Worry, anxiety sensitivity, and electronic cigarettes among adults

Abstract

Although electronic cigarette (e-cigarette) use is now a common substance use behavior, there is little understanding of the individual difference factors related to e-cigarette use beliefs and dependence. The present investigation sought to test a theoretically-driven model of anxiety sensitivity as an explanatory element in a worry-e-cigarette beliefs and dependence model. Participants included 558 adult e-cigarette users (51.4% female; 35.2 years, SD = 10.1) who were nationally recruited via an online survey system. Participants completed a single survey that assessed their mood and e-cigarette behavior and beliefs. Results supported a statistically significant indirect pathway for worry in relation to perceived benefits of e-cigarettes, e-cigarette positive outcome expectancies, and e-cigarette dependence via anxiety sensitivity; effect sizes were small. The indirect effects were evident when accounting for several theoretically relevant covariates (sex, income, education, concurrent cigarette use, and neuroticism). This study provides the first empirical evidence of the role of anxiety sensitivity in the relation between worry and e-cigarette use beliefs and behavior, which may represent a novel intervention target.

Keywords: Addiction; Anxiety sensitivity; Cognitive; E-cigarettes; Expectancies; Tobacco; Worry.

Fig. 1.

Conceptual model of the indirect effect (ab) of worry on perceived benefits of e-cigarettes, e-cigarette positive outcome expectancies, and e-cigarette dependence via anxiety sensitivity. Note: N = 558; *p < .05. a path = Effect of X on M; b paths=Effect of M on Y_i; c’ paths = Total effect of X on Y_i; c’ paths = Direct effect of X on Y_i controlling for M. Three separate paths were conducted (Y_1–3) with the predictor (X). PSWQ: Penn State Worry Questionnaire (Meyer et al., 1990); ASI-3: Anxiety Sensitivity Index-3 (Taylor et al., 2007); RABE-Ben: Risks and Benefits of E-cigarettes Questionnaire-benefits subscale (Copeland et al., 2017); SCQ-EC: The Smoking Consequences Questionnaire for Electronic Cigarettes-positive expectancies subscale (Harrell et al., 2014); PS-ECDI: Penn State Electronic Cigarette Dependence Index (Foulds et al., 2014). Covariates included in the establishment of paths included: sex; income; education; concurrent combustible tobacco use; and neuroticism.