(PS1-B39) The Effects of the State Mindfulness on Motivation to Quit and Smoking Risk Among Individuals with Mood Disorders

Significance: Smoking is the leading cause of preventable death, disability, and death worldwide. Individuals with mental disorders smoke at significantly higher rates than those without mental disorders. Although smoking quit rates are very high among the general population, these rates are significantly lower among individuals with mental disorders. Preliminary evidence suggests that mindfulness intervention can reduce smoking cessation rates among those individuals by targeting aversive negative affects and distress intolerance. This study aims to investigate the effects of mindfulness on smoking risk among individuals with mood disorders. This study's second goal is to explore mindfulness's mechanism on smoking risk through ecological momentary assessment (EMA) data. Based on the Self Determination Theory, we propose that mindfulness will increase the autonomous motivation for those with mental disorders to maintain their non-smoking status. As extant literature demonstrates that motivation is a dynamic construct and changes temporarily, we used EMA to capture those momentary changes and measure state mindfulness to examine the acute effects of both constructs on smoking risk. Thus, exploring this mechanism will help researchers and practitioners to implement required motivational strategies to increase commitment to abstinence goals with just-in-time interventions.

Method: This is a randomized controlled trial comparing Smartphone-assisted Mindfulness Smoking Cessation Intervention with Contingency Management (SMI-CM) and Enhanced Standard Treatment (EST). Individuals with bipolar or major depressive disorders (N=49), reporting smoking at least five cigarettes per day, were recruited at an outpatient setting in the Bronx, NYC. Participants reported their daily smoking outcomes, motivation, and mindfulness levels five times per day for 38 days (10 days pre-quit and 28 days post-quit).

Results: Data will be available in April 2023, and results will be presented at the conference. We will analyze our data with multilevel mediation analysis for nested data structure in EMA to unpack within-person effects of state mindfulness and motivation on daily smoking risk.

Conclusion: We expect to find an association between higher levels of state mindfulness and a lower likelihood of smoking risk mediated by state motivation. This study is novel in two ways: (1) examining the mindfulness intervention on smoking risk among individuals with mood disorders and (2) exploring the mechanism of mindfulness on smoking risk through the indirect effects of motivation.