Institutional members access full text with Ovid®

Share this article on:

Anxiety Sensitivity and Negative Urgency: A Pathway to Negative Reinforcement-Related Smoking Expectancies

Guillot, Casey R. PhD; Pang, Raina D. PhD; Leventhal, Adam M. PhD

doi: 10.1097/ADM.0000000000000017
Original Research

Objectives: Anxiety sensitivity—fear of anxiety symptoms—may increase motivation to smoke by influencing the development of cognitive expectations regarding smoking's negative reinforcing effects; yet, the nature and mechanisms of this pathway are unclear. We hypothesized that relations between anxiety sensitivity and negative reinforcement-related smoking expectancies would be mediated by negative urgency, that is, a trait tendency to act impulsively during negative affect.

Methods: In a cross-sectional design, we administered self-report measures of anxiety sensitivity, negative urgency, and negative reinforcement-related smoking outcome and abstinence expectancies to 205 smokers (≥10 cigarettes/d, 34% female, M age = 44.4 years).

Results: Anxiety sensitivity was associated with stronger expectancies that smoking alleviates negative affect (β = 0.30; P < 0.0001) and smoking abstinence exacerbates aversive withdrawal symptoms (β = 0.24; P = 0.0004). Negative urgency partially mediated the relation between anxiety sensitivity and both types of negative reinforcement-related smoking expectancies (βs ≥ 0.057; Ps ≤ 0.007). Results remained significant after statistically controlling for anxiety and nicotine dependence symptoms.

Conclusions: Smokers high in anxiety sensitivity tend to display negative urgency, which in turn is related to greater expectations of negative reinforcement consequences of smoking and smoking abstinence. Treatments that mitigate fear of anxiety symptoms and the tendency to act impulsively in response to negative affect (eg, interoceptive exposure, distress tolerance skills training, and mindfulness training) may be particularly useful in assisting with smoking cessation for high-anxiety sensitivity smokers.

From the Department of Preventive Medicine (CRG, RDP, AML), University of Southern California Keck School of Medicine, Los Angeles; and Department of Psychology (AML), University of Southern California, Los Angeles.

Send correspondence and reprint requests to Casey R. Guillot, PhD, University of Southern California Keck School of Medicine, 2250 Alcazar St, CSC 240, Los Angeles, CA 90033. E-mail:

Supported by funding from National Institutes on Drug Abuse Grant R01-DA026831 and American Cancer Society Grant RSG-13-163-01.

The authors declare no conflict of interest.

Received September 19, 2013

Accepted December 13, 2013

© 2014 American Society of Addiction Medicine