Distress tolerance in relation to cessation history and smoking characteristics among adult daily smokers. (January 2020) - Mathew, Amanda R.
Abstract: Introduction: Distress tolerance (DT) is linked to smoking initiation, maintenance, and difficulty quitting. However, there is a lack of consistency in prior findings on DT's relations with conceptually linked smoking variables, and few studies have examined differences across DT domains. We examined interrelations between cessation history, smoking characteristics, and a full battery of multimethod DT measures. Methods: We conducted a two-session laboratory assessment with 106 adult, daily smokers with moderate or lower smoking-specific DT, assessed by the Intolerance for Smoking Abstinence Discomfort Questionnaire. Additional DT indices included the Distress Tolerance Scale and four validated behavioral measures (mirror-tracing, serial addition, cold pressor, and breath-holding tasks). Participants reported on cessation history (length and number of prior quit attempts, withdrawal severity at previous attempt) as well as years smoking, cigarettes per day, and nicotine dependence. Results: Withdrawal severity and nicotine dependence were consistently associated with lower self-reported DT, and associations were strongest with perceived tolerance of smoking-specific versus general distress. Length and number of prior quit attempts, years smoking, and cigarettes per day demonstrated a lack of robust associations with behavioral DT measures. Conclusions: Findings suggest that perceived tolerance of smoking-specific distress may be the most robust indicator of cessation history and smoking characteristics. Highlights: We examined cessation history and smoking characteristics by multimethod DT indices. Smoking-specific DT was associated with greater withdrawal and nicotine dependence. Mirror-tracing latency was associated with shorter quit attempt duration. Findings support perceived smoking-specific DT as a key treatment target.