(PS10-49) Impact of Mindfulness Perception on Mood and Cigarette Craving in Adults with Mood Disorders During Smoking Cessation

Background: Mindfulness-based interventions (MBIs) for smoking cessation have shown mixed results but may benefit individuals who smoke to regulate negative affect (NA), including those with mood disorders. A recent study found that a smartphone-assisted MBI for smoking cessation significantly increased abstinence rates in this group. However, research on MBIs for smoking cessation in this population remains limited, particularly regarding perceived helpfulness of mindfulness intervention, and how it is linked to mood and craving immediately after practicing mindfulness. This study examines how perceived helpfulness of mindfulness practice is related to NA, positive affect (PA), and craving to smoke immediately after mindfulness practice, providing insight into its role in supporting smoking cessation.

Methods: Data from a randomized controlled trial examining efficacy of a mindfulness-based smartphone-assisted smoking cessation intervention for socioeconomically disadvantaged adults receiving outpatient psychiatric treatment for mood disorders who were assigned to the intervention group (N=24) were used. Participants completed 5 randomly scheduled daily ecological momentary assessment (EMA) reports and mindfulness practices, lasting 5-7 minutes each, over 38 days. Participants completed pre- and post-mindfulness practice ratings of mood and craving, and post-mindfulness practice ratings of perceived helpfulness. A series of hierarchical linear models were used where post-mindfulness NA, PA, and craving were regressed onto perceived helpfulness scores. To distinguish within-subject effects (report level) from the between-subject effects (individual level), both within-subject and between-subject (individual’s mean helpfulness score) variables were entered into the model as predictors.

Results: There was a total of 2,789 post-mindfulness reports (M=3 reports/day), with an average of 98.3% of prompted reports completed per participant. Linear random-effects models revealed that all three outcomes (i.e., post-mindfulness NA, PA, and craving) were predicted by within-subject perceived helpfulness (ps < .03) while PA and craving, but not NA, were associated with between-subject perceived helpfulness (ps < .003). These findings for PA and craving remained unchanged when pre-mindfulness scores were included in the models while the effects of within-subject helpfulness on NA became non-significant (p=.33) when pre-mindfulness NA was included.

Conclusions: Results indicate that within-subject increases in perceived helpfulness were related to post-mindfulness reductions in NA and craving and increases in PA. At the same time, those who tend to report greater helpfulness were more likely to report higher PA and lower craving, but not NA, in general. Moreover, the associations between perceived helpfulness and post-mindfulness PA and craving were not explained by pre-mindfulness PA and craving. However, pre-mindfulness, not post-mindfulness, NA seemed to have influenced perceived helpfulness of mindfulness practice. These findings may suggest that post-mindfulness changes in positive affect and craving, rather than NA, may shape perceptions of mindfulness benefits.