The Effects of State Mindfulness on Motivation to Quit and Smoking Risk Among Individuals With Mood Disorders

Individuals with mood disorders smoke at a disproportionate rate than the general population. Mindfulness appears as an effective intervention to reduce smoking cessation rates among this particular population. Previous studies explored different mechanisms (e.g., negative affect, response inhibition) to understand why mindfulness might be helpful for individuals who try to quit smoking. However, the role of motivation as a mediator has not been explored although theory and evidence state the positive relationship between mindfulness and motivation. This study investigated the mediating role of motivation to quit in the relationship between state mindfulness and smoking risk. As both motivation and mindfulness tend to fluctuate in a short period of time, this study examined the effects of state mindfulness on smoking risk within 6 hours through motivation to quit among individuals with mood disorders. This study used ecological momentary assessment (EMA) data which was collected in a randomized control smoking cessation trial (mindfulness-based intervention vs. enhanced standard treatment conditions) for adults with mood disorders (N=48). Based on our multilevel confirmatory factor analysis (MCFA), we ran all analyses with three facets of mindfulness (i.e., observing, acting with awareness and nonjudging). Our mediation models (for all three facets) failed to show that the relationship between state mindfulness and smoking risk within a 6-hour period was mediated by motivation to quit. However, within-person changes in the observing facet of the mindfulness, but not the acting with awareness and nonjudging facets, significantly increased motivation to quit in the same report at the within-person level (a path), and higher levels of motivation predicted lower levels of smoking risk in the subsequent report (b path) on both within- and between-person levels, consistent with our predictions. Our second hypothesis - the moderating role of the intervention on the relationship between mindfulness and motivation - was also not supported, indicating that the mindfulness-based intervention did not enhance the impacts of state mindfulness on motivation to quit smoking. Our study was the first to explore the role of motivation to quit as a mediator among individuals with mood disorders in a smoking cessation study using EMA. This study supported the dynamic structure of mindfulness and motivation, yet further research is needed to unpack other mechanisms and examine different time frames between state mindfulness and smoking risk