kassel, J. D., Stroud, L. R., & Paronis, C. A. (2003). Smoking, stress, and negative affect: correlation, causation, and context across stages of smoking. Psychological Bulletin, 129, 270–304.

    Article  PubMed  Google Scholar 

  • Lerman, C., Audrain, J., Orleans, C. T., Boyd, R., Gold, K., Main, D., et al. (1996). Investigation of mechanisms linking depressed mood to nicotine dependence. Addictive Behaviors, 21, 9–19.

    Article  PubMed  Google Scholar 

  • Leventhal, A. M., Waters, A. J., Boyd, S., Moolchan, E. T., Lerman, C., & Pickworth, W. B. (2007). Gender differences in acute tobacco withdrawal: effects on subjective, cognitive, and physiological measures. Experimental and Clinical Psychopharmacology, 15, 21–36.

    Article  PubMed  Google Scholar 

  • Lovibond, P. F., & Lovibond, S. H. (1995). The structure of negative emotional states: comparison of the depression anxiety stress scales (DASS) with the beck depression and anxiety inventories. Behaviour Research and Therapy, 33, 335–343.

    Article  PubMed  Google Scholar 

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

    Google Scholar 

  • Marlatt, G. A., Witkiewitz, K., Dillworth, T. M., Bowen, S. W., Parks, G. A., Macpherson, L. M., et al. (2004). Vipassana meditation as a treatment for alcohol and drug use disorders. In S. C. Hayes, V. M. Follette, & M. M. Linehan (Eds.), Mindfulness and acceptance: Expanding the cognitive-behavioral tradition. New York, NY: Guilford Press.

    Google Scholar 

  • Miranda, R., Rohsenow, D. J., Monti, P. M., Tidey, J., & Ray, L. (2008). Effects of repeated days of smoking cue exposure on urge to smoke and physiological reactivity. Addictive Behaviors, 33, 347–353.

    Article  PubMed  Google Scholar 

  • Moore, P. (2008). Introducing mindfulness to clinical psychologists in training: an experimental course of brief exercises. Journal of Clinical Psychology in Medical Settings, 15, 331–337.

    Article  PubMed  Google Scholar 

  • Myrsten, A., Elgerot, A., & Edgren, B. (1977). Effects of abstinence from tobacco smoking on physiological and psychological arousal levels in habitual smokers. Psychosomatic Medicine, 39, 25–38.

    PubMed  Google Scholar 

  • Niaura, R., Britt, D. M., Borrelli, B., Shadel, W. G., Abrams, D. B., & Goldstein, M. G. (1999). History and symptoms of depression among smokers during a self-initiated quit attempt. Nicotine & Tobacco Research, 1, 251–257.

    Article  Google Scholar 

  • Orlando, M., Ellickson, P. L., & Jinnett, K. (2001). The temporal relationship between emotional distress and cigarette smoking during adolescence and young adulthood. Journal of Consulting and Clinical Psychology, 69, 959–970.

    Article  PubMed  Google Scholar 

  • Peto, R., Lopez, A. D., Boreham, J., Thun, M., Heath, C., & Doll, R. (1996). Mortality from smoking worldwide. British Medical Bulletin, 52, 12–21.

    PubMed  Google Scholar 

  • Pollack, M. H., Penava, S. A., Bolton, E., Worthington, J. J., III, Allen, G. L. A., Farach, F. J., Jr., et al. (2002). A novel cognitive-behavioural approach for treatment-resistant drug dependence. Journal of Substance Abuse Treatment, 23, 335–342.

    Article  PubMed  Google Scholar 

  • Ree, M. J., & Craigie, M. A. (2007). Outcomes following mindfulness-based cognitive therapy in a heterogeneous sample of adult outpatients. Behaviour Change, 24, 70–86.

    Article  Google Scholar 

  • Salkovskis, P. M., & Reynolds, M. (1994). Thought suppression and smoking cessation. Behaviour Research and Therapy, 32, 193–201.

    Article  PubMed  Google Scholar 

  • Sayette, M. A., Martin, C. S., Wertz, J. M., Shiffman, S., & Perrott, M. A. (2001). A multi-dimensional analysis of cue-elicited craving in heavy smokers and tobacco chippers. Addiction, 96, 1419–1432.

    Article  PubMed  Google Scholar 

  • Shadel, W. G., & Shiffman, S. (2005). Assessment of smoking behavior. In D. M. Donovan & G. A. Marlatt (Eds.), Assessment of addictive behaviors (2nd ed., pp. 113–154). New York, NY: Guilford Press.

    Google Scholar 

  • Shiffman, S. (1991). Refining models of dependence: Variations across persons and situations. British Journal of Addiction, 86, 611–615.

    Article  PubMed  Google Scholar 

  • Sobell, M. B., Maisto, S. A., Sobell, L. C., Cooper, A. M., Cooper, T. C., & Sanders, B. (1980). Developing a prototype for evaluating alcohol treatment effectiveness. In L. C. Sobell, M. B. Sobell, & E. Ward (Eds.), Evaluating alcohol and drug abuse treatment effectiveness: Recent advances (pp. 129–150). Elmsford, NY: Pergamon Press.

    Google Scholar 

  • Sommese, T., & Patterson, J. C. (1995). Acute effects of cigarette smoking withdrawal: A review of the literature. Aviation Space and Environmental Medicine, 66, 164–167.

    Google Scholar 

  • Stapleton, J. (1998). Cigarette smoking prevalence, cessation, and relapse. Statistical Methods in Medical Research, 7, 187–203.

