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ANXIETY, STRESS, AND SMOKING 1 The Relationships among Anxiety, Stress, and Smoking Status by XXXXXXXXXXXXXXX Research Proposal Submitted in Partial Fulfillment of the Requirement for PSYC 3304 and 3104 at The University of Texas Permian Basin June 22, 2021 ANXIETY, STRESS, AND SMOKING 2 Abstract Stress and anxiety are both conditions experienced by many human beings. Depending on the degree to which these variables are prevalent, each, either separately or together, has the potential to greatly hinder an individual and limit the ability to function efficiently. Therefore, it is important for health research to determine potential causes or exacerbating variables that may contribute to an individual’s health. S moking status, for example, is a variable that has been shown to be related to both stress and anxiety . The purpose of the present study is to analyze the relationship between smoking status, anxiety , and stress. Data will be collected via online questionnaires through Qualt rics. The Depression Anxiety Stress Scale -2 (DASS -21) will be used to measure participants stress and anxiety. Smoking status and demographic information will be gathered using the demographic questionnaire . Keywords: health, stress, anx iety, smoking status , correlation ANXIETY, STRESS, AND SMOKING 3 The Relationship s among Anxiety, Stress, and Smoking Status Anxiety and stre ss are both hindering phenomena that occur frequently for many people in their day to day lives. Both anxiety and stress have been known to be associated w ith various ailments as well as general ability to function successfully . In order to fully understand the effects of stress and anx iety on performance and health, it is important to be aware of the factors that contribute to their occurrence. The present study aims to analyze the factor, smoking status, as it is related to both anxiety and stress in order to det ermine if any correlati ons exist among the three factors. Research has shown that smoking s tatus may be an indicator of stress levels . In a study con ducted by Cao et al. (2012), researchers analyzed the smoking status and perceived stress levels of a group of migrant workers in rural China. Their results concluded that the manifestation of perceived stress among the workers exhibited an excess likelihood to be smokers , relative to low stress counterparts . Additionally, p ast studies have also indicated that stress can occur in th e absence or reduction of smoking, if already a smoker . In a study conducted by Azagba and Sharaf (2012), findings concluded in their study on perceived stress associated with smoking bans at work that although the bans may not be the main determinant of perceived stress in the work environment, there is a positive correlation. Additionally , a study from Allen et al. (2015) analyzed the effects of nicotine withdrawal on stress; a strong positive correlation was observed. Previous research has indicated that anxiety is also significantly associated with smoki ng. In a study conducted by Farris et al. (2014) , the researchers concluded that anxiety sensitivity correlated positively with nicotine dependence as well as other health hindering factors such as alcohol use, perceived barriers to smoking cessation, and severity of problems faced while attempting to stop. Although there is an underlying directionality problem ANXIETY, STRESS, AND SMOKING 4 in many of these findings, a study by Asbridge et al. (2013) pro vides some insight for the current rationale regarding smoking status as it relates to the variables . This study focused on non - smokers and the effects of second hand smoke. Analyses revealed that smoke exposure to non - smokers was associated with increased anxiety disorders as well as poor mental health and high stress. Therefore, although stress and anxiety hav e been shown to exist with the reduction of smoking, or in the absence of it, there is also indication of a causal nature in smoking as it is related to stress and anxiety, w hich is important for health research. Furthermore, i n the previously mentioned study con ducted by Cao et al. (2012) regarding stress and smoking, it should be noted that the researchers used two model s; life stress and work stress. Interestingly, finding s displayed that the likelihood of smoking was more significant with the life stress model as opposed to the wo rk stress model. A different study conducted by Carpenter et al. (2011 ) examined this phenomenon of life stress as it relates to anxiety. The res earch focused on gene environment interaction s which contributed to stress which , in turn, is correlated with anxiety outcomes, further evidence of the ongoing relationship among the three factors. The present study aims to examine the correlation between anxiety and stress as well as a correlation among smoking status and each of these factors. Utilizing an online questionnaire, the researcher relied on self -reported measures . The researcher hypothesizes that smokers are more likely to report being stress ed compared to nonsmokers. The researcher also hypothesizes that smokers are more likely to report having anxiety compared to non -smokers. Additionally, it is hypothesized that stress and anxiety correlate positively; as stress increases, anxiety tends to increase, as well. Method ANXIETY, STRESS, AND SMOKING 5 Participants The researcher will recruit prospective participants online and send them an anonymous survey link. Data will be collected through Qualtrics. Measures Depression A nxiety Stress Scale. Anxiety and stress will be assessed using the Depression Anxiety Stress Scale (DASS -21; Lovibond & Lovibond, 1995; Appendix A). The questionnaire