Anxiety Sensitivity and Distress Tolerance in Relation to Smoking Abstinence Expectancies Among Black Individuals Who Smoke.

OBJECTIVE: Black individuals who smoke in the United States experience significant tobacco-related disparities. Although prior work has established that smoking abstinence expectancies play an important role in smoking-related outcomes, few studies have examined potential individual difference factors that may be relevant to smoking abstinence expectancies among Black individuals who smoke. The present study investigated anxiety sensitivity and distress tolerance in relation to smoking abstinence expectancies among a sample of Black individuals who smoke. METHOD: Participants were 86 Black adults who smoke cigarettes daily (M age = 46.07 years, SD = 10.37; 26.7% female). Four separate linear regression analyses were conducted to evaluate the relation between anxiety sensitivity, distress tolerance, and their interaction with each of the four smoking abstinence expectancies (i.e., somatic symptoms, positive consequences, harmful consequences, and negative mood). RESULTS: Results indicated that higher anxiety sensitivity was related to higher somatic symptoms, harmful consequences, and negative mood abstinence expectancies, whereas distress tolerance was related to higher positive consequences. Further, anxiety sensitivity and distress tolerance interacted to confer greater expectancies for the positive consequences of quitting. CONCLUSIONS: The current findings are among the first to document that anxiety sensitivity and distress tolerance are clinically relevant factors to consider when tailoring smoking cessation treatments for Black individuals who smoke. Future research is needed to examine distress tolerance and anxiety sensitivity as longitudinal predictors of smoking abstinence expectancies among Black individuals who smoke.

Pain Severity in Relation to Smoking Cessation Problems and Self-Efficacy for Quitting among Latinx Individuals Who Smoke Cigarettes: The Moderating Role of Perceived Discrimination.

Background: Latinx individuals experience significant tobacco cigarette smoking-related diseases and illnesses. Although most Latinx smokers report a desire to quit smoking, evidenced-based cessation treatments are underutilized in this group, which may partially be due to lower likelihood of receiving advice from a healthcare professional. Further, there are a lack of cessation treatments that account for comorbid symptoms/conditions (e.g., co-occurring pain) and social determinants of health (e.g., perceived discrimination). Extant work has established the reciprocal relation between pain and smoking trajectories. Additionally, although social determinants, such as perceived racial/ethnic discrimination, have demonstrated clinical relevance to a variety of health-related behaviors, limited work has examined the role of perceived discrimination in pain-smoking relations. The current study examined the effects of perceived discrimination and pain severity in relation to smoking cessation problems and self-efficacy for quitting among Latinx cigarette smokers. Method: Participants included 226 (Mage = 34.95 years, SD = 8.62; 38.5% female) adult Latinx daily cigarette smokers. Results: Results indicated that the interaction of pain and perceived discrimination was predictive of greater quit problems (p = 0.041) as well as greater confidence in the ability to refrain from smoking in response to internal (p < 0.001) and external stimuli (p < 0.001). Conclusions: Overall, this work provides a more nuanced understanding of the psychosocial contexts in which Latinx smokers may encounter problems related to quitting, and this data is important for future smoking cessation research and treatment.

Pain interference among adult dual combustible and electronic tobacco users in terms of perceived barriers for quitting.

Electronic cigarette (e-cigarette) use has become increasingly common among combustible cigarette users, and dual use may represent a more severe type of nicotine addiction. Experiencing pain is one prevalent domain that may be important to understand quit processes and behavior among dual users. Although most past research on pain and nicotine/tobacco has focused on combustible cigarette use, initial work on e-cigarette users has found that greater pain severity is associated with higher levels of dependence and negative thinking patterns about e-cigarette use. Yet, there has been no effort to explore the experience of pain among dual users in terms of perceived barriers for quitting combustibles or e-cigarettes. The present study sought to examine pain interference among dual combustible and e-cigarette users in terms of perceived barriers for quitting among 138 (45.9% female; Mage = 35.96 years, SD = 7.16) adult dual users (i.e., users of both combustible cigarette and e-cigarettes). Hierarchical linear regression models indicated that pain interference was significantly associated with both perceived barriers for cessation of combustible cigarettes and perceived barriers for cessation of e-cigarettes. Overall, the present investigation served as an initial evaluation of the role of pain interference in terms of perceived barriers for quitting combustible and e-cigarettes among adult daily dual users. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The Role of Pain Avoidance in the Relation between Pain Intensity and Smoking Cessation Processes.

