Mechanisms of mindfulness for smoking cessation: optimizing quantity and quality

摘要 戒烟的正念机制：优化数量和质量。香烟 在美国，吸烟是导致死亡的主要可预防原因，花费超过1930亿美元的健康 每年的护理成本和生产力损失。越来越多的证据表明， 训练（MT）对成瘾有效，包括酒精和尼古丁使用障碍。早期结果 这表明，在心理层面上，MT可能针对渴望和吸烟之间的联系。换句 换句话说，正念可以帮助个人“安然度过”渴望，而不是陷入其中- 不吸烟。然而，MT治疗糖尿病的神经生物学机制尚不清楚。 上瘾是未知的。我们开发了一个基于移动的应用程序的戒烟MT程序， 其已经显示出戒烟的初步功效（渴望戒烟，C2 Q）。移动的培训 例如，这是提供标准化治疗的理想选择， 在研究潜在的神经生物学机制时的可变性。鉴于他们的电子平台， 这些工具还可以更容易地被监测以用于遵守并适于改进。我们还 开发了一种实时EEG神经反馈设备，可以提供源估计反馈， 特定的大脑区域。目前正在临床试验中进行测试，以检查它是否可以增加 正念习得在个人谁正在采取正念为基础的减压（MBSR）。 然而，该技术尚未在临床人群中或针对特定条件进行测试， 紊乱把所有这些因素放在一起，我们现在有机会（1）确定 提示诱导吸烟的正念机制;（2）测试策略，以提高参与 移动的机器翻译;（3）确定神经反馈是否可以加强已确定的机器翻译机制。在 目标1将确定正念训练是否会改变 提示吸烟者的反应。为了实现这一点，吸烟者将随机接受MT（C2 Q）与 主动控制（经验采样）。将在给药前和给药后测量提示诱导的PCC活性。 训练目标2和3将优化治疗参与和正念质量 skills.这种拟议的分阶段研究方法将首次揭示神经生物学 吸烟的正念机制（以及更广泛的潜在成瘾）。它将利用这些 结果，以完善数量和质量的移动的MT，同时提供初步证据， 正念的调制机制与临床益处有关，包括吸烟 停止

Abstract Mechanisms of mindfulness for smoking cessation: optimizing quantity and quality. Cigarette smoking is the leading preventable cause of death in the U.S., costing more than $193 billion in health care costs and lost productivity annually. There is a growing body of evidence that mindfulness training (MT) is effective for addictions, including alcohol and nicotine use disorders. Early results suggest that on a psychological level, MT may target the link between craving and smoking. In other words, mindfulness may help individuals “ride out” cravings instead of getting caught up in them - without smoking. However, the neurobiological mechanisms underlying the efficacy of MT for addictions are unknown. We have developed a mobile app-based MT program for smoking cessation, which has shown preliminary efficacy in smoking cessation (Craving to Quit, C2Q). Mobile trainings such as this are ideal for providing standardized delivery of treatment, which helps minimize variability when studying underlying neurobiological mechanisms. Given their electronic platforms, these tools can also be more easily monitored for adherence and adapted for refinement. We have also developed a real-time EEG neurofeedback device that can provide source-estimated feedback from specific brain regions. This is now being tested in clinical trails to examine if it can augment mindfulness acquisition in individuals who are taking Mindfulness-Based Stress Reduction (MBSR). However, this technology has not been tested in clinical populations or for specific conditions or disorders. Bringing all of these elements together, we now have an opportunity to (1) determine the mechanism of mindfulness in cue-induced smoking; (2) test strategies to enhance engagement in mobile MT; and (3) determine if neurofeedback can strengthen identified mechanisms of MT. In the proposed study, Aim 1 will determine if mindfulness training alters neural correlates of cue reactivity in smokers. To achieve this, smokers will be randomized to receive MT (C2Q) vs. an active control (experience sampling). Cue-induced PCC activity will be measured pre- and post- training. Aims 2 and 3 will optimize treatment engagement and quality of mindfulness skills. This proposed phased research approach will be the first to uncover the neurobiological mechanisms of mindfulness for smoking (and potentially addiction more broadly). It will utilize these results to refine both quantity and quality of mobile MT while providing preliminary evidence that the modulated mechanisms of mindfulness are associated with clinical benefits, including smoking cessation.