Key messages:

• There is currently no clear evidence that mindfulness‐based treatments help people to stop smoking or improve their mental health and well‐being.
• However, our confidence in the evidence is low or very low, and further evidence is likely to change our conclusions.

What is mindfulness? Mindfulness involves focusing attention on your thoughts and feelings and observing them without judgment as they arise and pass away. Mindfulness is believed to help people better control their thoughts and feelings, rather than be controlled by them. Stopping smoking gives rise to distressing urges to smoke and low mood, so mindfulness‐based treatments could improve people's ability to cope with these. 

Types of mindfulness‐based therapies include:

• mindfulness training (which involves training in mindfulness‐based meditation); 
• acceptance and commitment therapy (ACT); which doesn't teach meditation but encourages people to embrace their thoughts and feelings rather than fighting them, while making committed behaviour change); 
• distress tolerance training (which provides parts of the ACT therapy, as well as presenting people who smoke with situations that make them want to smoke. This allows them to practise the skills that they have learnt through ACT); 
• yoga (which increases awareness of breathing and encourages a connection between mind and body).

What did we want to find out? We wanted to find out whether mindfulness‐based stop‐smoking programmes work better than other stop‐smoking programmes or no treatment to help people stop smoking.

We wanted to know:

• how many people stopped smoking for at least six months;
• whether there were changes in people's mental health and well‐being.

What did we do? We searched for studies that looked at the use of mindfulness to help people stop smoking. We compared and summarised the results of the studies and rated our confidence in the evidence, based on factors such as study methods and sizes.

What did we find? We found 21 studies in 8186 young people and adults who smoked.

The studies tested a range of mindfulness‐based treatments, including mindfulness training (8 studies), ACT (8 studies), yoga (3 studies), and distress tolerance training (2 studies). Studies compared these treatments with:

• other stop‐smoking treatments that were equally time‐intensive (such as counselling);
• other stop‐smoking treatments that were less intensive (such as brief advice);
• no treatment.

Most studies took place in the USA (15 studies). Others took place in Hong Kong (2 studies), Brazil (1 study), Ireland (1 study), and Cyprus (1 study). One study did not report the country it took place in.

Main results: We did not find clear evidence that mindfulness helped people to stop smoking. When we grouped studies by the type of mindfulness‐based intervention people received, we found no evidence that people who received mindfulness training, ACT, distress tolerance training, or yoga were more likely to stop than people who received any other stop‐smoking treatments or no support.

Nine studies looked at whether mindfulness‐based stop‐smoking treatments resulted in positive changes in mental health and well‐being, such as reductions in stress or anxiety or improvements in mood. One of these studies found that people who received a mindfulness training programme reported being less stressed than those who received an alternative stop‐smoking treatment. However, the other 8 did not find evidence of a difference in mental health and well‐being between groups.

What are the limitations of the evidence? Our confidence in the evidence is low to very low as there were problems with the design of studies, findings of studies were very different from one another, and not enough people took part, making it difficult to tell whether mindfulness helps people to stop smoking or was linked to better mental health and well‐being. We need more studies to draw firmer conclusions.