Breath Holding Duration and Self-Reported Smoking Abstinence Intolerance as Predictors of Smoking Lapse Behavior in a Laboratory Analog Task

Abstract

introduction: Distress intolerance (DI) is elevated in smokers and confers increased risk for relapse following a quit attempt. Intolerance of respiratory distress and of nicotine withdrawal may be particularly relevant predictors of smoking cessation outcomes. However, no studies to date have examined the association between smoking relevant DI and smoking lapse behavior in a laboratory setting. The current study examined whether DI was associated with the risk of initiating smoking in a laboratorybased lapse analog task.

Does smoking abstinence influence distress tolerance? An experimental study comparing the response to a breath-holding test of smokers under tobacco withdrawal and under nicotine replacement therapy

“…These results do not confirm Kahler et al (2013) but the inconsistency in not surprising due to the different methodological approaches used (see the introduction). Interestingly, the effect of abstinence on breath holding duration was observed only at the second attempt of apnea.…”

“…Very low breath holding and no significant correlations with IDQ-S (i.e., Smoking Abstinence Discomfort Questionnaire) subscales scores (r ¼0.02 and r ¼0.05; p ¼n.s.) were found (n¼ 96) (Kahler et al 2013). However, the participants were randomized to alcohol administration in a 2 Â 2 balanced placebo design; a double-blind design was not used, being subjects presented with 8 cigarettes and instructed to initiate smoking at any point over the following 50 minutes; because cigarette smoke contains carbon monoxide (CO) and CO 2 , nicotine inhalation was confounded with exposure to these gases; the abstinence condition may last from 5 to 50 min according to the individual urge to smoke; a control condition was not included; physiological or psychological measures to evaluate the response to the breath holding test were not used.…”

“…Only one experimental study (Kahler et al, 2013), according to our knowledge, evaluated the breath holding duration while quitting, that is in abstinent smokers. Very low breath holding and no significant correlations with IDQ-S (i.e., Smoking Abstinence Discomfort Questionnaire) subscales scores (r ¼0.02 and r ¼0.05; p ¼n.s.)…”

“…In this framework, we studied whether smoking abstinence influences breath holding duration trying to overcome the limitations described for Kahler et al (2013). We compared the response to a breath holding test of smokers who refrained from smoking for 4 h and wear once a nicotine patch (i.e., no abstinence) and once a placebo patch (i.e., abstinence) according to a cross-over design.…”

Anxiety, depression, and cigarette smoking: A transdiagnostic vulnerability framework to understanding emotion–smoking comorbidity.

“…There are fairly consistent associations between poor DT and lower ability to sustain abstinence using retrospective reports of quit history (Brown, Lejuez, Kahler, & Strong, 2002), prospective analyses of pre-quit DT as a predictor of cessation outcomes (Brandon et al, 2003; Brown et al, 2009; Cameron et al, 2013; Hajek, 1991; Hajek, Belcher, & Stapleton, 1987; Steinberg et al, 2012), and laboratory experimental analogues of relapse behavior (Kahler et al, 2013). Much of this work documents that low DT increases risk of very early lapse behavior, including within the first several hours or days of abstinence (e.g., Abrantes et al, 2008; Brown et al, 2002; Kahler et al, 2013).…”