ATTUD Journal Club Postings

The Efficacy of Pretreatment Treatment

A 2017 meta-analysis of mindfulness meditation noted that this treatment did not improve short term cessation but did increase long-term cessation (Oikonomou, 2017). It hypothesized that this was because the treatment needs to be practiced often to have an effect. To me, it also may be that the treatment is like taking up exercise- in the beginning it is aversive but over time becomes routine and, if not enjoyable, at least not aversive. Also, it may be that although one can “prepare” for a quit date, the motivation to learn how to cope really does not come until one is in trouble. So maybe we need to focus on learning to cope with longer and longer periods of abstinence that eventually to cessation. In fact this is why some believe reduction therapy works. But since mindfulness meditation focuses on accepting withdrawal discomfort, etc, it seems well-suited to this approach. So I wonder if a good approach to those who have failed abrupt cessation, is to have mindfulness meditation training during smoking reduction (or “practice quit attempts”) to be able to deal with craving and withdrawal and then did not have smokers quit until they were sure they could cope with craving an withdrawal. But the down side of this is that it delays cessation and many may lose motivation to quit over time.

Thoughts?

John