Using Mindfulness Training to Reduce Delay Discounting in Rural Adult Smokers

The potential health consequences of cigarette smoking in the United States are alarming. Complicating this issue, smoking rates are highest in rural regions where, unfortunately, access to evidence based prevention and treatment programs are exceedingly limited. In response, we are proposing to use online mindfulness training (Headspace©) to reduce impulsive behavior, perceived stress, and depression in rural smokers. Each of these target variables plays an important role in drug use (including cigarette smoking) and in treatment response. We have chosen online mindfulness training as our intervention because it has been shown to reduce cigarette smoking in college students and because of demonstrated effects on many of the cognitive and neural systems that underlie impulsive behavior. Furthermore, by using a web-based version of mindfulness training we increase program flexibility for difficult to reach populations, such as rural smokers. To explore use of this approach, we will utilize a two-arm, single blinded, randomized control design. For the active treatment condition (n = 50) participants will complete an online 30 day foundational program of mindfulness training (Headspace©). In the control condition (n = 50) participants will listen to an audio book about mindfulness training that is read by the same person guiding the mindfulness training for the active condition. This audio book has been divided into 30 sections that are time-matched with the 30 sessions of the active Headspace© program, and these audio book sections will be accessed by participants through the Headspace© site just as the active training program will be accessed by participants in that condition. Participants will complete laboratory sessions to assess impulsive behavior, perceived stress, and depression shortly before starting the active or control programs, immediately following program completion, and again 30 days post-program completion. We will also measure cigarette smoking for all participants at these three time points. We hypothesize that mindfulness training will reduce impulsive behavior, perceived stress and depression as well as cigarette smoking compared to the audio book control condition. If these hypotheses are confirmed, online mindfulness training can be readily adapted as an adjunct to existing prevention and treatment programs to improve outcomes. This research addresses a significant public health issue by directly engaging central behavioral targets for cigarette smoking.