Development, validation and feasibility testing of a 12-minute Yoga-Breath Linked Intervention to Stop Smoking...

This study aimed to develop and validate the yoga-breath-linked intervention to stop smoking (Y-BLISS), a novel, scalable, and cost-effective yoga-based module for smoking cessation as an add-on to standard care.

Thirty experts from yoga, psychiatry, and clinical psychology backgrounds evaluated a selection of yoga practices and brief yoga philosophy-based psychotherapeutic (BYPP) concepts for their potential efficacy in smoking cessation using the Content Validity Ratio (CVR), with a cut-off of 0.4. The final intervention module included ten items (8 practices and 2 psychotherapeutic concepts). The module was tested over two months with 26 participants (25 males) diagnosed with tobacco use disorder as per DSM -5 and enrolled in a smoking cessation program, with Fagerström Nicotine Dependence Scale (FTND) scores of 6 or above. Participants attended 15-25 sessions (including a single BYPP session) and provided feedback on safety, feasibility, and clinical outcomes.

Sixteen subjects provided post-data at 8 weeks. The module received high safety ratings (9-10) with no adverse effects. The analysis revealed a significant reduction in FTND scores from baseline to weeks 4 and 8, F (2,14) = 13.93; P < 0.01. There was also a significant improvement in peak expiratory flow rate after 8 weeks of practicing the Y-BLISS module, F (2,14) = 20.39; P < 0.01. Among the practices, Nadi Shuddhi (alternate nostril breathing), Kapalabhati (skull shining breath), and relaxation techniques were particularly well-received. However, Bhastrika (fast breathing) was challenging in workplace settings due to its intensity. Two yoga-based philosophical concepts: 1) Happiness analysis (Ananda Mimamsa) and 2) Analysis of the self (Aatma pariksha) satisfied the content validation criteria to be included in BYPP program.

Y-BLISS module including single session of BYPP was found to be a feasible and safe adjunctive tool for smoking cessation programs. These findings support further evaluation in randomized controlled trials to assess its efficacy and potential as part of integrative approaches toward management of tobacco use disorder. This could impact public health primary care if scaled up with high coverage.