Introduction: Distress intolerance (DI) is elevated in smokers and confers increased risk for relapse following a quit attempt. Intolerance of respiratory distress and of nicotine withdrawal may be particularly relevant predictors of smoking cessation outcomes. However, no studies to date have examined the association between smoking relevant DI and smoking lapse behavior in a laboratory setting. The current study examined whether DI was associated with the risk of initiating smoking in a laboratory-based lapse analog task.
Methods: This study is a secondary data analysis from a study of the impact of alcohol administration on smoking behavior. Ninety-six cigarette smokers completed measures of DI and a smoking lapse analog task. Breath holding (BH) duration and self-reported intolerance of smoking abstinence were analyzed as predictors of smoking initiation in a survival analysis model.
Results: Shorter BH duration was associated with greater risk of smoking initiation, controlling for nicotine dependence, nicotine withdrawal symptoms, and demographics. Self-report measures of smoking abstinence DI were not associated with BH duration or time to smoking initiation when controlling for nicotine dependence severity.
Conclusions: BH captures a domain of DI that is specifically associated with a higher risk of initiating smoking in this analog of smoking lapse. The prediction of smoking in an analog lapse task adds to the extant literature identifying an association between DI and smoking lapse and may enable further research to understand and address the mechanism through which BH affects smoking lapse risk.