ONLINE MINDFULNESS THERAPY AS A SMOKING CESSATION AID IN MALAYSIA: A RANDOMIZED CONTROL TRIAL

Authors

  • Hemanath Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah
  • Fredie Robinson Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah
  • Nicholas Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah
  • Eng Kean Lim Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah
  • Shi Joe Ong Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah
  • Alyssa Suraya Ahmad Farouk Faizi Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah
  • Joshua Selvaraj Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah
  • Jia Qi Lau Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah
  • Yong Xin Lim Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah
  • Vanushya Alagasan Ministry of Health of Malaysia

Keywords:

Smoking cessation; Quit smoking; Mindfulness therapy; Counselling therapy; Nicotine dependence; Number of cigarettes; Urge of smoking; Addiction.

Abstract

Effective smoking cessation programs are crucial in helping smokers to achieve cessation, indirectly reducing smoking-related morbidity and mortality. Several studies have shown promising results using mindfulness therapy and online platforms in smoking cessation. This study assesses the effectiveness of online mindfulness therapy (MT) as an aid in smoking cessation programmes compared with standardized behavioural approaches (SBA). A randomized control trial with a single-blind, two-group design was chosen, with assessment at baseline. Participants were recruited by advertising on social media platforms and accepted according to the eligibility criteria. The participants who fit the eligibility criteria were randomized and divided into two groups. Each group received three sessions of online therapy (MT or SBA) every 2 weeks with one telephone call each week as a reinforcement. Participants filled in questionnaires at baseline and end of the intervention (1st week and 5th week). The data was analyzed using Generalized Estimating Equation (GEE). The number of cigarettes smoked per day post-intervention was significantly lower in the MT group compared with the SBA group (?: -3.50, 95% CI -4.62 to -2.39, p-value: < 0.001). The MT group recorded low Fagerstrom nicotine dependence tests at the end of the study, compared to low to moderate scores in the SBA group (?: -1.82, 95% CI –2.31 to -1.33, p-value: < 0.001). Furthermore, participants in the MT group reduced their urge to smoke more than the SBA group (?: -2.44, 95% CI -3.76 to -1.12, p-value: < 0.001). In conclusion, online MT is more effective in helping smokers in reducing the number of cigarettes smoked per day, nicotine dependence, and urge for smoking compared to SBA. Further follow-up studies using online platforms should be conducted to compare the effectiveness of online MT longitudinally. 

References

John Elflein. Topic: Smoking. Statista. 2020. Retrived from: https://www.statista.com/topics/1600/smoking (assesed on 25 Nov 2020)

Ritchie H, Roser M. Smoking. Our World in Data [Internet]. 2013; Retrived from: https://ourworldindata.org/smoking (assesed on 25 Nov 2020)

WHO. Tobacco [Internet]. 2020. Retrived from: https://www.who.int/news-room/fact-sheets/detail/tobacco (assesed on 13 Apr 2021)

Roh S. Scientific Evidence for the addictiveness of tobacco and smoking cessation in tobacco litigation. J Prev Med Public Health. 2018 Jan;51(1):1–5.

Garrison KA, Pal P, Rojiani R, Dallery J, O’Malley SS, Brewer JA. A randomized controlled trial of smartphone-based mindfulness training for smoking cessation: a study protocol. BMC Psychiatry. 2015 Apr 14;15(1):83.

FDA C for T. Quitting Smoking: Closer with every attempt. FDA. 2020; Retrived from: https://www.fda.gov/tobacco-products/health-information/quitting-smoking-closer-every-attempt (assesed on 25 Nov 2020)

Bevins RA, Palmatier MI. Extending the role of associative learning processes in nicotine addiction. Behav Cogn Neurosci Rev. 2004 Sep;3(3):143–58.

Buczkowski K, Dachtera-Fr?ckiewicz M, Luszkiewicz D, Klucz K, Sawicka-Powierza J, Marcinowicz L. Reasons for and scenarios associated with failure to cease smoking: Results from a qualitative study among polish smokers who had unsuccessfully attempted to quit. Patient Prefer Adherence. 2021 Sep 16;15:2071–84.