Scientific evidence suggests that smokers who experience varying levels of pain are more likely to maintain their addiction to tobacco. The relationship between pain intensity and cognitive-based smoking processes within a mechanistic framework has received relatively little attention. Pain avoidance may influence the association between pain intensity and smoking, as it is a construct that is related to adverse pain and smoking processes. Thus, the current cross-sectional study examined the indirect effect of pain intensity on three clinically significant smoking processes (i.e., prior quit problems, perceived barriers for cessation, and negative affect reduction smoking expectancies) through pain avoidance among 95 treatment-seeking adult smokers. Regression analyses were conducted using bootstrapping techniques through PROCESS, a conditional modeling program that utilizes an ordinary least squares-based path analytical framework to test for both direct and indirect associations. Results indicated that pain intensity had a statistically significant indirect association with quit problems and perceived barriers for cessation, through pain avoidance. Pain intensity did not have a statistically significant indirect association with the negative affect reduction of smoking expectancies through pain avoidance. The current findings provide evidence for the role of pain avoidance as a potential transdiagnostic mechanism that contributes to maladaptive smoking outcomes within the larger context of the reciprocal model of pain and substance use.

Differences in Pain Severity and Interference between Latinx Combustible Cigarette Smokers and Dual Users with Current Pain.

Latinx individuals who smoke represent a tobacco health disparities group. Yet, limited research has focused on examining dual combustible and electronic cigarette use among Latinx populations. Importantly, Latinx persons who smoke also evince elevated rates of pain problems and symptoms and prior research has consistently linked pain problems and severity to smoking prevalence, maintenance, and behavior. Accordingly, the current study sought to build from the limited work that exists among dual combustible cigarette and electronic cigarette Latinx users comparing levels of pain severity and interference. The current sample consists of 196 adult Latinx daily cigarette smokers (35.48 years old; 39.4% female), of which 72 reported current daily dual use of an e-cigarette. Results indicated that Latinx dual users reported greater levels of pain severity (ηp2 = .12) and pain interference (ηp2 = .10) than exclusive combustible cigarette users. The study adds uniquely to the limited literature on the clinical importance of dual cigarette use in relation to pain severity and interference in that pain may serve as an important risk factor for the initiation and maintenance of dual use for increased analgesic nicotine effects.

Alcohol use severity in relation to pain severity and interference among latinx adults with current pain who smoke cigarettes.

Limited research has focused expressly on dual tobacco-alcohol use among the Latinx population. Latinx individuals who smoke represent a tobacco health disparities group and evince elevated rates of pain problems and symptoms. Prior research has consistently linked pain problems and severity to smoking and alcohol prevalence, maintenance, and behavior. Accordingly, the current study sought to build from the limited work that exists among Latinx persons who smoke and evaluate the role of alcohol use severity in terms of pain severity and interference. The current sample consisted of 228 adult Latinx daily cigarette smokers (Mage = 34.95 years; SD = 8.58; 39.0% female) who endorsed current pain. Results indicated that elevated alcohol use problems were associated with greater levels of pain severity (R2 = 0.06) and interference (R2 = 0.06). The present findings suggest that there may be utility in clinical screening for alcohol use problems among Latinx persons who smoke to offset pain problems among this high-risk group.

Pain Severity and Smoking Abstinence Expectancies among Latinx Individuals Who Smoke Cigarettes: The Moderating Role of Perceived Discrimination.

Latinx individuals experience significant health disparities related to smoking cessation in the United States (US). Although past works have consistently implicated pain in the maintenance of smoking behavior, limited research has examined the role of social determinants (e.g., perceived discrimination) in pain-smoking relations. The current study sought to examine the moderating role of perceived discrimination in the relation between pain severity and smoking abstinence expectancies (i.e., a cognitive factor related to poor smoking outcomes) among 226 Latinx individuals who currently smoke cigarettes (Mage = 34.95 years; SD = 8.62; 38.5% female). The results indicated a statistically significant interaction between pain severity and perceived discrimination with regard to smoking abstinence expectancies (i.e., negative mood, somatic symptoms, harmful consequences, and positive consequences). Post-hoc analyses revealed the association of pain severity and negative mood, harmful consequences, and positive consequences smoking abstinence expectancies evident for individuals with higher perceived discrimination. Moreover, the association between pain severity and somatic symptoms smoking abstinence expectancies was stronger for individuals with higher perceived discrimination. Overall, these results suggest that clinical and community-based public health strategies may benefit from addressing the role of perceived discrimination among Latinx individuals who smoke cigarettes in the context of pain.

