As a Trans-Disease Behavioral Process, delay discounting is related to almost all addictive behaviors, including addition to tobacco, alcohol, cannabis, stimulants, opiates, & gambling. Delay discounting is also associated with treatment outcomes and relapse to addictive behaviors, obesity, attention-deficit/hyperactivity disorder, and even risky behaviors like texting while driving. To increase the public-health impact of research involving delay discounting, it is of critical importance to identify innovative methods of improving discounting that are also scalable and accessible In response, we are proposing to use a mindfulness training app (Headspace) to reduce delay discounting, perceived stress, and depression in rural adult smokers. We have chosen 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 delay discounting. Furthermore, by using a web-based/app version of mindfulness training we increase program flexibility for difficult-to-reach populations, such as rural adult 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 a 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. Delay discounting, depression, perceived stress, mindfulness, and tobacco use will be assessed before starting either of these two conditions and also after every 10 days during the programs (days 10, 20, and 30) to track the time course of any changes. To conclude, we will collect all of these data again 30 days post intervention to evaluate stability of any observed effects. We hypothesize that in rural adult smokers mindfulness training will reduce delay discounting, 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 their outcomes. This research addresses a significant public health issue by directly engaging central behavioral targets for cigarette smoking in a difficult- to-reach population.
Delay discounting, perceived stress and depression are important behavioral targets related to cigarette smoking?which represents a significant threat to public health. This study will use and evaluate a mindfulness training app to reduce delay discounting, perceived stress and depression in rural adult smokers. If successful, mindfulness training can be added to prevention and treatment programs to improve their efficacy and reduce smoking in this difficult-to-reach population.
