{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T10:15:43Z","timestamp":1785147343429,"version":"3.55.0"},"reference-count":27,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T00:00:00Z","timestamp":1759881600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>The act of smoking is not solely driven by nicotine dependence, but also involves behavioral and sensorimotor components that may independently contribute to addiction maintenance. Among these, gestural rituals such as holding and bringing the cigarette to the mouth may play a role in emotional regulation and self-soothing, particularly in individuals with anxiety. This study aimed to explore the relationship between smoking-related gestures, nicotine dependence, and anxiety symptoms in a sample of smokers seeking addiction treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 81 treatment-seeking smokers were recruited from an Addiction Medicine Unit. Nicotine dependence was assessed using the Fagerstr\u00f6m Test for Nicotine Dependence (FTND), anxiety symptoms were measured with the Beck Anxiety Inventory (BAI), and the importance of smoking-related gestures was rated on a 7-point Likert scale via a single-item question. Correlational and non-parametric tests (Spearman\u2019s rho, Kruskal\u2013Wallis, Fisher\u2019s exact test) were used to analyze associations among the variables.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A significant positive correlation was found between anxiety levels and the perceived importance of smoking gestures (<jats:italic>\u03c1<\/jats:italic>\u202f=\u202f0.254, <jats:italic>p<\/jats:italic>\u202f=\u202f0.0224). No significant association emerged between BAI categorical levels and FTND categories (<jats:italic>p<\/jats:italic>\u202f=\u202f0.346). A trend toward significance was observed between anxiety severity and FTND levels [\u03c7<jats:sup>2<\/jats:sup>(4)\u202f=\u202f8.521, <jats:italic>p<\/jats:italic>\u202f=\u202f0.0742], but no significant correlation was detected between gesturality and FTND measures.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>These preliminary findings suggest that smoking-related gestures may be particularly salient for individuals with elevated anxiety, potentially functioning as ritualized coping behaviors independent of nicotine intake. This dimension may help explain why some smokers struggle to quit despite low biochemical dependence. Future studies should develop validated instruments to assess smoking-related motor patterns and explore tailored interventions targeting the behavioral components of tobacco use.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpubh.2025.1665612","type":"journal-article","created":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T05:42:32Z","timestamp":1759902152000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Smoking-related gestures and anxiety: a preliminary study in treatment-seeking smokers"],"prefix":"10.3389","volume":"13","author":[{"given":"Lorenzo","family":"Zamboni","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Locatelli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberta","family":"Vesentini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"Casari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessio","family":"Congiu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Guerra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela","family":"Bettoni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia","family":"Carli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Cappelletti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia","family":"Melchiori","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simone","family":"Campagnari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Verlato","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maurizio Valentino","family":"Infante","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabio","family":"Lugoboni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,10,8]]},"reference":[{"key":"ref1","volume-title":"WHO global report on mortality attributable to tobacco","year":"2012"},{"key":"ref2","volume-title":"WHO report on the global tobacco epidemic, 2017: Monitoring tobacco use and prevention policies","year":"2017"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1136\/tobaccocontrol-2016-053305","article-title":"Global economic cost of smoking-attributable diseases","volume":"27","author":"Goodchild","year":"2018","journal-title":"Tob Control"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"412","DOI":"10.3390\/jpm4030412","article-title":"Mhealth for smoking cessation programs: a systematic review","volume":"4","author":"Ghorai","year":"2014","journal-title":"J Pers Med"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"e111","DOI":"10.2196\/jmir.3091","article-title":"Usage and effectiveness of a fully automated, open-access, Spanish web-based smoking cessation program: randomized controlled trial","volume":"16","author":"Ma\u00f1anes","year":"2014","journal-title":"J Med Internet Res"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"g1151","DOI":"10.1136\/bmj.g1151","article-title":"Change in mental health after smoking cessation: systematic review and meta-analysis","volume":"348","author":"Taylor","year":"2014","journal-title":"BMJ"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"454","DOI":"10.1007\/s12160-016-9869-6","article-title":"Depression and smoking cessation: evidence from a smoking cessation clinic with 1-year follow-up","volume":"51","author":"Stepankova","year":"2017","journal-title":"Ann Behav Med"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"13807","DOI":"10.1038\/s41598-020-70458-4","article-title":"Associations of cigarette smoking with psychiatric disorders: evidence from a two-sample Mendelian randomization study","volume":"10","author":"Yuan","year":"2020","journal-title":"Sci Rep"},{"key":"ref9","year":"2013"},{"key":"ref10","volume-title":"Non-smokable electronic spray cigarette. 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