The smoking cessation application of mindfulness can change the brain

The researchers found that a smartphone-based awareness app designed to help people quit was effective in reducing the daily cigarette consumption reported by study participants. And those who have reduced their cigarette consumption the most have also shown reduced responsiveness to smoking-related images in an area of ​​the brain known to be activated when someone experiences a craving.

Dr. Jud Brewer, an associate professor of behavioral science, social sciences and psychiatry at Brown University, led a team to conduct a randomized controlled trial comparing smoking cessation applications. For four weeks, a group of 33 participants used an application based on mindfulness, while another group of 34 participants used a free application to quit smoking from the National Cancer Institute (NCI) ).

"This is the first study that shows that mindfulness training can specifically affect a brain mechanism and that changes in brain mechanics are linked to improved clinical outcomes," said Brewer, director of research. and innovation at Brown. Mindfulness Center of the University School of Public Health. "We are going in the direction of being able to screen somebody before the treatment and to suggest the behavior change interventions most likely to help them, which will save everyone time." and money. "

The results were published on Tuesday, April 30 in the journal neuropsychopharmacology.

The Mindfulness app includes videos and daily activities to help users identify their smoking triggers, become more aware of cravings and learn mindfulness methods to overcome them. The NCI app helps users track the triggers of smoking, provides inspiring messages and distracts visitors to help them cope with cravings.

The research team found that participants who used the mindfulness application for a month had significantly reduced their daily self-reported cigarette consumption, with an average drop of 11 cigarettes per day. Users of the NCI app also significantly reduced their cigarette consumption, with an average decrease of nine per day. Some participants in both groups said they did not smoke at the end of the month.

Participants in both groups completed an average of 16 of the 22 standalone modules of the application. Participants in the mindfulness group who completed more modules probably have a greater reduction in their cigarette consumption; this correlation was not found for the NCI group. Participants in the mindfulness group were also much more likely to say that they would recommend applying to a friend than participants in the NCI group.

To determine how the Mindfulness application works in the brain, the researchers performed functional magnetic resonance imaging brain scans of the participants when examining images associated with smoking or d & # 39; other images not associated with smoking. These analyzes were done before and after the use of one of the two applications by the participants.

Specifically, the researchers studied the evolution of brain activity in the posterior cingulate cortex – a cerebral area the size of a ping-pong-ball ball, known to be activated when someone One is in need of cigarettes, cocaine or even chocolate, Brewer said. Mediation also showed that the posterior cingulate cortex was deactivated, so Brewer hypothesized that this region would play a critical role in the way consciousness-based interventions – application-based and non-application – affect the brain and modify behaviors.

When the researchers directly compared changes in brain responsiveness in the target region between the two groups before and after using the applications, they found no statistical difference. However, when they examined the individual level and compared the reduction of smoked cigarettes to changes in brain responsiveness, they found that participants in the mindfulness group who had the greatest reduction in the number of cigarettes per day – those for which the application was more effective – also showed a significant reduction in brain responsiveness to smoker images. They found no correlation between the number of cigarettes smoked and brain reactivity among participants using the NCI application. They also noted that the correlation between the number of cigarettes smoked and the reactivity of the brain was particularly significant for women in the mindfulness group.

Surprisingly, 13% of participants did not react to tobacco images before using either application, a phenomenon that was not observed in the previous scientific literature, Brewer said. Other participants became more responsive to the smoke images after using one or the other of the applications. this has already been observed in people who crave more cigarettes while trying to quit, he added.

Brewer plans to study in more detail the apparent difference in the effectiveness of mindfulness application for women. He also plans to combine neurofeedback training with mindfulness application and follow the participants in the future study for six months after using the application, the benchmark for determining the number of participants. clinical efficacy in smoking cessation studies, he said.

"Digital therapies, such as smartphone applications, provide an affordable and accessible way to provide evidence-based processing – if an application is developed with an evidence base, 99% of applications are not – with fidelity 100%, "Brewer said. "You know exactly what people get from training, because you do not depend on a therapist to follow a manual.As a psychiatrist, I think a lot of us are very excited about the promise of digital therapies. "