Anxiety sensitivity and reasons for smoking among Black smokers.

Black smokers demonstrate higher nicotine dependence and experience higher rates of smoking-related diseases and mortality relative to European American/White smokers. A potential factor relevant to race-specific smoking health disparities may be smoking motives (i.e., motivational basis of smoking). Yet, little research has been conducted to understand psychological factors that may be associated with specific smoking motives among Black smokers. To address this gap in the literature, the current study explored the association between anxiety sensitivity and smoking motives within a subset sample of Black smokers who were interested in participating in a smoking cessation trial (N = 105; 70.5 % male; Mage = 44.8 years, SD = 11.6 years). Hierarchical regression analyses indicated anxiety sensitivity was associated with smoking motives related to habit (ß = 0.39, p <.001), negative affect reduction (ß = 0.32, p <.001), stimulation (ß = 0.31, p <.001), and sensorimotor manipulation (ß = 0.26, p =.008). Limited support was found for the effect of motives on past quit attempt engagement. These results may broaden understanding of the psychological mechanisms related to smoking motivation among Black smokers and may inform future intervention efforts to reduce smoking motivation among this health disparities population.

Anxiety sensitivity and its association with perceived barriers for quitting, smoking inflexibility, and severity of quit problems among Black smokers.

Black individuals who smoke in the United States experience health disparities related to tobacco use (e.g., greater nicotine dependence, less success in quitting smoking) and interoceptive distress (e.g., somatic symptoms, anxiety). Individual difference factors that amplify interoceptive distress and contribute to poorer smoking behaviors and outcomes warrant further attention and investigation. Thus, the present study sought to explore the association between anxiety sensitivity and clinically-relevant smoking variables of perceived barriers for quitting, smoking inflexibility, and problems experienced during past quit attempts. Participants in the current study included 98 Black adult smokers (71.4% male; Mage = 44.08 years, SD = 11.44 years). Results indicated greater levels of anxiety sensitivity were associated with greater levels of perceived barriers for quitting smoking (b = 0.10, SE = 0.08, p = 0.01), smoking inflexibility (b = 0.02, SE <.001, p <.001), and problems experienced during past smoking quit attempts (b = 0.17, SE = 0.07, p = 0.02). Clinical implications and future directions are further discussed as it relates to anxiety sensitivity and efforts to reduce or quit smoking for this health disparities population.

Trauma exposure and smoking outcomes: The indirect effects of anxious and depressive symptoms.

With a direct link between traumatic stress and poor smoking outcomes established, there is a clinically important need to identify underlying, targetable mechanisms that maintain these relations. The present study employed a parallel mediation model to assess the competing explanatory significance of four distinct facets of depression and anxiety (general anxiety, anxious arousal, general depression, and anhedonic depression) in the relation between traumatic load and perceived barriers for quitting smoking, severity of psychosomatic problems experienced when attempting to quit smoking in the past, and negative reinforcement expectancies related to smoking among 98 adult trauma-exposed daily smokers (Mage = 44.64, SD = 10.66). Results showed that only general anxiety symptoms, when controlling for the competing facets of depression and anxiety, had a statistically significant indirect effect on the relation between traumatic load and all smoking processes, such that general anxiety symptoms significantly, indirectly influenced the relation between traumatic load and barriers for smoking cessation (ab = 0.95, 95% CI [0.163, 0.2.14]), smoking quit problems (ab = 0.07, 95% CI [0.009, 0.165]), and negative reinforcement smoking expectancies (ab = 0.16, 95% CI [0.025, 0.399]). Anxious arousal demonstrated an indirect effect for trauma load on only negative reinforcement smoking expectancies (ab = -0.15, 95% CI [-0.345, -0.023]). The current findings highlight the potential importance of general anxiety symptoms as a targetable mechanism for smoking cessation treatments for trauma-exposed smokers.

Pain interference and cognitive processes of e-cigarette use: The differential effect of sex.

