Smoking-specific Experiential Avoidance Research Articles

A pilot randomized controlled trial of smartphone-assisted mindfulness-based intervention with contingency management for smokers with mood disorders.

Adult smokers receiving outpatient psychiatric treatment for mood disorders were randomized to receive a smartphone-assisted mindfulness-based smoking cessation intervention with contingency management (SMI-CM, n = 25) or enhanced standard treatment (EST, n = 24) with noncontingent rewards. Participants in SMI-CM were prompted to practice audio-guided mindfulness five times per day for 38 days (vs. no comparison intervention in EST), and received monetary incentives for carbon monoxide (CO) ≤ 6 ppm. The primary outcome was biochemically verified 7-day point prevalence abstinence rates 2, 4, and 13 weeks after a target quit day. Of the 49 participants, 63.3% were Latinx and 30.6% Black; 75.5% reported household incomes < $25,000. Abstinence rates for SMI-CM were 40.0%, 36.0%, and 16.0% versus 4.2%, 8.3%, and 4.2% in EST at weeks 2, 4, and 13. A generalized estimating equations (GEE) model showed significant overall differences in abstinence rates in SMI-CM versus EST (adjusted odds ratio [AOR] = 8.12, 95% CI = 1.42-46.6, p = .019). Those who received SMI-CM reported significantly greater reduction in smoking-specific experiential avoidance from baseline to 3 days prior to quit date (β = -7.21, 95% CI = -12.1-2.33, p = .006). SMI-CM may increase cessation rates among smokers with mood disorders, potentially through reduced smoking-specific experiential avoidance. SMI-CM is a promising intervention, and warrants investigation in a fully powered randomized controlled trial (RCT). (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Sex differences in smoking constructs and abstinence: The explanatory role of smoking outcome expectancies.

Scientific evidence suggests women experience more severe problems when attempting to quit smoking relative to men. Yet, little work has examined potential explanatory variables that maintain sex differences in clinically relevant smoking processes. Smoking outcome expectancies have demonstrated sex differences and associative relations with the smoking processes and behavior, including problems when attempting to quit, smoking-specific experiential avoidance, perceived barriers to quitting, and smoking abstinence. Thus, expectancies about the consequences of smoking may explain sex differences across these variables. Accordingly, the current study examined the explanatory role of smoking-outcome expectancies (e.g., long-term negative consequences, immediate negative consequences, sensory satisfaction, negative affect reduction, and appetite weight control) in models of sex differences across cessation-related problems, smoking-specific experiential avoidance, perceived barriers to quitting, and smoking abstinence. Participants included 450 (48.4% female; Mage = 37.45, SD = 13.50) treatment-seeking adult smokers. Results indicated that sex had an indirect effect on problems when attempting to quit smoking through immediate negative consequences and negative affect reduction expectancies; on smoking-specific experiential avoidance through long-term negative consequences, immediate negative consequences, and negative affect reduction expectancies; on barriers to quitting through negative affect reduction expectancies; and on abstinence through appetite weight control expectancies. The current findings suggest that sex differences in negative affect reduction expectancies and negative consequences expectancies may serve to maintain maladaptive smoking processes, whereas appetite weight control expectancies may promote short-term abstinence. These findings provide initial evidence for the conceptual role of smoking expectancies as potential "linking variables" for sex differences in smoking variables. (PsycINFO Database Record

Interplay of dysphoria and anxiety sensitivity in relation to emotion regulatory cognitions of smoking among treatment-seeking smokers.

There is evidence that anxiety sensitivity (AS) plays a role in the maintenance of smoking, yet there is little understanding of how AS interplays with other affective symptomatology variables that are also related to smoking, such as dysphoria. Therefore, the current cross-sectional study evaluated the interactive effects of AS and dysphoria on emotion regulatory cognitions, including smoking negative affect reduction expectancies, perceived barriers for cessation, and smoking-specific experiential avoidance. A total of 448 adult treatment-seeking daily smokers, who responded to study advertisements, were recruited to participate in a smoking cessation treatment trial (47.8% female; Mage = 37.2, SD = 13.5). The current study utilized self-report baseline data from trial participants. After accounting for covariates, simple slope analyses revealed that AS was positively related to negative affect reduction expectancies (β = .03, p = .01), perceived barriers to cessation (β = .22, p = .002), and smoking avoidance and inflexibility (β = .07, p = .04), among smokers with lower (vs. higher) levels of dysphoria. The current findings suggest that higher levels of dysphoria may mitigate the relation between AS and emotion regulatory cognitions of smoking. The current findings highlight the unique and additive clinical relevance of AS and dysphoria regarding emotion regulatory smoking cognitions that may impede quit success. (Am J Addict 2016;25:267-274).

