Development, validation and feasibility testing of a 12-minute Yoga-Breath Linked Intervention to Stop Smoking (Y-BLISS) module
ABSTRACT Objectives: 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. Methods: Thirty experts from yoga, psychiatry, and clinical psycho...
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| Published in | Journal of family medicine and primary care Vol. 14; no. 6; pp. 2502 - 2513 |
|---|---|
| Main Authors | , , , , , , , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
India
Wolters Kluwer - Medknow
01.06.2025
Medknow Publications and Media Pvt. Ltd Wolters Kluwer Medknow Publications |
| Edition | 2 |
| Subjects | |
| Online Access | Get full text |
| ISSN | 2249-4863 2278-7135 |
| DOI | 10.4103/jfmpc.jfmpc_1980_24 |
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| Abstract | ABSTRACT
Objectives:
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.
Methods:
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.
Results:
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.
Conclusion:
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. |
|---|---|
| AbstractList | ABSTRACT Objectives: 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. Methods: 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. Results: 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. Conclusion: 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. Keywords: Nicotine dependence, smoking, tobacco, yoga ABSTRACT Objectives: 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. Methods: 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. Results: 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. Conclusion: 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. 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.ObjectivesThis 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.MethodsThirty 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.ResultsSixteen 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.ConclusionY-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. Objectives: 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. Methods: 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. Results: 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. Conclusion: 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. 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; < 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; < 0.01. Among the practices, (alternate nostril breathing), (skull shining breath), and relaxation techniques were particularly well-received. However, (fast breathing) was challenging in workplace settings due to its intensity. Two yoga-based philosophical concepts: 1) Happiness analysis ( ) and 2) Analysis of the self ( ) 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. 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. |
| Audience | Academic |
| Author | Singh, Amit Chand, Prabhat Narasimha, Venkata Lakshmi Shekar, MV Chandra Holla, Bharath Snigdha, Atmakur Mahadevan, Jayant Keshavan, Matcheri Ramachandran, Padmavati Bhargav, Hemant Murthy, Pratima Maheswari, E Katla, Naresh Komal, S |
| AuthorAffiliation | 1 Division of Yoga and Life Sciences, Swami Vivekananda Yoga Anusandhana Samsthana, Bengaluru, Karnataka, India 5 Departmental Pharmacy, M.S. Ramaiah University of Applied Science, Bengaluru, Karnataka, India 2 Department of Integrative Medicine, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India 7 Beth Israel Deaconess Medical Center and Massachusetts Mental Health Center, Harvard Medical School, Boston, MA, USA 4 Department of Yoga and Science of Living, Samsthana, Jain Vishva, Bharathi Institute, Ladnun, Rajasthan, India 8 National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India 3 Centre for Addiction Medicine, Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India 6 Department of Psychiatry, Schizophrenia Research Foundation, Chennai, Tamil Nadu, India |
| AuthorAffiliation_xml | – name: 3 Centre for Addiction Medicine, Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India – name: 5 Departmental Pharmacy, M.S. Ramaiah University of Applied Science, Bengaluru, Karnataka, India – name: 8 National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India – name: 1 Division of Yoga and Life Sciences, Swami Vivekananda Yoga Anusandhana Samsthana, Bengaluru, Karnataka, India – name: 7 Beth Israel Deaconess Medical Center and Massachusetts Mental Health Center, Harvard Medical School, Boston, MA, USA – name: 6 Department of Psychiatry, Schizophrenia Research Foundation, Chennai, Tamil Nadu, India – name: 2 Department of Integrative Medicine, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India – name: 4 Department of Yoga and Science of Living, Samsthana, Jain Vishva, Bharathi Institute, Ladnun, Rajasthan, India |
