Efficacy of a workplace smoking cessation program: Mindfulness meditation vs cognitive-behavioral interventions

The purpose of this research is to study the efficacy of a holistic, self-reflective approach to changing behavior and decreasing smoking in a workplace setting. This study tests whether subjects who learn mindfulness meditation (MM) and cognitive behavioral interventions report significantly different levels of anxiety, depression, distress, and number of cigarettes smoked, and demonstrate lower cotinine levels than subjects who learn only cognitive-behavioral strategies. The transtheoretical model (TM) of behavior change is the theoretical framework used to study the effects of the specific interventions in the process of quitting. Thirty-nine cigarette smokers from an electronics company in the Northeast were randomly assigned into one of two experimental groups: group 1 received mindfulness meditation and cognitive behavioral intervention and group 2 received only cognitive-behavioral interventions. Measurements were obtained at four distinct time periods. Because of problems with subject attrition, the nonparametric Mann-Whitney U Statistic was used to test the research hypothesis. Nonsignificant differences were found between the groups on the major outcome measures. The null hypothesis was therefore upheld. Additional analysis using paired T-tests revealed significant within-subjects differences in cotinine, depression, distress, and cigarettes smoked per day from baseline to Time 4 measures. Subjects, regardless of group membership, demonstrated significantly lower cotinine, depression, distress, and number of cigarettes smoked at Time 4. Nine subjects quit smoking during the intervention. In order to determine why subjects dropped out of the study, and why subjects in the MM group did not practice the meditation, individual interviews were conducted with 20 subjects at Time 4. Interviews were transcribed and content analysis was used to analyze the data. A new model of worksite smoking cessation which builds on the results of this study conceptualizes cessation as a process consisting of four steps, including: (1) assessment of smoker and support systems; (2) meditation training; (3) cognitive-behavioral intervention; and, (4) maintenance. Future outcomes research demonstrating the contribution of nursing practice to smoking cessation is necessary to establish the discipline as leaders in this field.