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Why Do Anxiety Sensitive Smokers Perceive Quitting as Difficult? The Role of Expecting “Interoceptive Threat” During Acute Abstinence

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Abstract

There is a growing literature that documents the direct and indirect effects of anxiety sensitivity in terms of the maintenance of cigarette smoking and cessation problems, as maintained, at least in part, by affective-regulatory expectancies effects and motives for smoking. Yet, the role of expectancies about the interoceptive-specific consequences of smoking abstinence has yet to be empirically examined. Participants (N = 110) were daily tobacco smokers recruited as part of a self-guided tobacco cessation study. Baseline (pre-treatment) data were utilized. A structural equation model was constructed to examine the relations between anxiety sensitivity in terms of interoceptively-relevant smoking abstinence expectancies (somatic symptoms and harmful consequences) in regard to perceived barriers to smoking cessation, number of problematic symptoms experienced during past quit attempts, and the number of prior quit attempts. Anxiety sensitivity was significantly related to interoceptive threat abstinence expectancies (β = .56, p < .001). Expectancies were directly related to perceived barriers to smoking cessation (β = .39, p < .001) and number of problematic symptoms experienced during past quit attempts (β = .41, p < .001), but not the number of prior quit attempts. Mediational results indicated indirect (but not direct) effects of anxiety sensitivity on perceived barriers to smoking cessation and problems during prior quit attempts; effects that occurred through interoceptive threat smoking abstinence expectancies. The present findings suggest that one’s expectancies about the negative interoceptive consequences of smoking abstinence may be an explanatory mechanism between anxiety sensitivity and certain quit-relevant smoking processes.

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Notes

  1. The current data were collected between 2010 and 2013, prior to the publication of the DSM-5; thus, anxiety disorders included the following: panic disorder with/without agoraphobia, agoraphobia, social phobia, specific phobias, obsessive–compulsive disorder, posttraumatic stress disorder, and generalized anxiety disorder.

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Acknowledgments

This work was supported by a pre-doctoral National Research Service Award from the National Institute of Drug Abuse awarded to Dr. Langdon (F31-DA026634). Ms. Farris acknowledges support from a pre-doctoral National Research Service Award from the National Institute of Drug Abuse (F31-DA035564). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health, the Department of Veterans Affairs, or the United States Government, and the funding sources had no other role than financial support.

Conflict of Interest

Samantha G. Farris, Kirsten J. Langdon, Angelo M. DiBello, and Michael J. Zvolensky declare that they have no conflict of interest.

Informed Consent

All procedures followed were in accordance with the ethical standards of the University of Houston and the University of Vermont. Informed consent was obtained from all individual subjects participating in the study.

Animal Rights

No animal studies were carried out by the authors for this paper.

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Authors and Affiliations

  1. Department of Psychology, The University of Houston, 126 Fred J. Heyne Building, Suite 104, Houston, TX, 77204-5502, USA

    Samantha G. Farris, Angelo M. DiBello & Michael J. Zvolensky

  2. Women’s Health Sciences Division, National Center for PTSD, VA Boston Healthcare System, Boston, MA, USA

    Kirsten J. Langdon

  3. Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA

    Kirsten J. Langdon

  4. Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Michael J. Zvolensky

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  1. Samantha G. Farris
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  2. Kirsten J. Langdon
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  3. Angelo M. DiBello
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  4. Michael J. Zvolensky
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Correspondence to Samantha G. Farris.

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Farris, S.G., Langdon, K.J., DiBello, A.M. et al. Why Do Anxiety Sensitive Smokers Perceive Quitting as Difficult? The Role of Expecting “Interoceptive Threat” During Acute Abstinence. Cogn Ther Res 39, 236–244 (2015). https://doi.org/10.1007/s10608-014-9644-6

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