| Author_xml | – sequence: 1 givenname: MV Chandra surname: Shekar fullname: Shekar, MV Chandra – sequence: 2 givenname: Hemant surname: Bhargav fullname: Bhargav, Hemant email: drbhargav.nimhans@gmail.com – sequence: 3 givenname: Bharath surname: Holla fullname: Holla, Bharath – sequence: 4 givenname: Jayant surname: Mahadevan fullname: Mahadevan, Jayant – sequence: 5 givenname: Amit surname: Singh fullname: Singh, Amit – sequence: 6 givenname: Venkata Lakshmi surname: Narasimha fullname: Narasimha, Venkata Lakshmi – sequence: 7 givenname: Naresh surname: Katla fullname: Katla, Naresh – sequence: 8 givenname: Atmakur surname: Snigdha fullname: Snigdha, Atmakur – sequence: 9 givenname: S surname: Komal fullname: Komal, S – sequence: 10 givenname: E surname: Maheswari fullname: Maheswari, E – sequence: 11 givenname: Padmavati surname: Ramachandran fullname: Ramachandran, Padmavati – sequence: 12 givenname: Prabhat surname: Chand fullname: Chand, Prabhat – sequence: 13 givenname: Matcheri surname: Keshavan fullname: Keshavan, Matcheri – sequence: 14 givenname: Pratima surname: Murthy fullname: Murthy, Pratima |
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| References_xml | – volume: 12 start-page: 3866 year: 2020 ident: R3-20250707 article-title: Cardiovascular risk of smoking and benefits of smoking cessation publication-title: J Thorac Dis doi: 10.21037/jtd.2020.02.47 – volume: 45 start-page: 420 year: 2023 ident: R21-20250707 article-title: Exploring the therapeutic potential of yoga philosophy: A Perspective on the Need for Yoga-Based Counselling Program (YBCP) in common mental disorders publication-title: Indian J Psychol Med doi: 10.1177/02537176211051987 – volume: 89 start-page: 302 year: 2007 ident: R24-20250707 article-title: Subjective reactivity to the first cigarette of the day as a predictor of smoking relapse: A preliminary study publication-title: Drug Alcohol Depend doi: 10.1016/j.drugalcdep.2007.01.011 – volume: 225 start-page: 875 year: 2013 ident: R13-20250707 article-title: The acute effects of yogic breathing exercises on craving and withdrawal symptoms in abstaining smokers publication-title: Psychopharmacology (Berl) doi: 10.1007/s00213-012-2876-9 – volume: 22 start-page: 1217 year: 2021 ident: R2-20250707 article-title: WHO releases latest report on the global tobacco epidemic publication-title: Lancet Oncol doi: 10.1016/S1470-2045(21)00464-2 – volume: 281 start-page: 484 year: 1980 ident: R19-20250707 article-title: Expired air carbon monoxide: A simple breath test of tobacco smoke intake publication-title: Br Med J doi: 10.1136/bmj.281.6238.484 – volume: 92 start-page: 103907 year: 2024 ident: R22-20250707 article-title: Know thyself (Jnana Yoga): Psychotherapeutic insights from the East publication-title: Asian J Psychiatr doi: 10.1016/j.ajp.2023.103907 – volume: 15 start-page: 1436691 year: 2024 ident: R14-20250707 article-title: Validation and efficacy of a tele-yoga intervention for improving psychological stress, mental health and sleep difficulties of stressed adults diagnosed with long COVID: A prospective, multi-center, open-label single-arm study publication-title: Front Psychol doi: 10.3389/fpsyg.2024.1436691 – volume: 72 start-page: 167 year: 2016 ident: R23-20250707 article-title: Effectiveness of a brief community outreach tobacco cessation intervention in India: A cluster-randomised controlled trial (the BABEX Trial) publication-title: Thorax doi: 10.1136/thoraxjnl-2016-208732 – volume: 54 start-page: 102334 year: 2020 ident: R25-20250707 article-title: Tele-yoga for stress management: Need of the hour during the COVID-19 pandemic and beyond? 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This study aimed to develop and validate the yoga-breath-linked intervention to stop smoking (Y-BLISS), a novel, scalable, and... 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... ABSTRACT Objectives: This study aimed to develop and validate the yoga-breath-linked intervention to stop smoking (Y-BLISS), a novel, scalable, and... Objectives: This study aimed to develop and validate the yoga-breath-linked intervention to stop smoking (Y-BLISS), a novel, scalable, and cost-effective... |
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| SubjectTerms | Analysis Evidence-based medicine Health aspects nicotine dependence Original Original Article Philosophy Relaxation smoking Smoking cessation programs tobacco yoga |
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| Title | Development, validation and feasibility testing of a 12-minute Yoga-Breath Linked Intervention to Stop Smoking (Y-BLISS) module |
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