    Article  PubMed  Google Scholar 

  • Stuart, K., Borland, R., & McMurray, N. (1994). Self-efficacy, health locus of control, and smoking cessation. Addictive Behaviors, 19, 1–12.

    Article  PubMed  Google Scholar 

  • Substance Abuse and Mental Health Services Administration (2004). Results from the 2003 national survey on drug use and health: National findings (Office of Applied Studies, NSDUH Series H–25, DHHS Publication No. SMA 04–3964). Rockville, MD.

  • Thorsteinsson, H. S., Gillin, J. C., Patten, C. A., Golshan, S., Sutton, L. D., Drummond, S., et al. (2001). The effects of transdermal nicotine therapy for smoking cessation on depressive symptoms in patients with major depression. Neuropsychopharmacology, 24, 350–358.

    Article  PubMed  Google Scholar 

  • Tidey, J. W., Rohsenow, D. J., Kaplan, G. B., & Swift, R. M. (2005). Subjective and physiological responses to smoking cues in smokers with schizophrenia. Nicotine & Tobacco Research, 7, 421–429.

    Article  Google Scholar 

  • Toll, B. A., Sobell, M. B., Wagner, E. F., & Sobell, L. C. (2001). The relationship between thoughts suppression and smoking cessation. Addictive Behaviors, 26, 509–515.

    Article  PubMed  Google Scholar 

  • Toneatto, T., Vettese, L. C., & Nguyen, L. (2007). The role of mindfulness in the cognitive-behavioural treatment of problem gambling. Journal of Gambling Issues, 19, 91–100.

    Article  Google Scholar 

  • Traylor, A. C., Bordnick, P. S., & Carter, B. L. (2008). Assessing craving in young adult smokers using virtual reality. American Journal on Addiction, 17, 436–440.

    Article  Google Scholar 

  • United States Department of Health and Human Services (1988). The health consequences of smoking. In Nicotine addiction: A report of the US surgeon general. Washington, DC: Author.

  • United States Department of Health and Human Services (1990). Psychological and behavioral consequences and correlates of smoking cessation. In Health benefits of smoking cessation: A report of the US surgeon general (pp. 517–578). Rockville, MD: Author.

  • Vernig, P. M., & Orsillo, S. M. (2009). Psychophysiological and self-reported emotional responding in alcohol-dependent college students: The impact of brief acceptance/mindfulness instructions. Cognitive Behaviour Therapy, 38, 174–183.

    Article  PubMed  Google Scholar 

  • Vettese, L. C. (2008, April). Mindfulness, mental health and addictive behaviour in outpatient substance use treatment. Paper presented at the Conference for Integrating Mindfulness-Based Interventions into Medicine, Health Care, and Society, Worcester, MA.

  • Vettese, L. C., Toneatto, T., Stea, J. N., Nguyen, L., & Wang, J. J. (2009). Do mindfulness meditations participants actually practice? And does it make a difference? A review of the empirical evidence. Journal of Cognitive Psychotherapy: An International Quarterly, 23, 198–225.

    Article  Google Scholar 

  • Vidrine, J. I., Businelle, M. S., Cinciripini, P., Li, Y., Marcus, M., Waters, A. J., et al. (2009). Associations of mindfulness with nicotine dependence, withdrawal, and agency. Substance Abuse, 30, 318–327.

    Article  PubMed  Google Scholar 

  • Vieten, C. (2005). A mindfulness-based approach to relapse prevention [Abstract]. Tobacco-related disease research program. Abstract for grant #14IT-0178.

    Google Scholar 

  • Watkins, E. R., & Moulds, M. (2007). Revealing negative thinking in recovered major depression: a preliminary investigation. Behaviour Research and Therapy, 45, 3069–3076.

    Article  PubMed  Google Scholar 

  • Watson, D., Clark, L. A., & Tellegen, A. (1988). Development and validation of brief measures of positive and negative affect: the PANAS scales. Journal of Personality and Social Psychology, 54, 1063–1070.

    Article  PubMed  Google Scholar 

  • Wegner, D. M., & Zanakos, S. I. (1994). Chronic thought suppression. Journal of Personality and Social Psychology, 62, 615–640.

    Google Scholar 

  • Weiss-Gerlach, E., Franck, M., Neuner, B., Gentilello, L. M., Neumann, T., Tonnesen, H., et al. (2008). Motivation of trauma patients to stop smoking after admission to the emergency department. Addictive Behaviors, 33, 906–918.

    Article  PubMed  Google Scholar 

  • Wenzlaff, R. M., Wegner, D. M., & Klein, S. B. (1991). The role of thought suppression in the bonding of thought and mood. Journal of Personality and Social Psychology, 60, 500–508.

    Article  Google Scholar 

  • West, R. J., & Grunberg, N. E. (1991). Implications of tobacco use as an addiction. British Journal of Addiction, 86, 485–488.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Psychology, Ryerson University, 350 Victoria Street, Toronto, ON, M5B 2K3, Canada

    Jenny Rogojanski, Lisa C. Vettese & Martin M. Antony

Authors
  1. Jenny Rogojanski
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Lisa C. Vettese
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Martin M. Antony
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Martin M. Antony.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Rogojanski, J., Vettese, L.C. & Antony, M.M. Coping with Cigarette Cravings: Comparison of Suppression Versus Mindfulness-Based Strategies. Mindfulness 2, 14–26 (2011). https://doi.org/10.1007/s12671-010-0038-x

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12671-010-0038-x

Keywords

Search

Navigation