3 - (SYM 121) the Relationship Between Anxiety Sensitivity, Physical Activity Enjoyment, and Exercise Engagement over Time in Low-active Daily Smokers Participating in Smoking Cessation Treatment

Anxiety sensitivity (AS), fear of anxiety-related sensations, may be elevated in smokers. Higher intensity physical activity (PA) may be uncomfortable for those with high AS as it mimics feared sensations and may be associated with lower PA enjoyment. Exercise may reduce AS, possibly by increasing tolerance to feared sensations, which may enable greater PA enjoyment. The current study examined the relationship between changes in AS and exercise with PA enjoyment over time in low-active daily smokers.

This secondary analysis examined data from a trial of telephone cognitive behavioral therapy for smoking cessation and nicotine replacement therapy combined with 12 sessions of group aerobic exercise (n=106) or health education (n=94). 200 low-active daily smokers (73% female, 25% male, 2% missing; Mean age=45.7±11.2) with elevated depressive symptoms completed: Anxiety Sensitivity Index (ASI), Physical Activity Enjoyment Scale (PACES), and International Physical Activity Questionnaire (IPAQ; moderate/vigorous exercise) at baseline, post-intervention (3 months), and 6- and 12-month follow-up. Change from baseline was calculated for each time point. Positive change on ASI indicates worsening AS. Positive change indicates greater PA enjoyment on PACES and more exercise on IPAQ. Linear regressions were conducted with ASI change, IPAQ change, and their interaction predicting PACES change at the subsequent time point, controlling for intervention condition.

At each time point and across intervention conditions, ASI change was significantly negatively correlated with PACES change (3m: r(99)=-.22, p=.03; 6m: r(102)=-.35, p< .001; 12m: r(87)=-.30, p=.005), supporting the hypothesized association of AS and PA enjoyment. ASI change at 3 months (Beta=-0.36, p=.002) predicted PACES change at 6 months, but there was no effect of change in exercise (IPAQ), their interaction, or condition. Change in ASI (Beta=-0.29, p=.009) but not IPAQ (Beta=-0.02, p=.88) at 6 months significantly predicted PACES change at 12 months. The interaction was significant (Beta=-0.30, p=.009); those with improving AS at 6 months who engaged in more exercise demonstrated greater improvements in PACES at 12 months.

Results suggest a link between AS and PA enjoyment; those with improving AS demonstrate greater changes in PA enjoyment. This relationship may change over time and with more exercise. Specific interventions to target discomfort with exercise-related sensations may help improve PA enjoyment which in turn may enhance engagement with exercise long-term.