Recent years have been marked by an increase in electronic cigarette (e-cigarette) use. Although some evidence suggests that e-cigarettes used in isolation may be less harmful than combustible cigarettes, e-cigarette use carries significant health risks. Data are critically needed to identify risk factors that promote and maintain e-cigarette use. The current project examined how the relation between pain interference (i.e., how much pain interferes with daily functioning) and cognitive processes of e-cigarette use (i.e., perceived barriers for quitting e-cigarettes, perceived risks of e-cigarettes, and negative expectancies of using e-cigarettes) differ across sex. Participants included 340 (61.5% female; 77.1% Caucasian/White; Mage = 36.68 years, SD = 10.75) adult past-month e-cigarette users. Results suggested that increased pain interference was more strongly related to greater perceived barriers to cessation, perceived risks of e-cigarettes, and negative expectancies of using e-cigarettes among males relative to females. Importantly, this work suggests that e-cigarette use may operate differently than other substances that have been studied in the past in that male e-cigarette users may be more vulnerable than female e-cigarette users to the effects of pain interference on cognitive processes of e-cigarette use. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Anxiety Sensitivity and Emotion Dysregulation in Dual and Exclusive E-Cigarette Users.

Background: E-cigarette use has increased exponentially over the past decade, particularly among current combustible cigarette users. Preliminary evidence has demonstrated differences across exclusive and dual e-cigarette/combustible cigarette users, such that dual users represent a more clinically severe group. Yet, the extent to which these groups differ on critical transdiagnostic risk factors that may promote and maintain nicotine dependence, such as anxiety sensitivity and emotional dysregulation has yet to be systematically studied. The purpose of the current study was to examine differences between exclusive e-cigarette users and dual e-cigarette and combustible cigarette users in anxiety sensitivity and both global emotion regulation difficulties as well as within specific emotion regulation difficulty domains. Methods: Participants were 192 exclusive e-cigarette users and 315 dual e-cigarette and combustible cigarette users (52.1% female, Mage = 34.8 years, SD = 11.42). Results: Compared to exclusive e-cigarette users, dual users reported higher anxiety sensitivity, overall emotion regulation difficulties, and specific emotion regulation difficulties related to impulse control and lack of access to effective emotion regulation strategies. There were no group differences in emotion regulation difficulties related to emotional clarity, ability to engage in goal-directed behavior when upset, and emotional non-acceptance. Conclusion: The current data suggest that dual users are an at-risk group in terms of emotional processes. Dual users would likely benefit from targeted intervention efforts focused on reducing anxiety sensitivity and improving emotion regulation in order to reduce nicotine consumption and/or promote cessation.

Do Pain-Related Anxiety and Difficulties With Emotion Regulation Impact Abstinence Expectancies or Motivation to Quit E-Cigarette Use?

OBJECTIVE: Pain-related anxiety is a psychologically based construct that is associated with tobacco dependence and may have important relevance to e-cigarette use. Difficulties with emotion regulation, a relevant construct in motives for cigarette smoking, may interact with pain-related anxiety to yield worsened clinical outcomes among e-cigarette users. We evaluated whether pain-related anxiety and difficulties with emotion regulation independently and in interaction predict e-cigarette users' expectancies surrounding abstinence and their motivation to stop using e-cigarettes. METHOD: Daily e-cigarette users (n = 290, mean age= 35.5, SD = 10.9, 56.6% male) completed an online survey about e-cigarette use. We conducted hierarchical multiple regression analyses to evaluate the main and interactive influence of pain-related anxiety and difficulties with emotion regulation on our outcomes. RESULTS: Increased pain-related anxiety independently predicted negative abstinence expectancies and increased motivation to quit e-cigarette use (ps < .001). Increased difficulties with emotion regulation predicted only negative abstinence expectancies (ps < .01) when pain-related anxiety was included in the model. The interaction between pain-related anxiety and difficulties with emotion regulation was not significant. CONCLUSIONS: As hypothesized, increased pain-related anxiety was associated with both negative expectancies of abstinence and increased motivation to quit e-cigarette use, but contrary to our hypothesis, difficulties with emotion regulation were not significantly associated with increased motivation to quit e-cigarette use when evaluated with pain-related anxiety in the model. These findings may elucidate processes influencing abstinence expectancies and motivation to quit in a sample of e-cigarette users, although replication in a larger, more diverse sample is warranted.

Evaluating the psychometric properties of the e-cigarette barriers to cessation scale.

