(PS1-52) The Relationship Between Smoking Specific Experiential Avoidance and Nicotine Withdrawal During a Smoking Quit Attempt

Previous smoking cessation studies have focused on the role of smoking-specific experiential avoidance (EA) (i.e., the unwillingness to remain in contact with smoking-related aversive experiences) in the context of smoking lapse after a quit attempt. In fact, prior research has shown that reductions in EA are associated with an increased likelihood of quit-day abstinence. However, little is known about smoking-specific EA in regard to withdrawal symptoms during a quit attempt. Using data from an RCT of distress tolerance (DT)-based treatment for smoking cessation, this secondary analysis examined whether greater smoking-specific EA (Avoidance and Inflexibility Scale) at baseline predicted greater total withdrawal symptoms (Minnesota Nicotine Withdrawal Scale) one-week post-quit. Participants: 78 adult smokers who smoked ≥ 10 cigarettes a day for the past 3 years, and were motivated to quit smoking (≥ 5 on a 10-point scale).

Results: To examine the relationship between AIS and MNWS scores, we performed a simple linear regression, controlling for study condition, abstinence status (one-week post-quit), and gender. Consistent with our hypothesis, the initial results showed that greater pre-treatment AIS scores strongly predicted greater total withdrawal symptoms one-week after a quit attempt (p=0.02). However, after separating participants by abstinence status at one-week post-quit (n=41 abstinent, n=34 not abstinent; n=3 excluded for missing baseline AIS), the regression results demonstrated that the relationship between baseline smoking specific EA and post-quit withdrawal was only statistically significant for those who were not abstinent (p=0.05). Additionally, individuals who continued smoking one-week post-quit were significantly (p< 0.001) more likely to experience withdrawal than those who were abstinent. This may be in part due to the fact that those who experienced more severe withdrawal symptoms used smoking to reduce the frequency and intensity of those internal experiences.

Conclusions: Results mainly supported the hypothesized relationship between EA and withdrawal symptoms. Unfortunately, our sample was predominately White (90.4%), highlighting the need to include a more diverse sample of smokers in future studies. In all, these findings suggest that future research may examine whether populations vulnerable to greater post-quit withdrawal symptoms may benefit from smoking cessation interventions focusing on smoking-specific EA reduction.