Because the rate of smoking has largely stabilized over the past decade and most smokers are uninterested in quitting in the near future, unmotivated smokers represent an important population to target for public health efforts. Clinical interventions that induce quit attempts among smokers who are not yet ready to quit are limited in availability and effectiveness. Since quit attempts introduce marked symptoms of affective and somatic distress due to nicotine withdrawal, it stands to reason that inability or unwillingness to endure this distress impedes smokers from even trying to quit, just as it impedes success once an attempt is made. The literature on distress intolerance (DI) focuses almost exclusively on the latter (e.g., as a predictor of relapse), with very little focus on the former (e.g., undermining motivation to quit). The proposed study will assess DI among and between smokers who are vs. are not motivated to quit, as well as the impact of DI on smoking lapse behavior in a laboratory analog task. Findings are expected to identify between-group differences that help to clarify relationships between DI and motivation to quit smoking. As DI is a promising target for intervention, results are expected to inform treatment strategies that may help to foster motivation among smokers not ready to quit.

Public Health Relevance

Unmotivated smokers represent a large, important, and understudied population to target in public health efforts. However, intervention research typically relies on selected volunteer samples of smokers, so little is known about barriers to undergoing a quit attempt among unmotivated smokers. The proposed research has the potential to identify a promising target for treatment among unmotivated smokers and contribute to the development of tailored intervention strategies to increase rate and success of future quit attempts.

National Institute of Health (NIH)
National Institute on Drug Abuse (NIDA)
Postdoctoral Individual National Research Service Award (F32)
Project #
Application #
Study Section
Special Emphasis Panel (ZRG1-F16-L (20))
Program Officer
Grossman, Debra
Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
Medical University of South Carolina
Schools of Medicine
United States
Zip Code
Mathew, Amanda R; Heckman, Bryan W; Meier, Ellen et al. (2017) Development and initial validation of a cessation fatigue scale. Drug Alcohol Depend 176:102-108
Froeliger, B; Mathew, A R; McConnell, P A et al. (2017) Restructuring Reward Mechanisms in Nicotine Addiction: A Pilot fMRI Study of Mindfulness-Oriented Recovery Enhancement for Cigarette Smokers. Evid Based Complement Alternat Med 2017:7018014
Mathew, Amanda R; Hogarth, Lee; Leventhal, Adam M et al. (2017) Cigarette smoking and depression comorbidity: systematic review and proposed theoretical model. Addiction 112:401-412
Hogarth, Lee; Mathew, Amanda R; Hitsman, Brian (2017) Current major depression is associated with greater sensitivity to the motivational effect of both negative mood induction and abstinence on tobacco-seeking behavior. Drug Alcohol Depend 176:1-6
Mathew, Amanda R; Burris, Jessica L; Alberg, Anthony J et al. (2015) Impact of a brief telephone referral on quitline use, quit attempts and abstinence. Health Educ Res 30:134-9
Mathew, Amanda R; Burris, Jessica L; Froeliger, Brett et al. (2015) Impulsivity and cigarette craving among adolescent daily and occasional smokers. Addict Behav 45:134-8
Heckman, Bryan W; Mathew, Amanda R; Carpenter, Matthew J (2015) Treatment Burden and Treatment Fatigue as Barriers to Health. Curr Opin Psychol 5:31-36
Burris, Jessica L; Heckman, Bryan W; Mathew, Amanda R et al. (2015) A mechanistic test of nicotine replacement therapy sampling for smoking cessation induction. Psychol Addict Behav 29:392-9
Mathew, Amanda R; Cook, Jessica W; Japuntich, Sandra J et al. (2015) Post-traumatic stress disorder symptoms, underlying affective vulnerabilities, and smoking for affect regulation. Am J Addict 24:39-46
Mathew, Amanda R; Wahlquist, Amy E; Garrett-Mayer, Elizabeth et al. (2014) Affective motives for smoking among early stage smokers. Nicotine Tob Res 16:1387-93