Distress Intolerance in Relation to Reliance on Cigarettes for Weight, Shape, and Appetite Control
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Distress Intolerance in Relation to Reliance on Cigarettes for Weight, Shape, and Appetite Control Emily K. Burr 1 & Bailey O’Keeffe 2 & Mindy M. Kibbey 1 & Kathryn A. Coniglio 1 & Teresa M. Leyro 1 & Samantha G. Farris 1 Published online: 2 March 2020 # International Society of Behavioral Medicine 2020
Abstract Background Distress intolerance, one’s inability to withstand distressing emotional or physical states, is a transdiagnostic vulnerability implicated in affect-based health behaviors, including cigarette smoking and poor weight control. The current study evaluated associations between distress intolerance and the reliance on cigarettes for management of weight, appetite, or body dissatisfaction, which may pose a burden for cessation and increase risk of weight-related health problems. Method Daily smokers (n = 577) completed an online survey assessing distress tolerance and reliance on cigarettes for weight and shape control with the four subscales of the Smoking and Weight Eating Episodes Test (SWEET). Four hierarchical regression models were constructed to test the association between distress intolerance and SWEET scores, accounting for the effect of relevant covarying factors. Results After adjusting for model covariates, distress intolerance was significantly incrementally associated with greater tendency to rely on cigarettes to suppress appetite (adjR2 = .040), prevent overeating (adjR2 = .034), cope with body dissatisfaction (adjR2 = .046), and cope with nicotine withdrawal–related appetite increases (adjR2 = .030). Conclusion Distress intolerance may play an etiological role in maladaptive use of cigarettes to control appetite, weight, and body dissatisfaction among daily smokers, particularly those with weight- or shape-related concerns. Interventions aimed at increasing perceived ability to withstand distress could potentially reduce reliance on cigarettes for the aforementioned purposes. Keywords Distress intolerance . Cigarette dependence . Smoking behaviors . Weight control . Body dissatisfaction
Introduction Cigarette smokers commonly rely on cigarettes to manage body weight and shape [1–3] and may have more body image preoccupations than non-smokers [4]. Moreover, elevated body dissatisfaction has been linked to smoking onset [5], and fear of weight gain is independently predictive of poorer smoking cessation outcomes, such as early relapse following a quit attempt [3, 6, 7]. Smokers who rely on cigarettes for weight and shape control are more likely to report body shape concerns and endorse eating disorder symptoms [8, 9]. The tendency to rely on cigarettes to manage weight, shape, or appetite appears to be explained in part by high levels of psychological distress, wherein body image and weight
* Samantha G. Farris [email protected] 1
Department of Psychology, Rutgers, the State University of New Jersey, 53 Avenue East, Piscataway, NJ 08854, USA
2
Psychosocial Research, Butler Hospital, Providence, RI, USA
concerns contribute to elevated negative affe
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