Dysphoria and smoking among treatment seeking smokers: the role of smoking-related inflexibility/avoidance

Abstract

Background Emerging data suggest that dysphoria is one facet of depression that is especially related to various aspects of cigarette smoking. However, it is presently unknown what emotional processes may account for these relations. Objectives In the current cross-sectional study, the impact of avoidance and inflexibility to smoking (AIS), a smoking-specific form of experiential avoidance, was tested on the relationship of dysphoria to four specific smoking processes that are key factors in cessation: perceived barriers to cessation, severity of problems during prior quit attempts, negative reinforcement smoking expectancies, and motivation to quit smoking. Methods Participants (n = 465) were treatment-seeking adult daily smokers. Relative indirect effects were subjected to bootstrap analyses to test direct and indirect effects of dysphoria on smoking processes. Results After controlling for gender, nicotine dependence severity, drinking problems, cannabis use, negative affectivity, tobacco-related medical problems, and AIS, dysphoria remained directly, positively related to perceived barriers and cessation problems. Additionally, dysphoria was indirectly, positively related to perceived barriers, cessation problems, negative reinforcement smoking expectancies, and motivation to quit indirectly through higher levels of AIS. Conclusion In the context of dysphoria, AIS may explain a wide range of clinically-relevant smoking processes.

Smoking-Specific Experiential Avoidance is Indirectly Associated with Trait Worry and Smoking Processes among Treatment-Seeking Smokers

“…Second, trait worry was hypothesized to be associated with greater motivation to quit smoking, 11–13 and indirectly associated due to smoking-specific experiential avoidance. 33 Third, trait worry was hypothesized to be associated with greater perceptions/beliefs that quitting smoking will be challenging (i.e., expecting many difficulties/obstacles), 20 which would be indirectly explained by smoking-specific experiential avoidance. 32 Fourth, trait worry was expected to be associated with more severe withdrawal-related problems during prior quit attempts, based on the finding that worry and experiential avoidance are associated with cessation difficulties.…”

Psychometric evaluation of the Barriers to Cessation Scale.

“…Moreover, the BCS total score is related to other smoking-based processes that may interfere with cessation, including smoking outcome expectancies (Foster, Zvolensky, Garey, Ditre, & Schmidt, 2014; Johnson, Farris, Schmidt, & Zvolensky, 2012; Peasley-Miklus, McLeish, Schmidt, & Zvolensky, 2012), smoking-specific experiential avoidance (i.e., avoidance or inflexibility in the presence of uncomfortable or difficult sensations or thoughts related to smoking (i.e., avoidance or inflexibility in the presence of uncomfortable or difficult sensations or thoughts related to smoking; Foster et al, 2014), severity of quit problems (i.e., weight gain, nausea, headache; Farris, Langdon, DiBello, & Zvolensky, 2015; Mahaffey et al, 2015), and commitment to quitting (Moore et al, 2013). The BCS total score is also associated with several affective processes, including dysphoria (Buckner et al, 2015) and negative affect (Foster et al, 2014; Gregor, Zvolensky, McLeish, Bernstein, & Morissette, 2008; Zvolensky et al, 2007). Regarding quit behavior, the BCS total score has been found to differentiate and successfully classify quitters and non-quitters following a quit attempt (Macnee & Talsma, 1995a).…”

Anxiety sensitivity explains associations between anxious arousal symptoms and smoking abstinence expectancies, perceived barriers to cessation, and problems experienced during past quit attempts among low-income smokers

“…The SHQ is a self-report questionnaire used to assess history of smoking (e.g., smoking quantity, age of smoking onset) and problems experienced during previous quit attempts (e.g., weight gain, irritability). As in past work (Buckner et al, 2015), the SHQ was used to describe the sample and to derive a composite score of problems experienced during quit attempts. Each of 16 potential problems was rated on a Likert scale from 1 ( not at all ) to 5 ( extremely ) regarding the severity during quit attempts.…”