PROJECT SUMMARY Cigarette smoking among adults with emotional distress (i.e. anxiety, depression) is a recognized health disparity. Individuals who smoke cigarettes and experience co-occurring emotional distress (compared to those who do not) are more dependent on cigarettes, experience more withdrawal symptoms during quit attempts, and have greater difficulty achieving abstinence. Distress intolerance (DI), or one’s inability to withstand aversive states, is a cognitive-emotional vulnerability implicated in the emotion-smoking comorbidity. Decades of empirical inquiry have focused on translating DI to a smoking cessation treatment target. However, these efforts have been met with relatively little success, which appear to reflect weaknesses in the literature’s conceptualization and assessment of DI. To address these limitations, we propose a fresh perspective on this research topic, by reconceptualizing DI as a dynamic intraindividual process that can be activated by various types of distress (e.g., physical distress like pain or fatigue), and influenced by various contextual (situational) factors. This K23 proposal outlines a well-integrated research and training plan for mentored, patient-oriented career development. The proposed research involves a multi-method approach, to understanding how DI varies on a moment-to-moment basis and the factors that influence it among people who smoke. Phase I of the project will involve a qualitative investigation. Phase II will involve quantitative examination of naturalistic momentary data via ecological momentary assessment (EMA) over a 28-day period. EMA will include randomly sampled and self-initiated reports of DI, distress and situational context during smoking. Hypotheses of momentary within-person internal and situational factors that influence momentary DI during smoking will be evaluated primarily with longitudinal modeling methods. This research plan provides the necessary landscape for experiential learning and mentored training in applying an innovative momentary model of DI, studied through a multi-methodological approach. An impressive mentorship team with complementary expertise in emotion and addiction, EMA and qualitative methods, social-ecological theory and intensive longitudinal modeling, will guide training in these areas. The proposed 5-year career development period will facilitate a successful transition to independence and aid in securing future research funding to develop and/or refine idiographic, momentary interventions to bolster smoking cessation.

PROJECT NARRATIVE Distress intolerance (DI), or one’s inability to withstand difficult experiences, physically and emotionally, is a risk factor believed to underlie the co-occurrence of cigarette smoking and emotional distress/disorders. In this mentored research development application, we explore DI as a dynamic variable that can change moment-to- moment as the result of various internal and external factors. Through the proposed multi-method study, our goal is to understand these factors that influence DI and subsequent smoking in daily life in order to inform future interventions that can help people reduce DI in the moments when they are most likely to smoke.