Mindful

Research on smoking cessation conducted at Yale’s Therapeutic Neuroscience Clinic has been used to create the Craving to Quit program and smartphone app. The lab’s research was shown to be twice as effective as the gold standard in the field, the American Lung Association Freedom From Smoking program. The app, which uses mindful techniques, aims to have smokers quit in three weeks.

Carsten Knox, Mindful‘s former associate editor, sat down with Judson Brewer, former medical director of Yale’s Therapeutic Neuroscience Clinic, to talk about the app and research around smoking cessation. Brewer is now Dr. Judson Brewer, former medical director at Yale Therapeutic Neuroscience Clinic. He’s now director of research at Center for Mindfulness at UMass Medical School.

Carsten Knox: Where did the idea to apply mindfulness to quitting smoking come from?

Judson Brewer: My lab at Yale does clinical research looking at mindfulness training for addictions. A couple years ago we did a study with alcohol and cocaine dependence and found that it worked pretty well. We decided to tackle the mother of all addictions: smoking. It’s actually the hardest addiction to quit, which a lot of people don’t realize.

CK: How did you turn your study into an app?

JB: A documentary filmmaker we were working with looked at our study and said that we could actually make an app. We thought this would be a great way to disseminate the program, so we edited the scripts into bite-sized pieces, then found two animators. Three months later we had an app.

CK: And how do the study’s results get applied?

JB: It happens over 21 days—there’s a bonus on day 22. We took the modules and collected the data. We figured out what people were using the most, what directly correlated with quitting. We found that it was the noting-practices part of the program—the more they used this, the more likely they were to quit.

CK: You mean noting the way you’re feeling when you want a cigarette?

JB: Yes, exactly. And we teach people how to do a body scan as a way to become aware of cravings in their bodies, noticing how that’s driving them to smoke. And then something called R.A.I.N. exercise: Recognize the craving, Allow the craving to be there, Investigate or become curious about the feeling, and N for note, from moment to moment. That way they stay on top of this wave rather than be clobbered by it. And we include associative learning, too, where you become conscious of the link between smoking and some other behavior, such as eating or the stress of being chewed out by your boss. We introduce the sitting meditation practice later on.

CK: How does compassion play a part in quitting smoking?

JB: There’s lots of self-judgment that goes on when you’re trying to do something difficult, like trying to quit smoking. Also if we judge others, that can get us riled up, which can lead to smoking. We teach it as a way to learn to concentrate more but also to let go of judgment. When people have a craving, they can notice if they’re resisting or beating themselves up.

CK: There are a lot of different programs offered for people who want to quit smoking. What do you think yours has that will get people to try it?

JB: Lost of people make lots of claims. Mindfulness works, but only if you do it. You can’t just sleep on top of a mindfulness book and suddenly become mindful. You have to actually do the practice. All we know is we have twice the efficacy rate, which is good. We think that the app is engaging. The other thing we’re pairing this with is the Craving to Quit community, a closed online community for people to ask questions or offer peer support. It’s just as important as the app itself. You can go there at any time. I think Alcoholics Anonymous is a great model of that.

To learn more about the Craving to Quit app, watch the demo below:

This web extra provides additional information related to an article titled, “Kick the Habit,” which appeared in the August 2013 issue of Mindful magazine.

Carsten Knox

Carsten Knox is a freelance writer and former associate editor of Mindful.

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