title: Anxiety Sensitivity and Smoking Behavior Among Trauma-Exposed Daily Smokers: The Explanatory Role of Smoking-Related Avoidance and Inflexibility.
abstract: Anxiety sensitivity (AS), defined as the extent to which individuals believe that anxiety-related sensations have harmful consequences, is associated with smoking processes and poorer clinical outcomes among trauma-exposed smokers. Yet the specific mechanisms underlying this association are unclear. Smoking-specific avoidance and inflexibility is a construct implicated in multiple manifestations of mood regulation that may underlie smoking behavior. The current study examined the explanatory role of smoking-specific avoidance and inflexibility in terms of the relation between AS and indices of smoking behavior among trauma-exposed smokers. The sample consisted of 217 treatment-seeking adult smokers (44% female; M age = 37.8; SD = 13.2; age range: 18-65 years), who were exposed to at least one lifetime Criterion A trauma event (Diagnostic and Statistical Manual of Mental Disorders [4th ed., text rev.; DSM-IV-TR] Criterion A for trauma exposure). Bootstrap analysis (5,000 re-samples) revealed that AS was indirectly related to the (a) number of cigarettes smoked per day, (b) number of years being a daily smoker, (c) number of failed quit attempts, and (d) heaviness of smoking index among trauma-exposed smokers through its relation with smoking-specific avoidance and inflexibility. These findings provide initial evidence suggesting that smoking-specific avoidance and inflexibility may be an important construct in better understanding AS-smoking relations among trauma-exposed smokers. Future work is needed to explore the extent to which smoking-specific avoidance and inflexibility account for relations between AS and other smoking processes (e.g., withdrawal, cessation outcome) in the context of trauma and smoking comorbidity.
authors.affiliation: University of Houston, TX, USA JBakhshaie@uh.edu.
authors.forename: Jafar
authors.initials: J
authors.lastname: Bakhshaie
authors.affiliation: University of Houston, TX, USA Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, TX, USA.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Zvolensky
authors.affiliation: University of Houston, TX, USA.
authors.forename: Adriana
authors.initials: A
authors.lastname: Salazar
authors.affiliation: Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston, TX, USA.
authors.forename: Anka A
authors.initials: AA
authors.lastname: Vujanovic
authors.affiliation: Department of Psychology, Florida State University, Tallahassee, FL, USA.
authors.forename: Norman B
authors.initials: NB
authors.lastname: Schmidt
mesh_terms: D000293:Adolescent; D000328:Adult; D000339:Affect; D000368:Aged; D001007:Anxiety / Q000150:complications / Q000523:psychology; D001008:Anxiety Disorders / Q000523:psychology*; D001362:Avoidance Learning; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012907:Smoking / Q000523:psychology*; D016540:Smoking Cessation / Q000523:psychology*; D011795:Surveys and Questionnaires; D014947:Wounds and Injuries / Q000523:psychology*
keywords: anxiety sensitivity; avoidance; inflexibility; tobacco; trauma