Departamento de Psicobiologia, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
Instituto do Cérebro, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
Nicotine Tob Res. 2020 Aug 24;22(9):1605-1613. doi: 10.1093/ntr/ntaa057.
Posttreatment relapse is a major roadblock to stemming the global epidemic of tobacco-related illness. This article presents results from a pilot trial evaluating the feasibility and initial efficacy of Mindfulness-Based Relapse Prevention (MBRP) as an adjunct to standard relapse prevention treatment (ST) for smoking cessation.
Smokers (n = 86) in the maintenance phase of treatment were randomized to receive either ST plus MBRP (MBRP) (n = 44) or ST alone (ST) (n = 42). Data were collected at baseline and at 4-, 12-, and 24-week follow-up points. We evaluated the feasibility of the protocol with frequency analysis, and the efficacy with both intention to treat and complete case analyses of the effects of MBRP on abstinence. Secondary outcomes included mindfulness, craving, depression, anxiety, and positive/negative affect.
High adherence suggested MBRP is acceptable and feasible. Participants in the MBRP group reported increases in mindfulness (M = -7.833, p = .016), and reductions in craving (M = 17.583, p = .01) compared with the ST group. Intention to treat analysis found that, compared with MBRP (36.4%), ST (57.1%) showed trend-level superiority in abstinence at Week 4 (Prevalence Ratio = 0.63, p = .06); however at Week 24, the ST group (14.3%) demonstrated a twofold greater decrease in abstinence, compared with the MBRP group (20.1%) (Prevalence Ratio = 2.25, p = .08). Therefore, the MBRP group maintained a higher abstinence rate for longer. Reported effects were greater in the complete case analysis.
MBRP holds promise for preventing relapse after aided tobacco quit attempts.
Findings suggest that MBRP is acceptable, feasible, and valued by participants. At 24-week follow-up, there was a large effect size and a statistical trend toward fewer MBRP patients relapsing compared with ST patients. MBRP conferred ancillary benefits including reductions in craving and increases in levels of mindfulness. MBRP for tobacco cessation is highly promising and merits further research.
clinicaltrials.gov.
NCT02327104.
治疗后复发是阻止与烟草相关疾病全球流行的主要障碍。本文介绍了一项评估正念为基础的复发预防（MBRP）作为戒烟标准预防复发治疗（ST）辅助手段的可行性和初步疗效的试验结果。
治疗维持阶段的吸烟者（n = 86）被随机分为接受 ST 加 MBRP（MBRP）（n = 44）或 ST 单独治疗（ST）（n = 42）。数据在基线和 4、12 和 24 周随访点收集。我们通过频率分析评估方案的可行性，并用意向治疗和完全案例分析 MBRP 对戒烟效果的影响来评估疗效。次要结果包括正念、渴求、抑郁、焦虑和积极/消极情绪。
高依从性表明 MBRP 是可接受和可行的。MBRP 组报告正念增加（M = -7.833，p =.016），与 ST 组相比，渴求减少（M = 17.583，p =.01）。意向治疗分析发现，与 MBRP 组（36.4%）相比，ST 组（57.1%）在第 4 周（优势比 = 0.63，p =.06）的戒烟率略有优势；然而，在第 24 周，ST 组（14.3%）的戒烟率下降了两倍，与 MBRP 组（20.1%）相比（优势比 = 2.25，p =.08）。因此，MBRP 组在更长时间内保持了更高的戒烟率。完全案例分析中报告的效果更大。
MBRP 有望预防辅助戒烟后的复发。
研究结果表明，MBRP 是可接受的，可行的，参与者认为是有价值的。在 24 周随访时，与 ST 组相比，MBRP 组的复发患者较少，且效果较大，具有统计学趋势。MBRP 还带来了辅助益处，包括降低渴求感和提高正念水平。MBRP 对戒烟有很高的应用前景，值得进一步研究。
clinicaltrials.gov。
NCT02327104。
