Robust impact of social anxiety in relation to coping motives and expectancies, barriers to quitting, and cessation-related problems.

Abstract

Although social anxiety is related to smoking and nicotine dependence, little work has sought to identify factors that contribute to these relations. The current study examined whether social anxiety was associated with cognitive vulnerability factors related to smoking: perceived barriers for quitting, cessation-related problems, negative affect reduction outcome expectancies, and negative affect reduction motives. Further, we tested whether social anxiety was robustly related to these factors after controlling for cigarettes smoked per day, gender, alcohol use frequency, lifetime cannabis use status, panic attack frequency, anxiety sensitivity, and negative affectivity. The sample consisted of 580 (38.6% female) treatment-seeking smokers. Social anxiety was associated with perceived barriers for quitting, cessation-related problems, negative affect reduction outcome expectancies, and negative affect reduction motives. After controlling for covariates, social anxiety was robustly related to perceived barriers for quitting, cessation- related problems, and negative affect reduction outcome expectancies. Social anxiety was robustly related to negative affect reduction motives among men but not women. Results indicate that social anxiety is robustly related to cognitive vulnerability factors associated with poorer cessation outcomes, suggesting that social anxiety may be an important therapeutic target during smoking cessation.

Perceived barriers to smoking cessation among adults with substance use disorders

“…We aimed to characterize these barriers in adults with SUDs, and to examine whether prior findings from alcohol use disorder generalize to adults with opioid use disorder. We hypothesized that anxiety sensitivity would be associated with more perceived barriers to smoking cessation, consistent with data from the general population (Buckner et al, 2014; Gonzalez et al, 2008; Zvolensky et al, 2014; Zvolensky et al, 2007). Understanding perceived barriers to quitting smoking and anxiety sensitivity among those with SUDs may help in engaging this population in smoking cessation treatment.…”

“…Even among adults seeking smoking cessation treatment, perceived barriers to quitting are common, and are associated with poorer cessation outcomes, such as treatment dropout (e.g., Garey, Kauffman, Neighbors, Schmidt, & Zvolensky, 2016). Perceived barriers to smoking cessation also appear to be higher among those with greater psychiatric symptoms, particularly anxiety (e.g., Buckner, Zvolensky, Jeffries, & Schmidt, 2014). Smokers who have elevated anxiety sensitivity (the tendency to respond fearfully to anxiety symptoms and sensations) appear to be particularly susceptible to these negative beliefs about quitting (Buckner et al, 2014; Gonzalez, Zvolensky, Vujanovic, Leyro, & Marshall, 2008; Gregor, Zvolensky, McLeish, Bernstein, & Morissette, 2008; Zvolensky, Farris, Leventhal, & Schmidt, 2014; Zvolensky et al, 2007).…”

“…Thus, individuals presenting to SUD treatment have particularly poor smoking cessation rates and are vulnerable to a broader array of potential barriers to smoking cessation relative to those without SUDs, highlighting the importance of understanding barriers to smoking cessation in this population. Studies of adults presenting for smoking cessation treatment have found that substance use is associated with more perceived barriers to smoking cessation (Buckner et al, 2014; Foster, Schmidt, & Zvolensky, 2015), further highlighting the importance of considering perceived barriers among those with SUDs.…”

Relationships Between Social Anxiety and Smoking-Specific Experiential Avoidance

“…In order to inform targeted treatments for smokers with social anxiety, research has begun to examine the mechanisms underlying the smoking-social anxiety relationship and determine the unique barriers to quitting faced by socially anxious smokers. For example, smokers with social anxiety who smoke cigarettes to cope with their social anxiety symptoms and negative affectivity (i.e., negative affect reduction motives) may be particularly vulnerable to continued smoking and relapse (Buckner, Heimberg, Ecker, & Vinci, 2013; Buckner, Zvolensky, Jeffries, & Schmidt, 2014; Morissette, Tull, Gulliver, Kamholz, & Zimering, 2007; Watson, VanderVeen, Cohen, DeMarree, & Morrell, 2012). …”

An Examination of Social Anxiety in Marijuana and Cigarette Use Motives Among Adolescents

“…Of these, negative reinforcement motives (i.e. coping, conformity) have been most consistently linked with marijuana and cigarette use among socially anxious individuals (Buckner, Bonn-Miller, et al, 2007; Buckner, Zvolensky, Jeffries, & Schmidt, 2014), and may account for the elevated SA-use problems relation (Buckner, Farris, Schmidt, & Zvolensky, 2014; Lewis et al, 2008). …”