Evaluating the role of anxiety sensitivity in barriers to cessation and reasons for quitting among smokers with asthma

Abstract

The aim of the present study was to examine the unique predictive ability of anxiety sensitivity (AS) in terms of perceived barriers to cessation and smoking cessation motives among daily smokers with asthma (n = 125, 54% male, Mage = 37.7 years, SD = 12.1). As hypothesized, after controlling for the effects of race, asthma control, negative affect, and smoking rate, AS significantly predicted greater barriers to cessation, and reasons for quitting related to health concerns and self-control. Contrary to hypotheses, AS did not significantly predict external reasons for quitting. These findings suggest that smokers with asthma who are fearful of physiological arousal may be a particularly 'at-risk' population for smoking cessation difficulties due, in part, to greater perceived barriers to cessation. Interventions focused on enhancing intrinsic motivation for quitting and reducing AS may be most effective for this population.

Perceived barriers to smoking cessation among adults with substance use disorders

“…The association between anxiety sensitivity and smoking cessation barriers found in this study is consistent with the broader literature on smoking cessation in community samples (Zvolensky et al, 2007) and medical populations (McLeish, Johnson, Avallone, & Zvolensky, 2015). Given this association, as well as the predominance of affective barriers in this study and in prior studies in treatment-seeking alcohol-dependent patients (Asher et al, 2003), anxiety sensitivity may be an important therapeutic target to improve patients’ smoking cessation engagement and success.…”

How does anxiety sensitivity increase risk of chronic medical conditions?

“…Carr and colleagues’ findings suggest that AS may be associated with increased respiratory‐specific fears, such as fear of dyspnea, which may perpetuate panic‐related respiratory symptoms and maintain asthma over time. This conclusion is further supported by a recent study conducted by McLeish, Johnson, Avallone, and Zvolensky (), in which undergraduates with asthma completed a straw‐breathing task. Those with high AS‐physical concerns exhibited greater levels of anxiety and asthma symptoms after straw‐breathing, suggesting that they were more physically and emotionally reactive to the asthma‐like symptoms induced by the task.…”

“…Although cross‐sectional in nature, these studies suggest that AS does play an important role in the relationship between respiratory symptoms and smoking, despite limits in our current understanding of the temporal sequencing of these associations. AS is also associated with barriers to smoking cessation among individuals with respiratory illness (McLeish et al., ). Asthma status is indirectly related to both stronger motives for quitting and stronger motives for nicotine use and dependence through AS (McLeish, Farris, Johnson, Bernstein, & Zvolensky, ), a finding that supports the notion that, for individuals with respiratory illness, AS is associated with a greater desire to quit smoking but more difficulty doing so once dependency is established.…”

Smoking cessation strategies for patients with asthma: improving patient outcomes

“… 14 Anxiety sensitivity, the fear of aversive internal anxiety states, might offer some explanation as to why sustained quitting can be more difficult for smokers with asthma compared with non-asthmatics. 3 …”

“…Despite these potential consequences, some evidence suggests that such smokers are less likely to quit smoking than smokers without asthma ( Table 1 ). 2 , 3 Acknowledgment of these worse patient outcomes has given rise to an opportunity to improve current management practices.…”