An experimental investigation of the functional relationship between social phobia and cigarette smoking

• We recruited smokers either high or average in social phobia (SP) symptoms.
• Participants attended two experimental sessions: one neutral and one social stress.
• There were no significant SP group by condition effects on smoking topography.
• Smoking decreased negative affect for high SP smokers under social stress.
• This effect was specific to high SP smokers under social stress.

IntroductionIndividuals with social phobia (SP) represent a large group with elevated rates of cigarette smoking and cessation rates lower than that of individuals without psychopathology. For individuals with SP, cigarette smoking may be used to reduce social anxiety in anticipation of and during social situations. However, no study to date has experimentally examined this association. The aim of the current study was to experimentally examine the relationship between cigarette smoking and SP as a function of induced social stress.MethodWe recruited daily smokers ages 18–21 who scored in either a clinical or normative range on the Social Interaction Anxiety Scale (SIAS). Participants included 54 smokers (42.6% female, 77.8% White, age M(SD) = 19.65(1.18), CPSD M(SD) = 7.67(4.36), 46.30% high SP) who attended two sessions: one social stress session and one neutral session.ResultsResults indicated that high SP smokers experienced significant decreases in negative affect (NA) following smoking a cigarette when experiencing social stress. This effect was specific to high SP smokers under social stress and was not observed among individuals' average in SP or when examining changes in positive affect.ConclusionsFor individuals with SP, cigarette smoking may be maintained due to changes in NA associated with smoking specifically in the context of social stress. These results speak to the importance of targeted cessation interventions that address the nature of smoking for individuals with SP.