Results and Discussion Sections You have worked hard on this research project, and you are over halfway done! In the last project assignment, based on the data collected from your participants, you co

ANXIETY, STRESS, AND SMOKING 1 The Relationships among Anxiety, Stress, and Smoking Status by XXXXXXXXXXXXXXX Research Paper Submitted in Partial Fulfillment of the Requirement for PSYC 3304 and 3104 at The University of Texas Permian Basin August 5, 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, i s a variable that has been shown to be related to both stress and anxiety . The purpose of the present study was to analyze the relationship between smoking status, anxiety , and stress. Data was collect ed from 492 participants via online questionnaire s avai lable through Qualtrics. The Depression Anxiety Stress Scale -2 (DASS -21) was used to measure participants stress and anxiety , and demographic information was gathered using the demographic questionnaire . Results displayed that smokers scored significantly higher on the anxiety scale than non -smokers. Smokers also scored significantly higher on the anxiety scale than non -smokers. Additionally, there was a positive correlation identified between anxiety score and stress score. These findings may be relevant t o and provide insight for medical as well as mental health professionals. Keywords: health, stress, anxiety, smoking status , correlation ANXIETY, STRESS, AND SMOKING 3 The Relationship among Anxiety, Stress, and Smoking Status Anxiety and stre ss are both h indering 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 anxiety on performance and health, it is important to be aware of the factors that contribute to their occurrence. The present study attempted to analyze the factor, smoking status, as it is related to both anxiety and stress in order to det ermine if any correlations 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 grou p 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 the 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 th e 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 obs erved. 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 o ther 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 wi th 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, which 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, findings 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 st ress 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 at tempted to demonstrate a 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 hypothesized that smokers are more likely to report being stressed compared to nonsmokers. The researcher also hypothesized that smokers are more likely to report having anxiety compared to non -smokers. Additionally, it was hypothesized that stress and anxiety correlate positively; as stress increases, anxiety tends to increase, as well. Method ANXIETY, STRESS, AND SMOKING 5 Participants The survey was conducted through Qualtrics. There were 492 participants total in this study. The age mean of these participants (except the 16 participants who did not report their age) was 31.27 with a standard deviation of 11.94. Of the 492 participants 168 (34.2%) were male whereas 320 (65.0%) were female and 4 (0.8%) reported other. Of all participants, 358 (72.8%) were non -Hispanic W hite/Caucasians, 38 (7.7%) were Black/African American, 28 (5.7%) were Hispanic/Latino(a), 24 (4.9%) were Asians/ Pacific Islanders, 14 (2.8%) were Native American, 21 (4.3%) were biracial/multiracial, and 9 (1.8%) reported other. In regards to smoking sta tus, 78 (15.9%) were smokers whereas 414 (84.1%) were non -smokers. Table 1 displays the demographic information of the participants. Measures Depression A nxiety Stress Scale. Anxiety and stress were assessed using the Depression Anxiety Stress Scale (DAS S-21; Lovibond & Lovibond, 1995; Appendix A). The questionnaire consisted of 21 items that included factors related to stress and anxiety such as overreaction and nervousness (e.g.; “I found it difficult to relax). Each item was 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) was administered in order to collect basic demographic information such as smoking status, age, student status and year, gender, and ethnicity. Procedure ANXIETY, STRESS, AND SMOKING 6 The questio nnaire utilized for this study was the DASS -21, one of the five online questionnaires in a larger research study. The researcher collected the data via Qualtrics. Participants completed the survey in about 10 and 15 min, on average. Results The researcher hypothesized that smokers are more likely to report being stressed compared to nonsmokers. A one -way analysis of variance ( ANOVA ) was conducted in order to observe potential correlations between smokers and non -smokers. This hypothesis is supported as the results displayed a significant difference between stress scores in smokers ( M = 16.05, SD = 9.7 0), and non -smokers ( M = 12.45, SD = 8.26), F(1, 490) =11.77 , p = .001. Smokers scored signi ficantly higher on th e stress scale than non -smokers. The researcher also hypothesized that smokers are more likely to report having anxiety compared to non -smokers . A one -way ANOVA was conducted for this hypothesis, as well. The results supported the hypothesis as the results displayed a significant difference b etween anxiety scores for smokers ( M = 12.85, SD = 10.45) and anxiety scores for non -smokers ( M = 8.04, SD = 7.79), F(1, 490) = 22.16, p < .001. In other words, smokers scored significantly higher on the anxiety scale than non -smokers. Additionally, it