Anxiety Sensitivity Physical and Cognitive Concerns in Relation to Smoking-oriented Cognition: An Examination Among Treatment-seeking Adults Who Smoke

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Elevated levels of anxiety sensitivity (AS; fear of anxiety and internal sensations) is highly common among adults who smoke, and contributes to several maladaptive smoking beliefs and behaviors. AS is comprised of 3 empirically established factors, relating to fears of social concerns, fears of physical symptoms, and fears of cognitive dyscontrol. Relatively few studies have examined how these 3 subscales pertain to smoking processes. The aim of the present investigation was to examine, among treatment-seeking adults who smoke, the interactive effects of AS-physical and cognitive concerns in relation to: perceived barriers to smoking cessation; smoking-related negative reinforcement expectancies; and smoking-related avoidance and inflexibility.


Participants included 470 adults who smoke (47.8% female; mean age 37.2, SD 13.5), who were recruited to participate in a smoking-cessation treatment study. At the baseline assessment, participants completed self-report measures, including the Anxiety Sensitivity Index-3, Barriers to Cessation Scale, Smoking Consequences Questionnaire, and Avoidance and Inflexibility Scale.


Results indicated that after controlling for the effects of sex, cigarette dependence, alcohol problems, tobacco-related medical illness, current axis 1 disorder, and AS-social concerns, a significant interaction emerged, such that the association between AS-cognitive concerns and the studied smoking-based cognitions were stronger among lower levels of AS-physical concerns (but not higher physical concerns).


The current findings suggest that it may be beneficial to provide specialized smoking-cessation interventions for certain subgroups of adults who smoke, such as those with different AS profiles, to promote healthier beliefs about quitting.

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