consist s of 21 items that included factors related to stress and anxiety such as overreaction and nervousness (e.g.; “ I found it difficu lt to relax). Each item will be rated on a 0 - 3-point Likert -type scale that ranged from “did not apply” to “apply very much”. Cronbach’s alpha coefficient reported that DASS -21 used for this study has high reliability and validity: .81 for anxiety and .89 for stress (Lovibond & Lovibond, 1995). Demographic questionnaire. For each participant, a demographic questionnaire (Appendix B) will be administered in order to collect basic demographic information such as smoking status, age, student status and year, gender, and ethnicity. Procedure The questionnaire utilized for this study was the DASS -21, one of the five online questionnaires in a la rger research study. The researcher will collect the data via Q ualtrics. Participants will take on average 10 to 15 min to complete the surveys. Data Analysis Pearson correlation will be conducted to examine the relationships between anxiety and stress. To examine the differences between smokers and non -smokers in their stress and anxiety levels, a one -way analysis of variance ( ANOVA ) will be conducted. ANXIETY, STRESS, AND SMOKING 6 Referen ces Allen, S. S, Eberly, L. E., Grandits, G. A., Harrison, K., & Lawless, M. H. (2015). Perceived stress and smoking -related behaviors and symptomatology in male and female smokers . Addictive Behaviors , 51 , 80 -83. https://doi.org/ 10.1016/j.addbeh.2015.07.011 Asbridge, M., Ralph, K.., & Stewart, S. (2013). Private space second -hand smoke exposure and the mental health of non -smokers: a cross -sectional analysis of Canadian adults. Addictive Behaviors , 38 (3), 1679 -1686. https://doi.o rg/ 10.1016/j.addbeh.2012.10.008 Azagba, S. , & Sharaf, M. (2012). The association between workplace smoking bans and self - perceived, work -related stress among smoking workers. BMC Public Health , 12 , 123. https://doi.org/ 10.1186/1471 -2458 -12 -123 Cao, R., Cui, X., Rockett, I., & Yang, T. (2012). Work stress, life stress, and smoking among rural -urban migrant workers in China . BMC public health , 12 , 979. https://doi.org/ 10.1186/1471 - 2458 -12 -979 Carpenter, L. L., Nugent, N. R., Price, L., & Tyrka , A.R. (2011). Gene -environment interactions: early life stress and risk for depressive and anxiety disorders . Psychopharmacology , 214 , 175. https://doi.org/ 10.1007/s00213 -010 -2151 -x Farris, S., Leventhal, A., Schmidt, N., & Zvolensky, M. (2014). Anxiety sensitivity mediates relations between emotional disorders and smoking. Psychology of addicted behaviors , 28 (3), 912 -920. https://doi.org/ 10.1037/a0037450 Lovibond, P. F., & Lovibond, S. H. (1995). The structure of negative emotional states: compariso n of the depression anxiety stress scales (DAS -21) with the Beck Depression and Anxiety Inventories. Behavior Research and Therapy, 33 (3), 335 -343. https://doi.org/ 10.1016/0005 -7967(94)00075 -U ANXIETY, STRESS, AND SMOKING 7 Appendix A Depression Anxiety Stress Scale -21 (DASS -21) Please read each statement and circle a number 0, 1, 2 or 3 that indicates how much the statement apply to you in general. There are no right or wrong answers. Do not spend too much time on any statement. The rating scale is as follows: 0 Did not apply to me at all 1 Applied to me to some degree, or some of the time 2 Applied to me to a considerable degree, or a good part of time 3 Applied to me very much, or most of the time 1. I found it hard to wind down 0 1 2 3 2. I was aware of dryness of my mouth 0 1 2 3 3. I couldn't seem to experience any positive feeling at all 0 1 2 3 4. I experienced breathing difficulty (e.g., excessively rapid breathing, breathlessness in the absence of physical exertion) 0 1 2 3 5. I found it difficult to work up the initiative to do things 0 1 2 3 6. I tended to over -react to situations 0 1 2 3 7. I experienced trembling (e.g., in the hands) 0 1 2 3 8. I felt that I was using a lot of nervous energy 0 1 2 3 9. I was worried about situations in which I might panic and make a fool of myself 0 1 2 3 10 . I felt that I had nothing to look forward to 0 1 2 3 ANXIETY, STRESS, AND SMOKING 8 11 . I found myself getting agitated 0 1 2 3 12 . I found it difficult to relax 0 1 2 3 13 . I felt down -hearted and blue 0 1 2 3 14 . I was intolerant of anything that kept me from getting on with what I was doing 0 1 2 3 15 . I felt I was close to panic 0 1 2 3 16 . I was unable to become enthusiastic about anything 0 1 2 3 17 . I felt I wasn't worth much as a person 0 1 2 3 18 . I felt that I was rather touc hy 0 1 2 3 19 . I was aware of the action of my heart in the absence of physical exertion (e.g., sense of heart rate increase, heart missing a beat) 0 1 2 3 20 . I felt scared without any good reason 0 1 2 3 21 . I felt that life was meaningless 0 1 2 3 Source: Lovibond & Lovibond (1995) ANXIETY, STRESS, AND SMOKING 9 Appendix B Demographic Questionnaire Below are a series of demographic questions. Please answer them as accurately as you can. Be assured that information provided is confidential. 1. Do you smoke? (If you smoke, please indicate how many cigarettes you smoke per day ) □Yes: _____________ □No 2. What is your age (years old)? __________ 3. Gender (please select one): □ Male □ Female □ Other: __________ 4. Are you currently a student? □ Yes □ No 5. Year in college (please select one): □ Freshman □ Sophomore □ Junior □ Senior □ Graduate Student □ Other: __________ □ Not Applicable 6. What is your ethnicity? □ White/Caucasian (non -Hispanic) □ Black/African American □Hispanic/Latino(a) □ Asian/Pacific Islanders □ Native American □ Biracial/Multiracial: ____________________________ □ Other: ____________________________