Anxiety sensitivity as a moderator of association between smoking status and panic-related processes in a representative sample of adults

Abstract

The present investigation evaluated a moderational role of anxiety sensitivity (fear of anxiety and anxiety-related states; McNally, 2002) in the relation between smoking status and anxiety/depressive symptoms in a Russian epidemiological sample (n = 390; 197 females, Mean age = 43.55). Consistent with prediction, anxiety sensitivity moderated the association of smoking status with indices of anxiety and depressive symptoms; the effects were evident after controlling for the variance accounted for by alcohol use problems, environmental stress (past month), and gender. These findings are discussed with regard to the role of anxiety sensitivity in etiologic connection between smoking and panic-related processes. KeywordsSmoking; Panic; Anxiety; Comorbidity; Anxiety Sensitivity; Depression Research has increasingly highlighted clinically significant relations between smoking and anxiety symptoms (e.g., intensity of anxiety symptoms) and certain disorders (McCabe et al., 2004). Of the anxiety disorders, there appears to be a notable association between smoking and panic attacks, panic disorder, and agoraphobia (see Zvolensky & Bernstein, 2005;Zvolensky, Feldner et al., 2005, for reviews). For instance, epidemiological (Lasser et al., 2000), community (Hayward et al., 1989), and clinical (Baker-Morissette et al., in press;Himle et al., 1988;Pohl et al., 1992) studies have found that smoking is more common among those with panic-related problems (i.e., panic attacks, panic disorder, and agoraphobia) compared to those Correspondence concerning this article should be addressed to Michael J. Zvolensky, Ph.D. Dr. Zvolensky can be contacted at The University of Vermont, Department of Psychology, 2 Colchester Avenue, John Dewey Hall, Burlington,. Electronic mail may be sent to Michael.Zvolensky@uvm.edu. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. NIH Public Access NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript without such problems. Other work has found that smoking increases the risk for developing panic attacks and panic disorder in the future (Breslau & Klein, 1999;Breslau et al., 2004;Johnson et al., 2000;Isensee et al., 2003) and may exacerbate (concurrently) the severity of such anxiety problems Zvolensky, Kotov et al., 2003;Zvolensky, Schmidt, & McCreary, 2003) Although promising, considerably less is known as to whether other panic-related risk factors may influence the relation between smoking and panic processes (i.e., moderational effects; Ising, 2006). In a moderational model, the association between smoking and panic is dependent o...

Applying the Tripartite Model of Anxiety and Depression to Cigarette Smoking: An Integrative Review

“…However, similar to their findings regarding PA and NA, Zvolensky, Kotov, et al (2008 ) found that AA was unrelated to smoking status in a Russian sample.…”

“…Additionally, Morissette, Brown, Kamholz, and Gulliver (2006 ) found that smokers with anxiety disorders reported significantly higher NA than non-smokers with anxiety disorders. Finally, the same study that found PA was not associated with smoking status in Russians also found that NA was not associated with smoking status (Zvolensky, Kotov, et al 2008 ), further suggesting that differences in country of origin may influence the smoking status and affect relationship. …”

“…By contrast, Zvolensky, Kotov, Bonn-Miller, Schmidt, and Antipova (2008) did not find a relationship between anhedonia and smoking status. This discrepancy may be due to the fact that Zvolensky, Kotov, et al (2008) examined this relationship in a sample of Russians, whereas the other study measuring anhedonia contained a sample of primarily Americans, suggesting that differences in origin of country may potentially alter the strength of the anhedonia-smoking status relationship. Due to the small number of studies, further research is needed to understand the relationship between low PA, anhedonia, and smoking status.…”

Smoking, arousal, and affect: The role of anxiety sensitivity

“…Contrary to this notion, studies have not revealed a relationship between AS and smoking frequency (Novak, Burgess, Clark, Zvolensky, & Brown, 2003;Zvolensky, Kotov, Antipova, & Schmidt, 2003) or status (Zvolensky, Kotov, Bonn-Miller, Schmidt, & Antipova, 2008). In fact, studies have shown that AS is actually positively related to smoking to cope with negative affect (Brown, Kahler, Zvolensky, Lejuez, & Ramsey, 2001;Comeau, Stewart, & Loba, 2001).…”

Substance Use: Impact on Adherence and HIV Medical Treatment

“…Future research would benefit from comprehensive cessation programs including adherence-related skills for NRT and ART, and taking into account the effects of comorbid psychiatric problems, specifically anxiety, in terms of smoking cessation [105,106].…”