Can Breathing Exercises Actually Reduce Cravings?

What the study actually did

Researchers led by Dr. Ariel Dart Roxburgh at Monash University, with a team including Dan I. Lubman, Victoria Manning and Shalini Arunogiri, searched eight databases through November 2025 and pulled together every quantitative trial they could find on controlled breathing for substance use. Twenty trials qualified, covering 1,249 participants across alcohol, nicotine, opioid, stimulant and polysubstance use. Fifteen went into the meta-analysis proper.

They split the interventions into two families. Heart rate variability biofeedback uses a sensor to show you your own physiology in real time and teach you to steady it. Everything else is unassisted: resonant breathing at roughly six breaths a minute, yogic breathing, three-part breathing, and similar.

What it found

On cravings, the pooled effect was Hedge's g = 0.30, with a confidence interval of 0.12 to 0.48. In plain terms: a real effect, consistently in the same direction, and modest in size. It is not nothing and it is not a cure.

The other two outcomes are weaker evidence, and worth being careful about.

Withdrawal symptoms came out at g = 0.46, but the confidence interval ran from −0.28 to 1.19. That interval crosses zero, which means the honest reading is that we do not yet know.

Dependence showed a large effect, g = 0.85, but it rests on two studies and 144 people. A large effect from two trials is a reason to run more trials, not a reason to make claims.

The finding that actually matters

Buried in the modality comparison is the practically useful part.

Unassisted breathing outperformed biofeedback for acute relief. Biofeedback outperformed unassisted breathing over multiple sessions across time.

That maps cleanly onto two different problems. If you are trying to build long-term regulation with clinical support, the sensor-based approach has more behind it. If you are standing in a kitchen at 2am with a craving arriving, the thing with the evidence behind it is the simple version, the one requiring no device, no setup, and no account.

For anyone in a moment rather than in a program, that is the relevant column.

The part I am not going to skip

None of these studies were about gambling.

The review covered alcohol, nicotine, opioids and stimulants. Gambling disorder is a behavioral addiction, and while it shares a great deal of neurobiology with substance addiction, including overlapping reward and craving circuitry, sharing mechanisms is not the same as sharing evidence.

So the accurate statement is this. Controlled breathing has modest, replicated evidence for reducing substance cravings, and a plausible but untested case for gambling cravings. Anyone telling you a breathing exercise is a proven treatment for gambling disorder is ahead of the data.

The authors themselves call for "larger, pre-registered trials with standardised measures and longer follow-up." That is researchers saying the same thing in more formal language.

Why it still matters if you gamble

Two reasons, and neither requires overstating the study.

The downside is zero. A modest effect with no cost, no side effects, no prescription and no waiting list is worth having in a moment where the realistic alternative is nothing at all.

It fits the shape of a gambling urge. Gambling cravings tend to arrive fast, peak, and pass, often inside a few minutes. An intervention you can start instantly, without equipment, is matched to that timeline in a way a scheduled appointment is not.

That is not a claim that breathing solves gambling addiction. It is a claim that a free thing with real evidence behind it belongs in the toolkit, alongside cutting access, telling someone, and getting treatment.

What we do with this in Cope Compass

Cope Compass carries 192 techniques, and 12 of them are breath-based, including box breathing, 4-7-8, and the physiological sigh. Each runs on a countdown timer rather than a written instruction you have to pace yourself, because pacing yourself is the first thing to go when you are activated.

They sit inside the urge flow, so they appear at the moment someone opens the app in trouble, not in a menu they have to go looking for. And they are on the free tier, permanently, along with everything else in the crisis path.

This study did not change what we built. It did make the case for one part of it a little stronger, and it sharpened where that part belongs: the simple, unassisted version, offered fast, in the moment. That is the column the evidence supports.

If you want to try it right now, before reading anything else: breathe in through your nose for four, hold for seven, out through your mouth for eight. Do it four times. That is the 4-7-8, and it takes about thirty seconds.

• Neuroscience News: Controlled breathing reduces cravings
• Roxburgh, A.D., et al. Addiction (2026). DOI: 10.1111/add.70542
• National Council on Problem Gambling
• Related: How to recognise a gambling urge and the 5-minute rule