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‘Craving to quit’ app teaches mindfulness to counter smoking addiction

U. researchers find link between mindfulness, smoking cues in areas of brain

For smokers looking for alternatives to help wean themselves off nicotine, researchers at the School of Public Health have a new option — a mindfulness app.

“Craving to quit” is an app that delivers mindfulness exercises through short ten-minute daily modules. Users are shown a video and get some in-the-moment exercises to create tools to deal with their cravings.

Mindfulness techniques use practices such as meditation and breathing exercises to help break away from negative thought patterns.

Mindfulness helps people understand how their mind works and develop ways to control their actions, which can help prevent habit loops, said Judson Brewer, director of research and innovation at the University’s Mindfulness Center, associate professor of behavioral and social sciences and leader of the research project.

The research was an collaborative effort between Brewer and Amy Janes, director of the Functional Integration of Addiction Research Laboratory at the McLean Imaging Center and associate professor of psychiatry at Harvard Medical School. Their research focused on looking at the brain’s reaction to smoking cues and then examining how mindfulness impacted this activation.

The team scanned the brains of their participants with an fMRI, which is a machine that allows researchers to analyze how the brain reacts to a stimulus. The team showed the participants images associated with smoking and images that were completely neutral, Janes said. Participants then either used the mindfulness app or a different control app, and the researchers measured subsequent brain activity to detect any changes from the first imaging.

The tests showed that the mindfulness app caused a significant decrease in the number of cigarettes smoked and a decrease in brain activity. “The more modules they completed in the mindfulness app, the better they did,” Brewer said. The research also suggested a relationship between the areas of the brain activated by mindfulness and by smoking cues. When the researchers analyzed the relationship between brain activation and their participants’ smoking habits, they found that people who reduced their smoking habits also showed a reduction in brain activation in a region of the brain called the posterior cingulate cortex. “We’re finding more of a neurobiological mechanism for how mindfulness may be working,” Janes said.

The app could have a reach beyond clinical treatment, Brewer said. “Digital Therapeutics is an emerging field of medicine because there are a number of benefits to it. It’s much more affordable, it’s much more convenient and it reaches people anywhere. … (It is) helpful to get training every single day. You can imagine how inconvenient it can be for someone to come in and see their clinician every day, both for the patient and for the clinician,” he added.

In general, mindfulness has applications beyond smoking, Brewer said. He has previously developed apps for emotional eating and anxiety management.

Some specialists, however, point out that digital therapeutics do face several challenges.

“The initial teaching of mindfulness was aimed at deep transformation of the personality and the soul, and that it is very interesting to see when you take a practice that was initially intended for such deep transformation and then you put it into an app and apply it to a specific problem like smoking. You would think this a bad fit,” said James Davis, associate professor of Medicine at Duke University and member of the Duke Cancer Institute.

But mindfulness is actually a very good fit, Davis said. Smoking, anxiety and depression are states in which the person loses control of their rational and acts on impulsive behavior; mindfulness is a state of regaining control and being aware of decisions, he added.

Both Janes and Brewer hope to expand the research by making it more accessible to the public as well as running larger and longer trials to test the application. They also hope to incorporate patient feedback in future trials and create a more personalized experience.



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