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Black individuals who smoke in the United States experience health disparities related to tobacco use (e.g., greater nicotine dependence, less success in quitting smoking) and interoceptive distress (e.g., somatic symptoms, anxiety). Individual difference factors that amplify interoceptive distress and contribute to poorer smoking behaviors and outcomes warrant further attention and investigation. Thus, the present study sought to explore the association between anxiety sensitivity and clinically-relevant smoking variables of perceived barriers for quitting, smoking inflexibility, and problems experienced during past quit attempts. Participants in the current study included 98 Black adult smokers (71.4% male; Mage = 44.08 years, SD = 11.44 years). Results indicated greater levels of anxiety sensitivity were associated with greater levels of perceived barriers for quitting smoking (b = 0.10, SE = 0.08, p = 0.01), smoking inflexibility (b = 0.02, SE <.001, p <.001), and problems experienced during past smoking quit attempts (b = 0.17, SE = 0.07, p = 0.02). Clinical implications and future directions are further discussed as it relates to anxiety sensitivity and efforts to reduce or quit smoking for this health disparities population. [ABSTRACT FROM AUTHOR]

Background: Black smokers have greater difficulty in quitting and higher rates of smoking-related diseases and disabilities than the general population. The smoking disparities experienced by this group are, in part, a consequence of multiple chronic life stressors (eg, racial discrimination) that engender increased exposure to interoceptive stress symptoms (eg, anxiety), which can ultimately lead to smoking as a means of immediate emotion regulation. Objective: This study aimed to culturally adapt and initially test a novel mobile intervention (ie, Mobile Anxiety Sensitivity Program for Smoking [MASP]) that targets anxiety sensitivity (AS; a proxy for difficulty and responsivity to interoceptive stress) among Black smokers. The MASP intervention is culturally informed to address interoceptive stress management difficulties among Black smokers and is thus hypothesized to facilitate smoking cessation. Methods: In phase 1, a total of 25 Black smokers with elevated AS will be administered MASP for 6 weeks. Following the completion of phase 1, we will further refine the MASP based on qualitative and quantitative data from participants to produce the final MASP iteration. In phase 2, a total of 200 Black smokers with elevated AS will be enrolled and randomly assigned to receive nicotine replacement therapy and either the smartphone-based National Cancer Institute QuitGuide app for standard mobile smoking cessation treatment or the MASP intervention. All participants in phases 1 and 2 will be enrolled remotely and will complete a web-based study screener; smartphone-based baseline assessment; daily smartphone-based ecological momentary assessments for 6 weeks; phone-based end-of-treatment qualitative interviews; and smartphone-based follow-up assessments at postbaseline weeks 1, 2 (quit date), 3, 4, 5, 6, 28, and 54 (weeks 28 and 54 follow-ups will be completed by phase 2 participants only). The MASP intervention is intended to offset barriers to treatment and encourage treatment engagement via smartphones. Results: This project was funded in September 2020. Phase 1 data collection began in January 2022. Phase 2 data collection is scheduled to begin in July 2022. Conclusions: If successful, data from this study will support culturally informed treatment approaches for Black smokers and, pending findings of efficacy, provide an evidence-based mobile intervention for smoking cessation that is ready for dissemination and implementation. [ABSTRACT FROM AUTHOR]

The combined impact of chronic low back pain (CLBP) and fatigue severity is associated with increased burden and worsened symptoms. Understanding factors that may contribute to and maintain fatigue severity among individuals with CLBP is needed to isolate intervention modalities. The current study sought to investigate the role of anxiety sensitivity (AS) in terms of fatigue severity among 1,663 adults (70.0% female, Mage = 44.5 years, SD = 11.87) with current mild to severe CLBP as well as a subset of the sample with clinically significant fatigue (n = 778). Results indicated AS was a positively and statistically significant predictor of fatigue severity among the entire sample and the subset of the sample with clinically significant fatigue. These cross-sectional data highlight the potential promise of AS as an underrecognized cognitive vulnerability for greater fatigue severity among those with CLBP. [ABSTRACT FROM AUTHOR]

