Controlled breathing interventions can reduce cravings in people who use substances, including alcohol, tobacco, and other drugs, according to a new review published in the scientific journal Addiction. The study combined results from 20 studies involving 1,249 total participants, shedding new light on low-cost therapeutic add-ons for addiction treatment.
How Controlled Breathing Reduces Substance Cravings
The systematic review evaluated how paced breathing techniques help individuals manage cravings, withdrawal symptoms, and dependence. According to the findings published in Addiction, breathing interventions show strong potential for improving substance use outcomes, with the clearest evidence demonstrating small but statistically significant reductions in cravings across nicotine, alcohol, opiates, stimulants, and poly-substance use.
Lead author Dr Ariel Dart Roxburgh of Monash University noted the practical implications for public health. “Our review suggests that breathing interventions can be an effective and low-cost add-on to addiction treatment,” Dr Roxburgh stated. With widespread smartphone adoption globally, digital tools could easily deliver these techniques at scale.
Did You Know? Over three-quarters of the world’s population owns a mobile phone, opening the door for smartphone-assisted breathing exercises to serve as accessible recovery aids, according to researchers at Monash University.
Comparing Heart Rate Variability Biofeedback and Single-Session Breathing
The Monash University review differentiated between heart rate variability biofeedback (HRVB) and non-HRVB breathing methods. While researchers found no overall difference in efficacy between the two categories, their structural applications differed significantly.
Evidence for HRVB was concentrated in multi-session programs designed for long-term craving reduction. Conversely, non-HRVB studies spanned both single and multiple sessions, yielding stronger evidence for immediate, single-session craving relief. Researchers also examined withdrawal and dependence outcomes, though data here remained limited to fewer studies—specifically two studies examining dependence and four looking at withdrawal—showing less consistent effects that require further research.
Six Breathing Techniques Analyzed in the Addiction Study
The 20 studies analyzed in the Addiction review utilized six distinct breathing methodologies to assist participants:
- Heart Rate Variability Biofeedback (HRVB): Uses real-time sensors to track heart rate and help users pace breathing to match their heart rhythm.
- Resonant Breathing: Mimics HRVB pacing without biofeedback equipment, typically set at a rate of 6 breaths per minute.
- Yogic Breathing: Involves controlled patterns of inhalation, exhalation, and breath retention, such as Sudarashana Kriya Yoga.
- Rhemercise: Slow-paced breathing combined with behavioral elements like Duchenne smiling, yawning, and positive verbalizations.
- Mimicking Smoking: Uses controlled deep breaths at set intervals—such as inhaling for 5 seconds, holding for 2 seconds, and exhaling for 5 seconds—to replicate the physical action of smoking.
- Three-Part Breathing: Focuses deep inhalations on expanding different parts of the torso sequentially, including the abdomen, lower chest, and upper chest.
Pro Tip: If exploring resonant breathing independently, practitioners generally target a pace of approximately six breaths per minute to approximate the physiological effects of biofeedback training.
Frequently Asked Questions
What types of substance use did the breathing review cover?
The review encompassed studies involving nicotine, alcohol, opiates, stimulants, other substances, and poly-substance use.
What is the difference between HRVB and resonant breathing?
Heart Rate Variability Biofeedback utilizes a physical sensor to monitor heart rhythms in real time, whereas resonant breathing achieves a similar physiological pace—usually six breaths per minute—without specialized biofeedback equipment.
Are smartphone breathing apps proven to cure addiction?
No. According to the study authors, controlled breathing acts as a low-cost add-on intervention to reduce immediate and long-term cravings rather than a standalone cure.
What future research is needed on breathing interventions?
Researchers emphasized the need for larger, pre-registered clinical trials utilizing standardized measurements and longer follow-up periods to better understand the underlying mechanisms.
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