Fernandes TM de P, Almeida NL de, Santos NA dos. Effects of smoking and smoking abstinence on spatial vision in chronic heavy smokers. Sci Rep. 2017. Retrived from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5431787/ (assesed on 15 Dec 2020)

Brewer JA, Sinha R, Chen JA, Michalsen RN, Babuscio TA, Nich C, et al. Mindfulness training and stress reactivity in substance abuse: results from a randomized, controlled stage I pilot study. Subst Abus. 2009 Dec;30(4):306–17.

Bishop SR, Lau M, Shapiro S, Carlson L, Anderson ND, Carmody J, et al. Mindfulness: A proposed operational definition. Clinical Psychology: Science and Practice. 2004;11(3):230–41.

Brewer JA, Bowen S, Smith JT, Marlatt GA, Potenza MN. Mindfulness-based treatments for co-occurring depression and substance use disorders: What can we learn from the brain? Addiction. 2010 Oct;105(10):1698–706.

Chan EY. Mindfulness and smoking frequency: An investigation with Australian students. Addictive Behaviors Reports. 2021 Jun 1;13:100342.

Teasdale JD, Moore RG, Hayhurst H, Pope M, Williams S, Segal ZV. Metacognitive awareness and prevention of relapse in depression: empirical evidence. J Consult Clin Psychol. 2002 Apr;70(2):275–87.

Chiesa A, Serretti A. Are mindfulness-based interventions effective for substance use disorders? A systematic review of the evidence. Subst Use Misuse. 2014 Apr;49(5):492–512.

Jackson S, Brown J, Norris E, Livingstone-Banks J, Hayes E, Lindson N. Mindfulness for smoking cessation. Cochrane Database Syst Rev. 2022 Apr 14;2022(4):CD013696.

Faul F, Erdfelder E, Buchner A, Lang AG. Statistical power analyses using G*Power 3.1: Tests for correlation and regression analyses. Behavior Research Methods. 2009 Nov 1;41(4):1149–60.

Bricker J, Wyszynski C, Comstock B, Heffner JL. Pilot randomized controlled trial of web-based acceptance and commitment therapy for smoking cessation. Nicotine Tob Res. 2013 Oct;15(10):1756–64.

Gifford EV, Kohlenberg BS, Hayes SC, Antonuccio DO, Piasecki MM, Rasmussen-Hall ML, et al. Acceptance-based treatment for smoking cessation. Behavior Therapy. 2004;35(4):689–705.

Gifford EV, Kohlenberg BS, Hayes SC, Pierson HM, Piasecki MP, Antonuccio DO, et al. Does acceptance and relationship focused behavior therapy contribute to bupropion outcomes? A randomized controlled trial of functional analytic psychotherapy and acceptance and commitment therapy for smoking cessation. Behav Ther. 2011 Dec;42(4):700–15.

Hernández-López M, Luciano MC, Bricker JB, Roales-Nieto JG, Montesinos F. Acceptance and commitment therapy for smoking cessation: a preliminary study of its effectiveness in comparison with cognitive behavioral therapy. Psychol Addict Behav. 2009 Dec;23(4):723–30.

Mak YW, Loke AY. The acceptance and commitment therapy for smoking cessation in the primary health care setting: a study protocol. BMC Public Health. 2015 Feb 7;15(1):105.

Yee HA A, Cg N, Ar R. Validation of the Malay version of fagerstrom test for nicotine dependence (FTND-M) among a group of male Staffs in a University Hospital. Malaysian Journal of Psychiatry. 2011 Jun;20(1):30.

Blebil AQ, Sulaiman SAS, Hassali MA, Dujaili JA, Zin AM. The Malay version of the brief questionnaire on smoking urge: Translation and psychometric properties of the questionnaire. Journal of Epidemiology and Global Health. 2015 Mar 1;5(1):15–22.

