Addict Behav. 2025 Jan:160:108187. doi: 10.1016/j.addbeh.2024.108187.Epub 2024 Oct 2.

Michael J Zvolensky ¹, Tanya Smit ², Ileana Dragoi ², Rishitaa Tamminana ², Jafar Bakhshaie ³, Joseph W Ditre ⁴, Brooke Y Redmond ², Jeffrey Lackner ⁵

Author information

¹Department of Psychology, University of Houston, Houston, TX, USA; Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, USA; HEALTH Institute, University of Houston, Houston, TX, USA. Electronic address: mjzvolen@central.uh.edu.

²Department of Psychology, University of Houston, Houston, TX, USA.

³Center for Health Outcomes and Interdisciplinary Research, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.

⁴Department of Psychology, Syracuse University, USA; Center for Health Behavior Research & Innovation, Syracuse University, USA.

⁵Department of Medicine, Division of Behavioral Medicine, Jacobs School of Medicine & Biomedical Sciences, Buffalo, NY, USA.

Abstract

Introduction: Irritable bowel syndrome (IBS) is a prevalent disorder of gut-brain function associated with psychological distress as well as work and quality of life impairment. Smoking has been linked to gastrointestinal dysfunction, however, research focused on the prevalence of IBS and smoking is limited. Previous research has shown that anxiety sensitivity is linked to increased risk of aversive bodily experiences and subsequent coping-oriented regulation efforts. Higher anxiety sensitivity has also been associated with processes linked to tobacco cigarette smoking lapse and relapse. There is a need to clarify the explanatory roles of anxiety sensitivity in the context of more severe IBS symptoms among persons with IBS who are current smokers.

Method: The present investigation evaluated the main and interactive effects of IBS symptom severity and anxiety sensitivity in relation to processes related to the maintenance and relapse of tobacco smoking among adults with IBS. The sample consisted of 263 (52.1 % female; M_age = 44.13 years, SD = 12.71) adults who met criteria for IBS and smoke at least 5 cigarettes per day.

Results: Hierarchical regression results indicated that both anxiety sensitivity and IBS symptom severity independently predicted greater perceived barriers to smoking cessation, severity of problems experienced during quitting, and negative reinforcement smoking expectancies. A statistically significant interaction further indicated that IBS symptom severity was more strongly associated with negative reinforcement smoking expectancies among participants with higher, relative to lower, anxiety sensitivity.

Conclusions: This study is the first to show that both IBS symptom severity and anxiety sensitivity are related to greater perceived barriers to smoking cessation, previous difficulty quitting, and negative reinforcement expectancies among adults with IBS. There is a continued need to further scientific understanding of interrelations between anxiety sensitivity, IBS symptom severity, and smoking cessation-related beliefs and processes to identify novel approaches that can best support quitting among this understudied population.