Efficacy of a Validated Yoga-Breath Linked Intervention (Y-BLISS) for smoking cessation: A Randomized Controlled Trial

Tobacco use disorder remains a global health concern, and safe complementary interventions are needed. We evaluated a validated Yoga-Breath Linked Intervention to Stop Smoking (Y-BLISS).

In this randomized controlled trial, 139 smokers meeting DSM-5 criteria for tobacco use disorder with moderate to severe nicotine dependence (Fagerström Test for Nicotine Dependence, FTND ≥4) were randomized to Y-BLISS (n = 70) or desktop exercise control (n = 69). Y-BLISS comprised a 12-minute yoga-breath protocol with single-session yoga philosophy-based psychotherapy, delivered online under live supervision 5 days/week for 8 weeks. Controls received attention-matched desktop exercise with health education. The primary outcome was cigarettes per day (CPD). Secondary outcomes included 7-day point-prevalence abstinence, FTND, Tobacco Craving Questionnaire Short Form (TCQ-SF), peak expiratory flow rate (PEFR), and exhaled carbon monoxide (eCO). Assessments occurred at baseline, 4 and 8 weeks; analysis was intention-to-treat with linear mixed-effects models.

Baseline characteristics were broadly comparable, with slightly higher dependence and craving in Y-BLISS (mean age 38.7 ± 8.6 years; 95% male; FTND 5.2 ± 1.2). At 8 weeks, Group × Time effects (β, 95% CI) favored Y-BLISS for CPD, FTND, TCQ-SF and PEFR, all p < 0.001, and eCO (p = .04). Seven-day point-prevalence abstinence was 25.7% versus 11.6% (odds ratio 2.64, 1.06 to 6.57; p = 0.037). Differences were already present at 4 weeks for CPD, FTND, TCQ-SF and PEFR.

These findings support Y-BLISS as a promising adjunct to standard cessation care and justify longer-term, multicenter effectiveness and implementation trials.