Examining an underlying mechanism between perceived stress and smoking cessation-related outcomes

The mediational role of negative reinforcement smoking outcome expectancies in the relation between perceived stress and (1) perceived barriers to cessation, (2) severity of problematic symptoms during past quit attempts, and (3) smoking-specific experiential avoidance (AIS) was examined. Data were drawn from a baseline assessment of a larger clinical trial. Participants included 332 adult treatment-seeking smokers (47.3% female; Mage=38.45; SD=.50; age range: 18–65years). Results indicated that perceived stress was indirectly related to perceived barriers to smoking cessation, severity of problematic symptoms during past quit attempts, and AIS through negative reinforcement outcome expectancies. These results were evident after accounting for the variance explained by gender, negative affectivity, and alternative outcome expectancies for smoking. The present findings suggest that smokers with greater perceived stress experience greater negative reinforcement smoking expectancies, which in turn, may be related to numerous processes involved in the maintenance of smoking.

Sustained smoking abstinence is associated with reductions in smoking-specific experiential avoidance among treatment-seeking smokers

Background and objectivesSmoking-specific experiential avoidance is related to the maintenance of cigarette smoking. However, it is unclear whether sustained smoking abstinence is associated with subsequent reductions in smoking-specific experiential avoidance. MethodsDaily smokers (n = 149) underwent a cessation attempt in the context of a 4-session smoking cessation treatment trial. Participants provided biochemical verification of smoking status at 1 week, 2 weeks, and 1 Month post-quit day. Smoking-specific experiential avoidance was assessed per the Avoidance and Inflexibility Scale (AIS) – the total score and two factor scores were examined at 1 Month post-quit day as a function of abstinence status. Two path models were conducted and included participant sex, treatment condition, and pre-cessation nicotine dependence, smoking-specific experiential avoidance, and presence of emotional disorders as covariates. ResultsAfter adjusting for covariates, sustained smoking abstinence was associated with a reduction in the AIS total score at Month 1 post-quit (β = −.45, p < .001). Sustained smoking abstinence was associated with reductions across both facets of experiential avoidance -- smoking-related thoughts and feelings (β = −.44, p < .001) and internal bodily sensations (β = −.41, p < .001). LimitationsBiochemical verification of smoking status was confirmed only at three time points post-quit day, and continued abstinence throughout the one-month post-quitting period is not fully known. ConclusionsSustained smoking abstinence may contribute to reductions in smoking-specific experiential avoidance. Findings add to the research documenting the relevance of experiential avoidance in various processes of smoking (including smoking abstinence).

The role of smoking-specific experiential avoidance in the relation between perceived stress and tobacco dependence, perceived barriers to cessation, and problems during quit attempts among treatment-seeking smokers

Despite the clinically-significant association between perceived stress and smoking, there is little understanding of the mechanisms underlying this relation. The present study examined smoking-specific experiential avoidance as an explanatory mechanism linking perceived stress and smoking, including nicotine dependence, perceived barriers to cessation, and problems reported during past quit attempts among treatment-seeking daily smokers (n=365; 48.5% female; Mage=38.02; SD=13.10). Results indicated that smoking-specific experiential avoidance had a significant, indirect effect on perceived stress and the studied smoking criterion variables. The present findings provide initial empirical support that smoking-specific experiential avoidance may help explain how perceived stress is associated with smoking. These data suggest that there may be merit to targeting smoking-specific experiential avoidance during smoking cessation among smokers with elevated perceived stress.

