Why Do Anxiety Sensitive Smokers Perceive Quitting as Difficult? The Role of Expecting “Interoceptive Threat” During Acute Abstinence

There is a growing literature that documents the direct and indirect effects of anxiety sensitivity in terms of the maintenance of cigarette smoking and cessation problems, as maintained, at least in part, by affective-regulatory expectancies effects and motives for smoking. Yet, the role of expectancies about the interoceptive-specific consequences of smoking abstinence has yet to be empirically examined. Participants (N = 110) were daily tobacco smokers recruited as part of a self-guided tobacco cessation study. Baseline (pre-treatment) data were utilized. A structural equation model was constructed to examine the relations between anxiety sensitivity in terms of interoceptively-relevant smoking abstinence expectancies (somatic symptoms and harmful consequences) in regard to perceived barriers to smoking cessation, number of problematic symptoms experienced during past quit attempts, and the number of prior quit attempts. Anxiety sensitivity was significantly related to interoceptive threat abstinence expectancies (β = .56, p < .001). Expectancies were directly related to perceived barriers to smoking cessation (β = .39, p < .001) and number of problematic symptoms experienced during past quit attempts (β = .41, p < .001), but not the number of prior quit attempts. Mediational results indicated indirect (but not direct) effects of anxiety sensitivity on perceived barriers to smoking cessation and problems during prior quit attempts; effects that occurred through interoceptive threat smoking abstinence expectancies. The present findings suggest that one’s expectancies about the negative interoceptive consequences of smoking abstinence may be an explanatory mechanism between anxiety sensitivity and certain quit-relevant smoking processes.