Catastrophic interpretation of withdrawal symptoms in smokers.

Objectives: we evaluated the effects of anxiety sensitivity and somatosensory amplification on a panic-like response to a biological challenge in smokers under nicotine abstinence and in smokers under nicotine replacement treatment conditions. Methods: sixty smokers consuming at least 10 cigarettes per day and having 18-65 years of age were enrolled. A placebo-controlled, double-blind design was used. Smokers were asked to refrain from smoking for 12 hours before the challenge and wear a placebo or a nicotine patch. Thereafter, they underwent the 35% carbon dioxide (CO2) challenge, that is a biological test inducing a panic-like response under controlled laboratory conditions. Nicotine withdrawal symptoms, anxiety sensitivity, and somatosensory amplification, as well as physiological (i.e., heart rate, blood pressure) and psychological (i.e., subjective and objective anxiety, fear, discomfort) variables were measured at baseline, immediately before and after the challenge. Results: nicotine withdrawal symptoms (NWS) and anxiety sensitivity (AS) seems to moderate the fear response to the challenge (High NRW and High AS > low NWS and low AS, p= 0.02; High NRW and High AS > low NWS and high AS, p= 0.020; High NRW and High AS > high NWS e low AS, p= 0.014) while a moderation between nicotine withdrawal and somatosensory amplification was not verified. Conclusions. high levels of anxiety sensitivity, together with intense withdrawal symptoms, can increase the risk of panic in abstinent smokers.