Dysphoria and smoking among treatment seeking smokers: the role of smoking-related inflexibility/avoidance

Abstract

Background: Emerging data suggest that dysphoria is one facet of depression that is especially related to various aspects of cigarette smoking. However, it is presently unknown what emotional processes may account for these relations. Objectives: In the current cross-sectional study, the impact of avoidance and inflexibility to smoking (AIS), a smoking-specific form of experiential avoidance, was tested on the relationship of dysphoria to four specific smoking processes that are key factors in cessation: perceived barriers to cessation, severity of problems during prior quit attempts, negative reinforcement smoking expectancies, and motivation to quit smoking. Methods: Participants (n = 465) were treatment-seeking adult daily smokers. Relative indirect effects were subjected to bootstrap analyses to test direct and indirect effects of dysphoria on smoking processes. Results: After controlling for gender, nicotine dependence severity, drinking problems, cannabis use, negative affectivity, tobacco-related medical problems, and AIS, dysphoria remained directly, positively related to perceived barriers and cessation problems. Additionally, dysphoria was indirectly, positively related to perceived barriers, cessation problems, negative reinforcement smoking expectancies, and motivation to quit indirectly through higher levels of AIS. Conclusion: In the context of dysphoria, AIS may explain a wide range of clinically-relevant smoking processes.

• Anhedonia
• avoidance
• dysphoria
• psychological inflexibility
• smoking
• tobacco

Acknowledgements

This work was supported by National Institute of Mental Health grants awarded to Drs Zvolensky and Schmidt (R01-MH076629-01A1) and to Dr Buckner (R21DA029811-02, R34DA031937-01A1). Ms Farris is supported by the National Cancer Institute (R25T-CA057730) and the National Institute of Drug Abuse (F31-DA035564-01).

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this paper.