Differential associations between components of anxiety sensitivity and smoking-related characteristics

Abstract

Anxiety sensitivity (AS)—the tendency to fear anxiety-related experiences—is a risk factor for anxiety disorders and may contribute to smoking motivation and maintenance. Few studies have examined relations between conceptually distinct components of AS and smoking behavior. The purpose of the current study was to examine associations between AS components—Physical Concerns, Mental Concerns, and Social Concerns—and an array of smoking-related characteristics. In a cross-sectional design, we administered the Anxiety Sensitivity Index (ASI) and self-report measures of tobacco dependence, smoking abstinence behavior, and smoking outcome and abstinence expectancies to 314 smokers (≥10 cigarettes/day, 32% female, M age = 44 years). ASI Mental Concerns was most clearly associated with greater difficulty maintaining abstinence and stronger expectations of smoking-related negative reinforcement and withdrawal (βs = .21-31, ps≤ .005); ASI Social Concerns was most clearly associated with stronger positive reinforcement smoking expectancies (β = .20, p = .0009); and ASI Physical Concerns was most clearly associated with stronger tobacco withdrawal symptoms experienced in prior quit attempts (β = .20, p = .002). Based on these findings of patterns of associations with smoking-related characteristics across distinct components of AS, we speculate that: (1) mindfulness training may be useful for treating tobacco addiction in smokers high in ASI Mental Concerns; and (2) smokers high in ASI Physical and Social Concerns may benefit from smoking cessation treatment that incorporates interoceptive exposure and cognitive-behavioral therapy for social anxiety, respectively.

Anxiety sensitivity facets in relation to tobacco use, abstinence-related problems, and cognitions in treatment-seeking smokers

“…[24,25] High-AS smokers report experiencing more severe withdrawal symptoms [26–28] and stronger motives and expectations in regard to reducing NA by smoking, [17–20] and AS associations with smoking-related variables have persisted when controlling for anxiety, depression, NA, daily cigarette use, and tobacco dependence severity. [29–31] Additionally, two experimental studies have shown that high-AS individuals report greater NA reduction from smoking subsequent to laboratory-induced social stress. [32,33] Thus, it appears that AS is a risk factor for smoking largely due to its ability to heighten NA in response to stressors (e.g., tobacco withdrawal), which in turn increases negative reinforcement smoking motivation.…”

“…[6,35,36] Yet, relatively few studies have examined smoking variables in relation to the three AS facets, and extant work shows that different facets of AS have different smoking-related correlates. AS physical and cognitive concerns have been consistently associated with greater negative reinforcement-related smoking motives and expectancies, [31,37–39] whereas only one study has associated AS cognitive concerns with positive reinforcement-related smoking motives. [37] Although most studies have reported no relationship between AS facets and cigarette frequency or dependence severity, [31,38,39] one study reported that all three AS facets were associated with daily cigarette consumption.…”

“…AS physical and cognitive concerns have been consistently associated with greater negative reinforcement-related smoking motives and expectancies, [31,37–39] whereas only one study has associated AS cognitive concerns with positive reinforcement-related smoking motives. [37] Although most studies have reported no relationship between AS facets and cigarette frequency or dependence severity, [31,38,39] one study reported that all three AS facets were associated with daily cigarette consumption. [23] Then in a recent study of non-treatment-seeking smokers, [31] we found that AS physical and cognitive concerns were associated with more severe (retrospectively reported) problems during tobacco abstinence; all three AS components were associated with stronger negative reinforcement-related smoking outcome expectancies; only AS social concerns were associated with stronger positive reinforcement-related smoking outcome expectancies; and none of the AS facets were associated with tobacco dependence severity or subtypes.…”

“…[37] Although most studies have reported no relationship between AS facets and cigarette frequency or dependence severity, [31,38,39] one study reported that all three AS facets were associated with daily cigarette consumption. [23] Then in a recent study of non-treatment-seeking smokers, [31] we found that AS physical and cognitive concerns were associated with more severe (retrospectively reported) problems during tobacco abstinence; all three AS components were associated with stronger negative reinforcement-related smoking outcome expectancies; only AS social concerns were associated with stronger positive reinforcement-related smoking outcome expectancies; and none of the AS facets were associated with tobacco dependence severity or subtypes. However, no prior study has examined AS facets in relation to smoking outcome expectancies or tobacco dependence severity or dependence subtypes in treatment-seeking smokers.…”

“…However, no prior study has examined AS facets in relation to smoking outcome expectancies or tobacco dependence severity or dependence subtypes in treatment-seeking smokers. Also, our recent study [31] is the only AS facet study to investigate tobacco abstinence-related problems, and no other study has associated AS social concerns with positive or negative reinforcement-related smoking motives or expectancies. Further examining such understudied AS-smoking relations could benefit individualized smoking cessation treatments for high-AS smokers who have different fears regarding anxiety-related experiences.…”