Personalized Feedback for Smokers with Elevated Anxiety Sensitivity

Objective: Cigarette smoking is the leading cause of preventable death and disability. The majority of smokers report a desire to quit and most make a serious quit attempt each year. Unfortunately, more than 95% of cessation attempters relapse within 6 months. Clinical and laboratory studies have identified negative affect as a potent precipitant of relapse and more severe smoking behavior. Yet, limited brief, accessible treatments exist to address the range of negative affective symptoms. One promising, integrative approach to address this need is to focus on underlying transdiagnostic processes that capture negative mood states and are related to smoking. Anxiety sensitivity (AS), the tendency to fear anxiety-related sensations, is a core transdiagnostic vulnerability factor for the etiology and maintenance of anxiety disorders and other emotional disorders, and is also related to smoking maintenance and relapse. Progress has been made in developing intensive, integrated treatments that address AS in the context of smoking treatment. However, limited efforts have focused on developing brief (single session) interventions for AS and smoking. The current study was conducted to develop, refine, and test a brief, integrated personalized feedback intervention (PFI) for smoking and AS. Method: Participants (N=95; 63.2% male; Mage = 46.20 years, SD = 10.90) included general smokers in the early stage of quitting who received either a single session, computer-delivered PFI or smoking treatment as usual. The primary aims focused on examining the effects of PFI on (1) quit attempts, (2) cigarette reduction, and (3) trajectories of affective vulnerability assessed at 2- and 4-week follow-ups. Results: Results indicated 48.3% of participants at 2-week follow-up and 53.4% at 4-week follow-up engaged in a self-defined quit attempt. Substantial smoking reduction was observed in 21.8% and 28.4% of participants at 1-week post-baseline and 1-week pre 4-week follow-up. Treatment condition did not significantly predict quit attempt or smoking reduction. PFI had a significant effect on symptoms of anxiety arousal over time (β = -.32, p = .04). Conclusions: Current data provide preliminary evidence for the utility of a PFI to encourage behavior change related to smoking and address physical manifestations of anxiety. The effects, however, were limited in magnitude. Nevertheless, the initial ‘signal’ observed in this small trial provides a strong rationale for continued work within this domain.