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Objective: To compare the efficacy of Mindfulness-Based Addiction Treatment (MBAT) to a Cognitive Behavioral Treatment (CBT) that matched MBAT on treatment contact time, and a Usual Care (UC) condition that comprised brief individual counseling. Method: Participants (N = 412) were 48.2% African American, 41.5% non-Latino White, 5.4% Latino, and 4.9% other, and 57.6% reported a total annual household income < $30,000. The majority of participants were female (54.9%). Mean cigarettes per day was 19.9 (SD = 10.1). Following the baseline visit, participants were randomized to UC (n = 103), CBT (n = 155), or MBAT (n = 154). All participants were given self-help materials and nicotine patch therapy. CBT and MBAT groups received 8 2-hr in-person group counseling sessions. UC participants received 4 brief individual counseling sessions. Biochemically verified smoking abstinence was assessed 4 and 26 weeks after the quit date. Results: Logistic random effects model analyses over time indicated no overall significant treatment effects (completers only: F(2, 236) = 0.29, p = .749; intent-to-treat: F(2, 401) = 0.9, p = .407). Among participants classified as smoking at the last treatment session, analyses examining the recovery of abstinence revealed a significant overall treatment effect, F(2, 103) = 4.41, p = .015 (MBAT vs. CBT: OR = 4.94, 95% CI: 1.47 to 16.59, p = .010, Effect Size = .88; MBAT vs. UC: OR = 4.18, 95% CI: 1.04 to 16.75, p = .043, Effect Size = .79). Conclusion: Although there were no overall significant effects of treatment on abstinence, MBAT may be more effective than CBT or UC in promoting recovery from lapses.

In this chapter, we begin to explore the wealth of research and theory on the implications of mindfulness for emotional experience by examining a variety of models of mindfulness and how they inform mindful emotion regulation. Then, we provide an empirical overview of the role of mindfulness in general emotional states, emotional reactions to stimuli and events, and emotions over time. Within this overview, we provide evidence for several distinct avenues through which mindfulness benefits emotion regulation, including increased willingness to experience negative emotions, reduced reactivity to emotional stimuli and situations, a decentered perspective, and increased emotional stability; we also highlight some research which suggests the neurological underpinnings of mindful emotion regulation. Finally, we link the impact of mindfulness on emotion regulation to behavioral change. Specifically, by highlighting research on smoking, alcohol use, and other addictive behaviors, we demonstrate that emotion regulation serves as a key mechanism in the relationship between mindfulness and some domains of behavioral regulation.