Acceptance and Commitment Therapy for Smoking Cessation

This article summarizes the theory, clinical methods, evidence, and mechanisms of action for the application of acceptance and commitment therapy (ACT) to tobacco smoking cessation. Following an overview of the relational frame theory underlying the ACT cessation interventions and contrasts between ACT and standard behavioral clinical practice guideline cessation interventions, a session-by-session clinical summary is presented for the delivery of an ACT cessation intervention. The evidence reviewed from the 15 randomized clinical trials published to date (total n = 6991) shows that ACT is a strong alternative to standard behavioral therapies when delivered in traditional modalities (e.g., group) and is particularly efficacious as a smartphone-delivered cessation intervention (e.g., iCanQuit smartphone app). Acceptance of cravings is an important mechanism of action. Future directions include next generations of digital delivery, such as conversational agents (i.e., “chatbots”).