Evidence suggests that electronic cigarette (e-cigarette) users have difficulty quitting e-cigarettes. The Electronic Cigarette Barriers to Cessation Scale (E-BCS) was developed to assess barriers to cessation among e-cigarette users. Yet, no work has evaluated the psychometric properties of the E-BCS. The current study utilized data from two independent samples of adult e-cigarette users to evaluate the psychometric properties and structure of the E-BCS. In Study 1, competing models of the E-BCS were evaluated, and initial construct validity and reliability were explored using data from 599 adult e-cigarettes users (52.3% female, Mage = 35.16 years, SD = 10.30). Results supported a unidimensional structure for the E-BCS comprised of 18 items. In Study 2, the unidimensional structure of the 18-item E-BCS and construct validity were evaluated among a sample of 516 current e-cigarette using adults (52.3% female; Mage = 34.74, SD = 11.37). Results confirmed the unidimensional structure, measurement invariance across sex, and construct validity across related e-cigarette behavior constructs and psychopathology for the E-BCS. These findings suggest that the E-BCS is a potentially useful clinical instrument for measuring barriers that may interfere with e-cigarette cessation.

Substance Use among Exclusive Electronic Cigarette Users and Dual Combustible Cigarette Users: Extending Work to Adult Users.

BACKGROUND: Electronic cigarettes (e-cigarettes) have become increasingly popular in recent years. Existing evidence indicates e-cigarettes used in isolation are less harmful than combustible cigarettes, yet emerging work has demonstrated that adults use e-cigarettes largely in combination with combustible cigarettes (i.e. dual use). Despite this data, little is understood about how exclusive and dual e-cigarette users may differ across behavioral outcomes, such as substance use dependence and behaviors among adults. OBJECTIVES: Thus, the current project examined differences in e-cigarette dependence, problematic alcohol use, cannabis use, and nonmedical prescription opioid use (e.g. methadone and oxycodone) across both exclusive and dual e-cigarette adult users. RESULTS: Participants included 531 (53.6% female; Mage = 35.29 years, SD = 10.44) adults with past-month e-cigarette use. Dual users reported greater e-cigarette dependence, alcohol use, current cannabis use, and endorsement of nonprescription opioid use. Conclusions/Importance: Importantly, this work suggests that adults who use both combustible and e-cigarettes may constitute a group more vulnerable to experiencing problematic substance use and more severe e-cigarette dependence than exclusive e-cigarette users.

Personalized Feedback for Smoking and Anxiety Sensitivity: A Randomized Controlled Trial.

BACKGROUND: Cigarette smoking is the leading preventable cause of death and disability globally. Most smokers want to quit, and most make a serious quit attempt each year. Nevertheless, more than 95% of cessation attempters relapse within six months. Thus, alternative interventions are needed to combat this major public health concern. Objective: The current study was conducted to develop and test a smoking treatment among 95 (63.2% male; Mage = 46.20 years, SD = 10.90) adult daily cigarette smokers that targets a known risk factor for smoking maintenance and relapse: anxiety sensitivity (AS). Methods: The current study employed a randomized controlled trial design to test an integrated, brief, computer-delivered smoking and AS intervention among current, daily smokers. Participants completed four appointments: (a) phone-screener; (b) baseline (pre-intervention assessment, intervention [personalized feedback intervention (PFI) versus smoking information control], and post-intervention assessment); (c) 2-week follow-up; and (d) 4-week follow-up. Results: Participants indicated highly positive evaluations of both the PFI and control intervention. Between the baseline and 2-week follow-up, 44.2% [PFI: 46.9% (n = 23); control: 41.3% (n = 19)] of participants reported a quit attempt. At the 4-week follow-up, 49.5% [PFI: 57.1% (n = 28); control: 41.3% (n = 19)] of participants reported a quit attempt since their previous laboratory session. Conclusion: Within the context of an intervention development approach, the present investigation provides descriptive data on the feasibility, acceptability, and initial efficacy of a single-session, computer-delivered, AS/smoking PFI.

Tobacco use severity in relation to opioid misuse and dependence among adult tobacco users with chronic pain: The moderating role of pain-related anxiety.

