Worry and the Socially Anxious Smoker
Suzi W. Highfill, Student, School of Psychology; Mary A. Couvillion, Student, School of Psychology; Jared P. Dempsey, Ph.D., Faculty, School of Psychology
Purpose: This preliminary study investigated the relationship between worry and smoking to cope among socially anxious smokers. Pathological worry is defined as excessive and unrealistic apprehension characterized by uncontrollable thoughts which focus on negative outcomes (Borkovec, Shadick, & Hopkins, 1991; Andrews et al., 2010). Worry is based in non-reality, but comprises a component of perceived control, such that individuals who worry use it to help them find solutions and prevent bad things from happening. Therefore, individuals may cling to worry in order to increase personal control and help them manage uncertainty during negative life events (Anderson & Schwartz, 1992; Freeston et al., 1994). Research indicates that among anxious individuals who smoke, worry is correlated with positive beliefs about smoking, such as “worry will help me cope,” and “if I worry I will solve the problem,” leading to a perception that negative affect can be personally controlled (Andrews et al., 2010; Nikcevic & Spada, 2008). These beliefs may contribute to enhanced motivation to smoke in order to reduce anxiety and manage emotions, strengthening barriers to smoking cessation (Nikcevic & Spada; 2008; Peasley-Miklus et al., 2012) and consequently perpetuating the maintenance of smoking to cope behaviors (Santanello & Gardner, 2006; Watson et al., 2012). According to a recent national epidemiologic survey, cigarette smoking is the number one cause of preventable death in our country (Grant et al., 2004) yet because of worriers’ distorted beliefs, smoking cessation may become even less achievable (Watson et al., 2012); and since worry interferes with effective coping, this study hypothesized that socially anxious individuals who smoke to cope with anxiety would suffer from greater pathological worry compared with socially anxious individuals who do not smoke to cope with anxiety. Methods: Participants included 138 undergraduate smokers who were enrolled in university in northwestern Oklahoma. Procedure: This data was gathered as part of a large multi-survey study of 1580 undergraduate introductory psychology students. Excluded from these were non-smokers, non-socially anxious individuals, and cases with missing data. The resulting 138 students who were self-reported socially anxious smokers were included in this analysis. Measures: An abbreviated version of the Smoking-to-Cope scale (STC) (based on the Drinking to Cope survey, Thomas, Randall, Book, & Randall, 2008) was used to distinguish individuals who utilized cigarette smoking to cope with anxiety (N = 82) from smokers who did not (N = 55). An abbreviated version of the Penn State Worry Questionnaire (PSWQ) (Meyer, Miller, Metzger, & Borkovec, 1990) was used to determine the degree of pathological worry among this sample of socially anxious smokers. Results: An analysis of variance indicated that socially anxious smokers who utilize smoking to cope score significantly higher on pathological worry compared with socially anxious smokers who do not utilize smoking to cope. In other words, cigarette smokers who smoke to cope with social anxiety symptoms suffer from greater levels of pathological worry, in comparison to smokers who do not purposefully smoke to cope with social anxiety symptoms. These findings highlight the need to improve clinical recognition of pathological worry to target more accurate treatment interventions for individuals with social anxiety who utilize cigarette smoking to cope.