Cocaine-cue extinction learning in rats: Impact of cocaine training dose and modulation by environmental enrichment

and that these effects would not be explained by gender, tobaccorelated illnesses, presence of anAxis I psychiatric disorder, negative affectivity, alcohol use or cannabis use. Methods: The sample consisted of 349 treatment-seeking adult daily smokers (45.3% female) who reported smoking at least 8 cigarettes per day during the past year and at least one serious lifetime quit attempt. Participants responded to community advertisements to participate in a larger study examining the efficacy of two smoking cessation interventions. Data for this study came from the baseline assessment of this larger trial and before randomization. After providingwritten informed consent, participants were interviewed and completed an on-line survey. Analyses were conducted using bootstrapping techniques through a conditional modeling program that utilizes an ordinary least squares-based path analytical framework to test for bothdirect and indirect effects of perceived stress, smoking-specific experiential avoidance, and criterion variables (i.e., severity of problematic symptoms during past quit attempts, latency to first cigarette of the day, nicotine dependence, and heaviness of smoking index). Results: Smoking-specific experiential avoidance indirectly explained the relation between perceived stress and (a) severity of problems experienced while trying to quit, (b) latency to first cigarette of the day, (c) nicotine dependence, and (d) heaviness of smoking index after accounting for covariates. Conclusions: The present findings underscore the importance of addressing smoking-specific experiential avoidance among smokers seeking smoking cessation treatmentwho report elevated perceived stress. Financial support: R01-MH076629-01A1.

The role of smoking-specific experiential avoidance in the relation between perceived stress and tobacco use among treatment-seeking smokers

The role of smoking-specific experiential avoidance in the relation between perceived stress and tobacco use among treatment-seeking smokers

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

Limited work has examined worry, or apprehensive anticipation about future negative events, in terms of smoking. One potential explanatory factor is the tendency to respond inflexibly and with avoidance in the presence of smoking-related distress (smoking-specific experiential avoidance). Participants (n = 465) were treatment-seeking daily smokers. Cross-sectional (pre-treatment) self-report data were utilized to assess trait worry, smoking-specific experiential avoidance, and four smoking criterion variables: nicotine dependence, motivational aspects of quitting, perceived barriers to smoking cessation, and severity of problematic symptoms reported in past quit attempts. Trait worry was significantly associated with greater levels of nicotine dependence, motivation to quit smoking, perceived barriers for smoking cessation, and more severe problems while quitting in the past; associations occurred indirectly through higher levels of smoking-specific experiential avoidance. Findings provide initial support for the potential role of smoking-specific experiential avoidance in explaining the association between trait worry and a variety of smoking processes.

Smoking-specific experiential avoidance cognition: Explanatory relevance to pre- and post-cessation nicotine withdrawal, craving, and negative affect

BackgroundNegative-reinforcement based cognitive processes have been implicated in the maintenance of cigarette smoking. Given the expectation that smoking will attenuate aversive internal experiences, smokers may be particularly unwilling to experience or remain in contact with smoking-related distress (i.e., experiential avoidance). Yet, there is little known about a cognitive-based process termed smoking-specific experiential avoidance with regard to withdrawal, craving, or negative affect during a quit attempt. MethodData were collected from adult daily smokers (n=259) participating in a larger smoking cessation trial. Pre- and post-quit experiences of nicotine withdrawal, craving, and negative affect were examined in terms of cognitive-based smoking-specific experimental avoidance, measured by the Avoidance and Inflexibility Scale (AIS). ResultsResults indicated that baseline smoking-specific experiential avoidance was associated with greater overall levels of withdrawal, craving, and negative affect at treatment initiation (pre-cessation). Reductions in smoking-specific experiential avoidance from baseline to quit day were associated with increased likelihood of quit day abstinence. Such reductions were also predictive of lower levels of nicotine withdrawal, craving, and negative affect on quit day. Also, less reduction in experiential avoidance was associated with experiencing greater withdrawal in the early phase of quitting. DiscussionThe impact of cognitive-based experiential avoidance pertaining to smoking impacts both pre- and post-cessation experiences in terms of negative affect, withdrawal, and smoking cravings and may represent an important treatment target.