Distress Intolerance in Relation to Reliance on Cigarettes for Weight, Shape, and Appetite Control

Background: Distress intolerance, one’s inability to withstand distressing emotional or physical states, is a transdiagnostic vulnerability implicated in affect-based health behaviors, including cigarette smoking and poor weight control. The current study evaluated associations between distress intolerance and the reliance on cigarettes for management of weight, appetite, or body dissatisfaction, which may pose a burden for cessation and increase risk of weight-related health problems. Method: Daily smokers (n = 577) completed an online survey assessing distress tolerance and reliance on cigarettes for weight and shape control with the four subscales of the Smoking and Weight Eating Episodes Test (SWEET). Four hierarchical regression models were constructed to test the association between distress intolerance and SWEET scores, accounting for the effect of relevant covarying factors. Results: After adjusting for model covariates, distress intolerance was significantly incrementally associated with greater tendency to rely on cigarettes to suppress appetite (adjR² =.040), prevent overeating (adjR² =.034), cope with body dissatisfaction (adjR² =.046), and cope with nicotine withdrawal–related appetite increases (adjR² =.030). Conclusion: Distress intolerance may play an etiological role in maladaptive use of cigarettes to control appetite, weight, and body dissatisfaction among daily smokers, particularly those with weight- or shape-related concerns. Interventions aimed at increasing perceived ability to withstand distress could potentially reduce reliance on cigarettes for the aforementioned purposes.