Smoking is one of the leading causes of preventable disease and death in the U.S. Over the last several decades, slow and steady progress effectively decreased the number of people who smoked – then the pandemic happened.
For the first time in 20 years, cigarette sales increased in 2020, and that’s not the only alarming trend. In 2022, researchers found that more than 2.5 million middle and high school students in the U.S. reported using e-cigarettes or vaping.
It is well established that smoking negatively impacts almost every organ in the body and can cause conditions such as heart disease, cancer, lung diseases, stroke, chronic obstructive pulmonary disease (COPD), and diabetes. Yet, this fact begs a serious question: Why do people smoke despite the evidence showing tremendous harm?
The culprit isn’t a lack of understanding that smoking is harmful – in fact, the reality is quite the opposite. Nearly 70% of people who smoke want to quit. However, nicotine, the chemical found in tobacco, is a highly addictive substance. The physical addiction along with the rituals of lighting up after a stressful interaction or joining fellow smokers for a break make for a potent and potentially lethal combination. There is an obvious disconnect between desire and results, since only around 7% of quitting attempts are successful.
Typically, smoking cessation programs try to change one’s beliefs about smoking or avoid the situations that trigger cravings. It’s fair to say these strategies are not adequate given the unimpressive success rates, and we suspect this is because these treatments do not target how people learn and feel rewarded. To help people quit effectively, we need a way that not only addresses the addiction, but also the habitual act of smoking. New research from my lab at Brown University provides a potential path forward.
We studied real users of Sharecare’s award-winning digital therapeutic, Craving to Quit, to see if mindfulness can help disrupt the habit of smoking. The 21-day app-based program provides daily instruction through a combination of video and audio lessons, daily reminders, and goal-setting tools to help people quit smoking. It also utilizes a tool that delivers on-demand mindfulness training as the participant comes face-to-face with a cigarette craving. Users are guided through an exercise to remember the last time they smoked. What did it taste and smell like? How did it feel in their mouth, throat, and lungs? After the smoking simulation, they are given the option to pay attention as they actually smoke or “ride out” the craving with a brief mindfulness practice.
Results showed that repeated use of the Craving Tool corresponded with a decrease in the perceived reward of smoking. This in turn lessened the strength of a craving the next time users wanted to smoke. By disrupting the cycle between the urge to smoke and acting on it, the Craving to Quit approach helps make quitting easier.
With Craving to Quit, we are empowering tobacco users with the right tools to face their urge to smoke and manage it from moment to moment rather than choking on a huge, scary craving. While anyone can download Craving to Quit, we also are working with health plans, employers, and community organizations to put this valuable program in the hands of those who need it across their populations.
If you’re interested in making Craving to Quit available for tobacco users in your organization, request more information and a demo at https://www.sharecare.com/digital-therapeutics/tobacco-cessation. You also can try it for yourself by downloading Craving to Quit from the App Store or Google Play.