Hölzel BK, Lazar SW, Gard T, Schuman-Olivier Z, Vago DR, Ott U. How does mindfulness meditation work? Proposing mechanisms of action from a conceptual and neural perspective. Perspect Psychol Sci. 2011 Nov;6(6):537–59.

Tang YY, Yang L, Leve LD, Harold GT. Improving executive function and its neurobiological mechanisms through a mindfulness-based intervention: Advances within the field of developmental neuroscience. Child Dev Perspect. 2012 Dec;6(4):361–6.

Begh R, Lindson-Hawley N, Aveyard P. Does reduced smoking if you can’t stop make any difference? BMC Med. 2015 Oct 12;13:257.

Inoue-Choi M, Hartge P, Park Y, Abnet CC, Freedman ND. Association between reductions of number of cigarettes smoked per day and mortality among older adults in the United States. American Journal of Epidemiology. 2019 Feb 1;188(2):363–71.

Ikonomidis I, Thymis J, Kourea K, Kostelli G, Neocleous A, Katogiannis K, et al. Fagerstrom score predicts smoking status six months after hospitalization for acute myocardial infarction: a prospective study. Hellenic Journal of Cardiology. 2022 Sep 1;67:28–35.

Lin H, Chen M, Yun Q, Zhang L, Chang C. Tobacco dependence affects determinants related to quitting intention and behaviour. Sci Rep. 2021 Oct 12;11(1):20202.

Rodríguez-Cano R, López-Durán A, Martínez-Vispo C, Becoña E. Causes of smoking relapse in the 12 months after smoking cessation treatment: Affective and cigarette dependence–related factors. Addictive Behaviors. 2021 Aug 1;119:106903.

van Zundert R, Ferguson S, Shiffman S, Engels R. Dynamic effects of craving and negative affect on adolescent smoking relapse. Health psychology?: official journal of the Division of Health Psychology, American Psychological Association. 2011 Sep 26;31:226–34.

Tang YY, Tang R, Posner MI. Brief meditation training induces smoking reduction. Proc Natl Acad Sci U S A. 2013 Aug 20;110(34):13971–5.

Hartwell KJ, Johnson KA, Li X, Myrick H, LeMatty T, George MS, et al. Neural correlates of craving and resisting craving for tobacco in nicotine dependent smokers. Addict Biol. 2011 Oct;16(4):654–66.

Peters EN, Hughes JR. The day-to-day process of stopping or reducing smoking: A prospective study of self-changers. Nicotine Tob Res. 2009 Sep;11(9):1083–92.

Kant R, Yadav P, Bairwa M. Effectiveness of the internet-based versus Face-to-Face Interaction on Reduction of tobacco use among adults: A meta-analysis. Cureus. 2021;13(11):e19380.

Kato A, Tanigawa T, Satake K, Nomura A. Efficacy of the ascure smoking cessation program: Retrospective study. JMIR Mhealth Uhealth. 2020 May 14;8(5):e17270.

Lozano P, Thrasher JF, Forthofer M, Hardin J, Shigematsu LMR, Arillo Santillán E, et al. Smoking-related stigma: A public health tool or a damaging force? Nicotine Tob Res. 2018 Jul 25;22(1):96–103.

Vasthare. Carbon monoxide breath analyzers and its role in tobacco cessation: A narrative review of literature. 2018. Retrived from: https://www.jioh.org/article.asp?issn=0976-7428;year=2018;volume=10;issue=2;spage=71;epage=76;aulast=Vasthare (assesed on 26 Jan 2023)

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Published

2023-12-28

How to Cite

Sinnathamby, H., Robinson, F., Pang, N. T. P., Lim , E. K., Ong , S. J., Ahmad Farouk Faizi, A. S., … Alagasan, V. (2023). ONLINE MINDFULNESS THERAPY AS A SMOKING CESSATION AID IN MALAYSIA: A RANDOMIZED CONTROL TRIAL. Malaysian Journal of Public Health Medicine, 23(3), 44–52. Retrieved from http://mjphm.org/index.php/mjphm/article/view/2096