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Effect of Emotion Regulation Difficulties on Acute Smoking Urges Following a 35% Carbon Dioxide Challenge

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Abstract

Background

Carbon dioxide (CO2) challenges produce uncomfortable anxious arousal sensations and can be leveraged to study how vulnerability factors influence smoking outcomes in contexts of acute distress. Emotion dysregulation is associated with elevated anxious arousal among smokers, which may acutely reduce smoking motivation following CO2 exposure as immediate smoking may further amplify CO2-induced arousal. However, no studies have examined the effect of emotion regulation (ER) difficulties on smoking motivation immediately following CO2-induced distress. This study examined the role of ER difficulties on the effect of 35% CO2-induced arousal and acute smoking urges.

Methods

Smokers were randomized to receive a single vital capacity breath of either 35% CO2-enriched or compressed room air. Trait ER difficulties and pre- and immediate post-challenge smoking urges were assessed. Consistent with work showing emotion dysregulation is associated with elevated anxious arousal and reactivity to bodily sensations, we hypothesized that smokers higher in ER difficulties would experience reduced urges immediately following 35% CO2-exposure (relative to room air).

Results

Analyses showed a significant interaction between challenge condition and ER difficulties on smoking urges. Smokers with greater ER difficulty evidenced reduced urges following CO2-exposure, whereas urges increased following room air.

Conclusion

This study found that smokers with greater ER difficulties evidenced an acute dampening in smoking urges following 35% CO2-exposure. These findings may suggest a modification to extant negative reinforcement models of addiction by suggesting that contexts characterized by acute anxious arousal may decrease immediate negative reinforcement smoking.

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Authors and Affiliations

  1. Department of Psychology, Rutgers, the State University of New Jersey, 53 Avenue E, Piscataway, NJ, 08854, USA

    Hannah R. Brinkman, Jacqueline E. Smith, Teresa M. Leyro & Samantha G. Farris

  2. Department of Psychology, University of Houston, Houston, TX, USA

    Michael J. Zvolensky

  3. Department of Behavioral Sciences, University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Michael J. Zvolensky

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  1. Hannah R. Brinkman
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  2. Jacqueline E. Smith
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  5. Samantha G. Farris
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Correspondence to Samantha G. Farris.

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Hannah R. Brinkman, Jacqueline E. Smith, Teresa M. Leyro, Michael J. Zvolensky, Samantha G. Farris declare that they have no conflicts of interest.

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This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the ethics committee of the University of Houston.

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Brinkman, H.R., Smith, J.E., Leyro, T.M. et al. Effect of Emotion Regulation Difficulties on Acute Smoking Urges Following a 35% Carbon Dioxide Challenge. Cogn Ther Res 47, 84–93 (2023). https://doi.org/10.1007/s10608-022-10342-9

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