was hypothesized that stress and anxiety correlate positively; as stress increases, anxiety tends to increase, as well. To test this hypothesis, a Pearson correlation was conducted. Results show there was a significant correlation between anxiety ( M = 8.80, SD = 8.44) and stress ( M = 13.02, SD = 8.60), r(490) = .78 , p < .001. In other words, there was a positive correlation identified between anxiety score and stress score. Discussion ANXIETY, STRESS, AND SMOKING 7 The present study attempted to analyze whether the factor, smoking status, is related to both anxiety and stress. The researcher hypothesized that smokers are more likely to report being stressed compared to nonsmokers. The results supported this hypothesis; smokers scored significantly higher on the stres s scale than non -smokers. The researcher also hypothesized that smokers are more likely to report having anxiety compared to non -smokers. Results supported this hypothesis, as well, as smokers scored significantly higher on the anxiety scale than non - smoke rs. Finally, it was hypothesized that stress and anxiety correlate positively; as stress increases, anxiety tends to increase, as well. Once again, results supported this hypothesis as there was a significant and positive correlation between anxiety and st ress. In most studies, including the study conducted by Cao, Cui, Rockett, and Yang (2012), results demonstrated a positive correlation among stress and anxiety. The results of the present study are consistent with thi s knowledge structure. This study is a lso consistent with the present hypothesis, regarding smoking and stress, as results concluded that the perception of stress more likely manifested in smokers compared to lower stress counterparts. However, there is also an inconsistency due to additional factors assessed in other studies but not examined in the present study such as entire smoke history and level of nicotine dependency. For example, the study conducted by Az agba and Sharaf (2012), studied a positive correlation between stress and workplace smoking bans. Additionally, a study from Allen et al. (2015) analyzed the effects of nicotine withdrawal on stress and a strong positive correlation was observed. These results are the opposite of the present study in terms of correlation. As for anxiety and smoking, the present study is consistent with the current structure of knowledge in that the variable does correlate positively with smoking. This is the result s of most other studies analyzing these variables, such ANXIETY, STRESS, AND SMOKING 8 as the study conducted by Farris et al. (2014) , concluding that there is , indeed , a positive correlation The researcher observed limitations to this study. Although the researcher did observe a statistical significance among the variable s, the participants were random and not controlled, it is difficult to determine whether individual differences contributed to the results of this study, s uch as gender or age; there could be an additional, confounding variable, damaging the internal validity of this study. Anoth er limitation could be the tru thfulness of the participants. It is possible that participants gave untrue answers in an attempt to manipulate results. The most important limitation would be the directionality problem. Although the variables correlate, this study does not determine the cause of these correlations. There is still further research needed in order to determine the directionality of these correlations. For example, these results display a correlation but it is unclear if stress causes smoking or sm oking causes stress . The re searcher recommends utilizing an experimental design in order to control confounding variables and improve internal validity. Utilizing twins, for example, would be a sufficient method of minimizing individual differences that result from factors such as g ender, personality, and age. Using another method, such as within -subjects designs, can also serve to minimize individual differences. Temporal factors should be considered, as well, for future studies, especially clinical observations, as temporal factors relate to level of dependency for smokers, which could directly affect the variables. In certain cases, that is, for heavy smokers, not smoking when having previously been a smoker could, could potentially lead to an increase in anxiety and stress, creati ng a negative correlation ANXIETY, STRESS, AND SMOKING 9 References 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. http://dx.doi.org/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: comparison of the depression a nxiety 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 10 Table 1 Participant Demographic Information Variable Age M = 31.27 SD = 11.94 Gender Female n = 320 65.0% Male n = 168 34.2% Other n =4 0.8% Ethnicity White/Caucasian (Non -Hispanic) n = 358 72.8% Black/ African American n = 38 7.7% Hispanic/Latino n = 28 5.7% Asian/Pacific Islander n = 24 4.9% Biracial/Multiracial n = 21 4.3% Native American n = 14 2.8% Other n = 9 1.8% Smoking Non -smokers n =414 84.1% Smokers n = 78 15.9% Note . N = 492. Sixteen participants did not report their age. ANXIETY, STRESS, AND SMOKING 11 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, breath lessness 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 12 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 touchy 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 13 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 □ J unior □ 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: ____________________________