A simple act that happens automatically thousands of times a day may have a role in helping people manage one of addiction's most difficult challenges: craving. A new systematic review and meta-analysis published in the journal Addiction has found that controlled breathing and breathing-based interventions were associated with significantly lower cravings among people using nicotine, alcohol and other drugs. The researchers say the findings support breathing practices as a potentially low-cost, scalable adjunct for managing cravings in substance use disorders, though the evidence for withdrawal symptoms and other outcomes remains less certain. What did the 2026 study find about controlled breathing and addiction?Led by Ariel Dart Roxburgh and colleagues affiliated with Monash University and Eastern Health in Melbourne, Australia, the research team systematically reviewed 3,502 studies and identified 20 studies that met its inclusion criteria. Of these, 15 studies were eligible for meta-analysis, bringing together evidence on breathing-based interventions and substance use-related outcomes.The clearest finding involved craving. Across 12 studies involving 696 participants, breathing-based interventions produced a small but statistically significant and consistent reduction in craving compared with control groups.Also Read: Ecological cost of US-Iran war: Scientists warn ships stranded for months in the Strait of Hormuz could now carry invasive species, posing an ‘immense international biosecurity threat’The evidence covered people using different substances, including nicotine, alcohol and other drugs, suggesting that breathing practices may have relevance across different forms of substance use disorders.A simple intervention with potentially wide reachThe researchers examined controlled breathing practices, including interventions involving heart rate variability biofeedback (HRVB). Heart rate variability biofeedback combines controlled breathing with physiological feedback intended to help people regulate activity in their autonomic nervous system. However, when the researchers compared HRVB with other breathing-based approaches, they found no significant difference between the intervention types for reducing craving.That finding is important because it suggests the potential benefit was not limited to a single specialized technique requiring sophisticated equipment.The review also found that the effects on craving were consistent despite differences in how interventions were delivered. Some programmes involved clinician-led breathing, while others were entirely self-directed, supporting the possibility that such practices could be implemented at relatively low cost.How could breathing influence cravings?The researchers point to the body's autonomic nervous system as one possible explanation. Emotional distress is generally associated with increased sympathetic nervous system activity, while calmer, more regulated states are associated with greater parasympathetic activity. According to the study, controlled breathing may help reduce sympathetic activity while enhancing parasympathetic activity.The researchers suggest that breathing interventions may therefore influence substance-use outcomes by improving autonomic regulation and self-regulation. The study also discusses heart rate variability as a measure connected to the body's ability to adapt to internal and external demands.In simple terms, the findings suggest that regulating breathing could potentially help people manage the intense psychological and physiological states associated with craving.The evidence was strongest for craving, not every addiction symptomThe researchers cautioned that the results should not be interpreted as showing that breathing practices solve every aspect of substance use disorders.While the evidence showed a statistically significant reduction in craving, the findings for withdrawal symptoms were uncertain. The meta-analysis examining withdrawal included only four studies and showed substantial variation between them.The review also found a larger effect for substance dependence, but that analysis was based on only two studies involving 144 participants, meaning the evidence remains more limited than it is for craving. The authors therefore described breathing-based interventions as a promising approach, particularly for craving, while stressing the need for further high-quality research.Why researchers see breathing practices as a scalable addition to addiction treatmentSubstance use disorders can require treatments that are time-consuming and resource-intensive. The researchers noted that breathing-based interventions have potential advantages because they generally involve minimal training requirements, low implementation costs and the possibility of self-directed use.Their conclusion does not position controlled breathing as a replacement for established addiction treatment. Instead, the findings support its potential integration as an accessible adjunct within broader treatment frameworks.The study ultimately synthesized evidence from 1,249 participants across 20 studies and concluded that breathing-based interventions showed consistent and significant effects in reducing cravings among people with substance and nicotine use disorders.