Differential prevalence of established risk factors for poor cessation outcomes among smokers by level of social anxiety

Abstract

Background and Objectives Despite clear associations between social anxiety (SA), high prevalence of smoking, and cessation failure, little is known about factors contributing to these relationships. Moreover, the extent to which smokers with moderate SA represent an at-risk group of smokers is also unknown. This study examined the extent to which established risk factors for poor cessation (e.g., sociodemographic, smoking history, mental health comorbidity) are prevalent among smokers with low, moderate, and high levels of SA. Methods Participants (N = 2,637) were adult smokers from a web-based smoking cessation trial. Nineteen characteristics considered risk factors for poor cessation outcomes were assessed at baseline. Those associated with social anxiety were subsequently compared by SA level. Results Regression models indicated that 10/19 risk factors were associated with SA. Compared to smokers with low SA, those with moderate and high SA endorsed 4/10 and 10/10 risk factors as more prevalent or severe, respectively. Compared to smokers with low SA, High SA was associated with greater sociodemographic risk factors, while both moderate and high SA was associated with more severe mental health symptoms. Conclusions and Scientific Significance Smokers with moderate and high levels of SA endorse more risk factors for poor cessation outcomes than those with low levels of SA, particularly mental health symptoms. These factors may help explain the differential smoking outcomes of socially anxious smokers. Results suggest that smokers with both moderate and high levels of SA would likely benefit from cessation interventions that address and consider these risk factors.

Comparing Treatment Acceptability and 12-Month Cessation Rates in Response to Web-Based Smoking Interventions Among Smokers Who Do and Do Not Screen Positive for Affective Disorders: Secondary Analysis

“…Individuals who screened positive for affective disorders may not all have the disorders they screened positive for and instead have elevated, subthreshold symptoms of the disorders. In line with previous research indicating that even individuals with subthreshold symptoms of affective disorders are at risk for continued smoking [3,46] and that screening instruments for affective disorders can be used to predict cessation [2], this study highlights that the screening instruments used in this study can be useful in identifying smokers who are less likely to quit even without a formal diagnostic assessment. Finally, we did not biochemically verify self-reported smoking abstinence at the 12-month follow-up.…”

Quality of life in a smoking cessation program: lifestyle, anxiety, and depression

“…However, we observed that the patients who had the worst results (lowest score) were the same ones who did not cease and/or relapsed, while the patients who completely stopped had the best results in the evaluation of the lifestyle. In a recent study, Xue et al (2017), demonstrated that smokers who quit smoking after drug-eluting stents implantation showed comparable improvement health status and quality-of-life benefits when compared with nonsmokers and significantly better HRQoL than smokers who continued smoking [41]. However, in the aforementioned study, there was a compulsory need for post-infarction cessation, as opposed to the present study in which treatment was initiated voluntarily.…”

“…In a study by Mitra et al (2004), it was demonstrated that individuals who quit smoking showed a significant improvement in mean SF-36 scores overtime for health in general, including the domains of mental health, energy, and vitality [40]. Accordingly, Xue et al (2017), who used SF36 as an instrument to evaluate patients with non-smokers coronary heart disease had a better health-related quality of life (HRQoL) than the smokers' group [41]. In our study, the evaluation after the smoking cessation treatment showed that the indicators of the LPA, SA, and EA domains had higher scores.…”

“…These results suggest that at the time of application of the questionnaires, the participants were more anxious than usual and also may be associated with the large number of relapses that occurred in this sample. According to Watson et al (2017), smokers with moderate to high levels of anxiety are at higher risk for cessation failure than those with low anxiety levels [42].…”