Anxiety sensitivity as a transdiagnostic vulnerability factor for cigarette smoking: Clinical and treatment implications

Abstract

Tobacco smoking is the leading preventable cause of premature death worldwide and, despite the fact that many therapies are available for smoking cessation, additional efficacious interventions are needed since many quit attempts are unsuccessful and a high percentage of patients relapse within the months following a quit attempt. In particular, both cigarette consumption and relapse rates among smokers with comorbid mental health problems have shown to be higher than those without them. So far, smoking cessation treatments usually include different approaches aimed at treating specific mental health disorders, particularly anxiety and depression. However, this traditional approach is turning towards a transdiagnostic vulnerability model that includes a set of key clinical factors underlying tobacco use and different emotional conditions, being anxiety sensitivity (AS) increasingly becoming the focus of attention. Preceding research conducted in United States and Argentina has demonstrated that integrating AS reduction components into broader smoking cessation treatments leads to reduced AS levels as well as improved treatment retention and cessation rates. Nonetheless, there are no published behavioral treatment protocols addressing anxiety and smoking concurrently, or using a transdiagnostic approach for this population, in our country. So far, little is known about the mechanisms underlying the relationship between AS and smoking in Spain. Both clinicians and researchers should focus on explore the AS global construct among Spanish smokers, including the most clinically-relevant variables related to both smoking behavior and smoking cessation, with the purpose of developing novel treatment proposals for quitting.