Exploring mindfulness and its psychosocial correlates in a population of low-income, female, tobacco smokers with young children

Abstract

Background: Tobacco use is the leading preventable cause of disease and death in the US and smoking rates are high in low-income populations (28% vs. 17% of those living above the poverty line).1,2 Consequently, low-income groups have elevated tobacco-related disease risk exacerbating health disparities.3,4 Mindfulness has been associated with positive effects on psychosocial, physical and mental health outcomes, which has increased interest in using mindfulness as an adjunctive treatment for smoking cessation and relapse prevention.5,6 However, research on mindfulness in relation to such factors in underserved populations is lacking.
 Purpose/Hypothesis: The purpose of this research is to investigate the psychometric qualities and correlates of the Cognitive and Affective Mindfulness Scale (CAMS-R)7 in a sample of low-income, mostly minority women who smoke cigarettes. It is hypothesized that the CAMS-R will be reliable, and mindfulness will be associated with known barriers to cessation.
 Methods: Secondary analysis of self-report data from 12-month follow-up in a large, randomized smoking cessation trial, Babies Living Safe and Smokefree,8 was used to explore mindfulness and its relationship to known cessation barriers and facilitators. Temple University IRB approval was received before data collection. CAMS-R items were summed to create a composite score.
 Results: The sample of women (N=187) was mostly (72%) African American, average age was 30 years old, ~28% had less than a high school degree/GED and on average smoked ~9 cigarettes/day. The CAMS-R was reliable (α=.74). Zero-order correlations showed higher mindfulness was significantly correlated with greater social support (p < .01). Higher mindfulness was significantly correlated with lower depressive symptoms, social constraints, household chaos, sleep disturbances, childhood trauma, life stressors, and chronic mental, and physical health conditions (p's < .01 except physical health p < .05).
 Conclusions/Relevance: The sample had higher CAMS-R scores compared to central tendency scores in broader populations. The high scores may indicate an amenable characteristic of mindfulness that could be trained for interventions. Yet, more research is needed on feasibility/acceptability in this population. Higher mindfulness is inversely related to many negative health and psychosocial factors which are known barriers to cessation, as well as positively related to social support, an important facilitator of cessation. The interplay between social support and mindfulness should be explored, as each is theorized as a “stress buffer.” research should investigate psychosocial factors as potential mediators in mindfulness interventions for smoking cessation targeting vulnerable female smokers.