Anxiety Sensitivity and Distress Tolerance in Smokers: Relations With Tobacco Dependence, Withdrawal, and Quitting Success†.
Anxiety Sensitivity and Distress Tolerance in Smokers: Relations With Tobacco Dependence, Withdrawal, and Quitting Success†.
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吸烟者的焦虑敏感性和痛苦耐受性：与烟草依赖、戒断和戒烟成功的关系。
DOI：
10.1093/ntr/ntz070
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发表时间：
2020
期刊：
影响因子：
--
通讯作者：
Piper,MeganE
中科院分区：
文献类型：
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作者：
Schlam,TanyaR;Baker,TimothyB;Smith,StevensS;Cook,JessicaW;Piper,MeganE
本研究探讨了高焦虑敏感性（AS）和低痛苦耐受性（DT）两种情感脆弱性与烟草依赖、戒断、戒烟和药物治疗反应的关系。方法有意戒烟的吸烟者（N= 1067，女性占52.2%，非裔美国人占28.1%）随机分为尼古丁贴片组、尼古丁贴片加尼古丁含片组或伐尼克兰组。基线问卷评估AS、DT、负面影响、焦虑和依赖性。戒断后第一周通过生态瞬时评估评估戒断行为。结果：在戒烟后的第4、12、26和52周，dt（而非AS）预测了生物化学证实的点患病率戒断（ps < 0.05）；在控制药物治疗、AS、基线负面情绪、焦虑和焦虑障碍史后，关系仍然存在（ps < 0.05）。另外，对第4周戒断的探索性分析显示，即使在控制了基线依赖性、戒断后戒断（渴望和负面影响）和治疗后，DT也能预测戒断（p= 0.004）。探索性分析中，DT调节了戒断治疗的效果（interactionp= 0.025）；那些DT高的患者在第4周服用贴片加含片比单独服用贴片更有可能戒酒。结论：sdt，而不是AS，预测戒烟后1年的戒断（较高的DT与较高的戒烟率相关），与其他情感测量几乎没有重叠。DT还预测了独立于依赖和戒断症状的早期戒断。结果表明，低DT可能在使用烟草的动机中发挥有意义的作用，并构成戒烟失败的额外情感风险因素，而不是负面影响或临床情感障碍。在一项戒烟研究中，有更强承受痛苦能力的人更有可能在一年后戒烟并保持无烟状态。如果吸烟者服用尼古丁贴片和尼古丁含片，而不是单独服用尼古丁贴片，高DT吸烟者更有可能在目标戒烟日四周后无烟。RegistrationNCT01553084审判。
IntroductionThis study examined relations of two affective vulnerabilities, high anxiety sensitivity (AS) and low distress tolerance (DT), with tobacco dependence, withdrawal, smoking cessation, and pharmacotherapy response.MethodsSmokers interested in quitting (N= 1067; 52.2% female, 28.1% African American) were randomized to 12 weeks of nicotine patch, nicotine patch plus nicotine lozenge, or varenicline. Baseline questionnaires assessed AS, DT, negative affect, anxiety, and dependence. Withdrawal was assessed the first-week post-quit via ecological momentary assessment.ResultsDT, but not AS, predicted biochemically confirmed point-prevalence abstinence at multiple endpoints: weeks 4, 12, 26, and 52 post-quit (ps < .05); relations remained after controlling for pharmacotherapy treatment, AS, baseline negative affect, anxiety, and anxiety disorder history (ps < .05). Additional exploratory analyses examining week 4 abstinence showed DT predicted abstinence (p= .004) even after controlling for baseline dependence, post-quit withdrawal (craving and negative affect), and treatment. DT moderated treatment effects on abstinence in exploratory analyses (interactionp= .025); those with high DT were especially likely to be abstinent at week 4 with patch plus lozenge versus patch alone.ConclusionsDT, but not AS, predicted abstinence over 1 year post-quit (higher DT was associated with higher quit rates), with little overlap with other affective measures. DT also predicted early abstinence independent of dependence and withdrawal symptoms. Results suggest low DT may play a meaningful role in motivation to use tobacco and constitute an additional affective risk factor for tobacco cessation failure beyond negative affect or clinical affective disorders.ImplicationsPeople in a stop-smoking study who reported a greater ability to tolerate distress were more likely to quit smoking and remain smoke-free 1 year later. Smokers with high DT were more likely to be smoke-free 4 weeks after their target quit day if they received nicotine patch plus nicotine lozenge rather than nicotine patch alone.Trial RegistrationNCT01553084.