AUTHOR=Zamboni Lorenzo , Locatelli Francesca , Vesentini Roberta , Casari Rebecca , Congiu Alessio , Guerra Anna , Bettoni Daniela , Carli Silvia , Cappelletti Sara , Melchiori Silvia , Campagnari Simone , Verlato Giuseppe , Infante Maurizio Valentino , Lugoboni Fabio 

TITLE=Smoking-related gestures and anxiety: a preliminary study in treatment-seeking smokers

JOURNAL=Frontiers in Public Health

VOLUME=Volume 13 - 2025

YEAR=2025

URL=https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2025.1665612

DOI=10.3389/fpubh.2025.1665612

ISSN=2296-2565

ABSTRACT=BackgroundThe 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.MethodsA total of 81 treatment-seeking smokers were recruited from an Addiction Medicine Unit. Nicotine dependence was assessed using the Fagerström 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’s rho, Kruskal–Wallis, Fisher’s exact test) were used to analyze associations among the variables.ResultsA significant positive correlation was found between anxiety levels and the perceived importance of smoking gestures (ρ = 0.254, p = 0.0224). No significant association emerged between BAI categorical levels and FTND categories (p = 0.346). A trend toward significance was observed between anxiety severity and FTND levels [χ2(4) = 8.521, p = 0.0742], but no significant correlation was detected between gesturality and FTND measures.ConclusionThese 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.