The opioid epidemic is a significant public health crisis that is often linked to chronic pain management. One ensuing consequence of long-term opioid use for chronic pain is a high potential for opioid misuse and dependence. Although tobacco is commonly used among individuals with chronic pain, it is associated with an increased risk for opioid-related problems. Given the deleterious outcomes of tobacco use in the context of chronic pain, identifying individual difference factors involved in tobacco-opioid relations is of public health importance. Pain-related anxiety, or a tendency to respond to pain sensations with anxiety and fear, maybe an especially important mechanistic factor associated with the relationship between tobacco use severity and opioid misuse. Therefore, the current study examined the moderating role of pain-related anxiety on the relationship between tobacco use severity and opioid misuse and dependence. Participants were 258 tobacco-using adults who endorsed moderate to severe chronic pain and current use of an opioid medication (72.1% female, Mage = 37.19 years, SD = 10.17). Two hierarchical linear regression analyses were conducted to test main and interactive effects of tobacco use severity and pain-related anxiety for current opioid misuse and severity of opioid dependence. Results indicated a significant moderation effect, such that the relationship between tobacco use severity and opioid misuse and dependence was stronger among individuals with higher (but not lower) pain-related anxiety. These findings build upon the extant literature by demonstrating an interactive effect of tobacco use severity and pain-related anxiety in terms of opioid-related outcomes and suggest that current tobacco users with elevated levels of pain-related anxiety may be at increased risk for opioid misuse and dependence.

Anticancer Potential of Sutherlandia frutescens and Xysmalobium undulatum in LS180 Colorectal Cancer Mini-Tumors.

Colorectal cancer remains to be one of the leading causes of death worldwide, with millions of patients diagnosed each year. Although chemotherapeutic drugs are routinely used to treat cancer, these treatments have severe side effects. As a result, the use of herbal medicines has gained increasing popularity as a treatment for cancer. In this study, two South African medicinal plants widely used to treat various diseases, Sutherlandia frutescens and Xysmalobium undulatum, were evaluated for potential activity against colorectal cancer. This potential activity for the treatment of colorectal cancer was assessed relative to the known chemotherapeutic drug, paclitaxel. The cytotoxic activity was considered in an advanced three-dimensional (3D) sodium alginate encapsulated LS180 colorectal cancer functional spheroid model, cultured in clinostat-based rotating bioreactors. The LS180 cell mini-tumors were treated for 96 h with two concentrations of each of the crude aqueous extracts or paclitaxel. S. frutescens extract markedly decreased the soluble protein content, while decreasing ATP and AK per protein content to below detectable limits after only 24 h exposure. X. undulatum extract also decreased the soluble protein content, cell viability, and glucose consumption. The results suggested that the two phytomedicines have potential to become a source of new treatments against colorectal cancer.

The moderating role of anxiety sensitivity in terms of fatigue severity and e-cigarette use expectancies.

Little is understood about individual difference factors related to e-cigarette expectancies about use. This study examined the interactive effects of fatigue severity and anxiety sensitivity in relation to e-cigarette expectancies among 525 e-cigarette users (51.0% female, Mage = 35.25 years, standard deviation = 10.10). Results indicated a significant interaction between fatigue severity and anxiety sensitivity in terms of positive expectancies (ß = 0.57, p < 0.001, 95% confidence interval = (0.002, 0.01)), but not for negative expectancies (ß = 0.25, p = 0.08, 95% confidence interval = (0, 0.005)) for e-cigarette use. These results support anxiety sensitivity as a moderator in the relation between fatigue severity and positive outcome expectancies for e-cigarette use.

Worry and e-cigarette cognition: The moderating role of sex.

As electronic cigarette (e-cigarette) use continues to rise, it is important to identify individual characteristics that may influence e-cigarette use behavior and potential group-level moderators of effects, such as sex. Initial evidence has suggested that worry, defined as excessive, unrealistic thoughts focused on the possibility of future negative events, may contribute to e-cigarette use behavior. Yet, how these established relations differ across groups, such as male and female e-cigarette users, has not been explored. The present study evaluated the effect of worry on perceived barriers for quitting e-cigarettes, perceptions of benefits for e-cigarette use, and perceived negative consequences of e-cigarette use across sex. The sample included 584 current e-cigarette users (52.2% female, Mage = 35.15 years, SD = 10.27). Analyses indicated a significant interaction between sex and worry on each criterion variable (perceived benefits: b = 0.02, SE = 0.01, t = -2.73, p = .01; perceived barriers for quitting e-cigarettes: b = -0.45, SE = 0.08, t = -5.70, p ≤ 0.001; negative consequences to use: b = -0.033, SE = 0.01, t = -4.50, p < .001), such that worry was more strongly related to each outcome among males than females. These findings suggest that sex plays a role in e-cigarette use behaviors and that males may constitute a group that is especially vulnerable to the effects of worry on both positive and negative e-cigarette use perceptions and perceived barriers for quitting e-cigarettes.