Date of Award

January 2012

Document Type

Open Access Thesis

Degree Name

Medical Doctor (MD)



First Advisor

Judson A. Brewer

Subject Area(s)

Medicine, Public health



Authors: Hani M. Elwafi, Katie Witkiewitz, Sarah Mallik, Thomas Thornhill IV, Judson Alyn Brewer

Cigarette smoking is the leading cause of preventable deaths in the world. A majority of smokers identify tobacco as harmful and express a desire to quit. Currently available treatments have shown only modest success, and abstinence rates remain low. Mindfulness Training (MT) shows promise as an effective treatment for smoking cessation, yet the mechanisms remain unclear. Craving has been shown to be a central component of the addictive process, and a strong predictor of smoking. MT is theorized to work by dismantling this addictive process by targeting craving. The purpose of this report was to examine the effects of MT on the relationship between cigarette craving and smoking. We hypothesized that MT would work to weaken the relationship between craving and subsequent smoking, and that this diminution would be directly related to the amount of home practice that individuals performed.

33 adults received MT as part of a randomized controlled trial for smoking cessation, each of whom recorded home practice details in daily diaries. Analyses showed that strong positive correlations between craving and smoking at baseline (r = 0.582) disappeared by the end of the treatment period (r = 0.126). Multiple regression models revealed home practice as a significant predictor of cigarette use (formal: R2=0.315, p=0.004; informal: R2=0.437, p<0.001). Furthermore, regression analyses revealed that the amount of informal home practice as measured in days/week moderated the relationship between craving and smoking such that individuals were smoking less regardless of their level of craving. These findings suggest that MT decouples the relationship between smoking and craving, and also show a direct link between theoretical mechanisms of mindfulness and behavior.


This is an Open Access Thesis.

Open Access

This Article is Open Access