Black persons who smoke are recognized as a smoking health disparity group and face higher rates of tobacco-related disease and morbidity. These disparities result from, in part, exposure to minority-related stress, which results in lower rates of quit success. Anxiety sensitivity (AS), which refers to the fear of stress, is associated with lower rates of cessation and impedes quit success among Black adults who smoke. The current study evaluated the feasibility, utilization, acceptability, and initial efficacy of a smoking cessation and AS reduction smartphone application for Black adults with elevated AS who smoke (The Mobile Anxiety Sensitivity Program for Smoking [MASP]). Participants (N = 24; 62.50% female; Mage = 47.83 years, SD = 9.32) participated in a 6-week trial of MASP. Retention was 83.33% at the 6-week follow-up and MASP utilization was high, with all features used by most participants. Participants reported that MASP was acceptable and 25% of participants reported 7-day point-prevalence abstinence, demonstrating strong utility and impact potential. Results also indicated a statistically significant reduction in AS from baseline to follow-up (p = .003, Cohen’s d=.76). Black persons who smoke with AS may benefit from an accessible, adaptive app with culturally tailored treatment that addressed AS in the context of smoking cessation. [ABSTRACT FROM AUTHOR]

With a direct link between traumatic stress and poor smoking outcomes established, there is a clinically important need to identify underlying, targetable mechanisms that maintain these relations. The present study employed a parallel mediation model to assess the competing explanatory significance of four distinct facets of depression and anxiety (general anxiety, anxious arousal, general depression, and anhedonic depression) in the relation between traumatic load and perceived barriers for quitting smoking, severity of psychosomatic problems experienced when attempting to quit smoking in the past, and negative reinforcement expectancies related to smoking among 98 adult trauma-exposed daily smokers (Mage = 44.64, SD = 10.66). Results showed that only general anxiety symptoms, when controlling for the competing facets of depression and anxiety, had a statistically significant indirect effect on the relation between traumatic load and all smoking processes, such that general anxiety symptoms significantly, indirectly influenced the relation between traumatic load and barriers for smoking cessation (ab = 0.95, 95% CI [0.163, 0.2.14]), smoking quit problems (ab = 0.07, 95% CI [0.009, 0.165]), and negative reinforcement smoking expectancies (ab = 0.16, 95% CI [0.025, 0.399]). Anxious arousal demonstrated an indirect effect for trauma load on only negative reinforcement smoking expectancies (ab = -0.15, 95% CI [-0.345, -0.023]). The current findings highlight the potential importance of general anxiety symptoms as a targetable mechanism for smoking cessation treatments for trauma-exposed smokers. [ABSTRACT FROM AUTHOR]

• Anxiety sensitivity was significantly related to habit motives. • Anxiety sensitivity was significantly related to affect reduction motives. • Anxiety sensitivity was significantly related to sensorimotor and stimulant motives. • These results are novel especially for a Black smoker sample. Black smokers demonstrate higher nicotine dependence and experience higher rates of smoking-related diseases and mortality relative to European American/White smokers. A potential factor relevant to race-specific smoking health disparities may be smoking motives (i.e., motivational basis of smoking). Yet, little research has been conducted to understand psychological factors that may be associated with specific smoking motives among Black smokers. To address this gap in the literature, the current study explored the association between anxiety sensitivity and smoking motives within a subset sample of Black smokers who were interested in participating in a smoking cessation trial (N = 105; 70.5 % male; M age = 44.8 years, SD = 11.6 years). Hierarchical regression analyses indicated anxiety sensitivity was associated with smoking motives related to habit (β = 0.39, p <.001), negative affect reduction (β = 0.32, p <.001), stimulation (β = 0.31, p <.001), and sensorimotor manipulation (β = 0.26, p =.008). Limited support was found for the effect of motives on past quit attempt engagement. These results may broaden understanding of the psychological mechanisms related to smoking motivation among Black smokers and may inform future intervention efforts to reduce smoking motivation among this health disparities population. [ABSTRACT FROM AUTHOR]