Association Between Cigarette Smoking and Anxiety Disorders During Adolescence and Early Adulthood.

Box 60, New York State Psychiatric Institute, 1051 Riverside Dr, New York, NY 10032, USA.
JAMA The Journal of the American Medical Association (Impact Factor: 35.29). 11/2000; 284(18):2348-51.
Source: PubMed


Cigarette smoking is associated with some anxiety disorders, but the direction of the association between smoking and specific anxiety disorders has not been determined.
To investigate the longitudinal association between cigarette smoking and anxiety disorders among adolescents and young adults.
The Children in the Community Study, a prospective longitudinal investigation.
Community-based sample of 688 youths (51% female) from upstate New York interviewed in the years 1985-1986, at a mean age of 16 years, and in the years 1991-1993, at a mean age of 22 years.
Participant cigarette smoking and psychiatric disorders in adolescence and early adulthood, measured by age-appropriate versions of the Diagnostic Interview Schedule for Children.
Heavy cigarette smoking (>/=20 cigarettes/d) during adolescence was associated with higher risk of agoraphobia (10.3% vs 1.8%; odds ratio [OR], 6.79; 95% confidence interval [CI], 1.53-30.17), generalized anxiety disorder (20.5% vs 3.71%; OR, 5.53; 95% CI, 1.84-16.66), and panic disorder (7.7% vs 0.6%; OR, 15.58; 95% CI, 2.31-105.14) during early adulthood after controlling for age, sex, difficult childhood temperament; alcohol and drug use, anxiety, and depressive disorders during adolescence; and parental smoking, educational level, and psychopathology. Anxiety disorders during adolescence were not significantly associated with chronic cigarette smoking during early adulthood. Fourteen percent and 15% of participants with and without anxiety during adolescence, respectively, smoked at least 20 cigarettes per day during early adulthood (OR, 0.88; 95% CI, 0.36-2.14).
Our results suggest that cigarette smoking may increase risk of certain anxiety disorders during late adolescence and early adulthood. JAMA. 2000;284:2348-2351.

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    • "Nevertheless, the extent of nicotine's effects on anxiety disorder symptoms varies between specific anxiety disorder subtypes. For example, while panic disorder has the highest prevalence of smoking among anxiety disorders and smoking is shown to increase the risk of initiation and maintenance of panic attacks [49] [79], OCD patients show the lowest rates of smoking and prospective studies could not find any predictive power of smoking on the development of OCD (e.g., [80]). Thus, different neural pathways may be involved in the different subtypes of anxiety disorders and nicotine's effect on these pathways may vary. "
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    ABSTRACT: Anxiety disorders are a group of crippling mental diseases affecting millions of Americans with a 30% lifetime prevalence and costs associated with healthcare of $42.3 billion. While anxiety disorders show high levels of co-morbidity with smoking (45.3% vs. 22.5% in healthy individuals), anxiety disorders are also more common among the smoking population (22% vs. 11.1% in the non-smoking population). Moreover, there is clear evidence that smoking modulates symptom severity in patients with anxiety disorders. In order to better understand this relationship, several animal paradigms are used to model several key symptoms of anxiety disorders; these include fear conditioning and measures of anxiety. Studies clearly demonstrate that nicotine mediates acquisition and extinction of fear as well as anxiety through the modulation of specific subtypes of nicotinic acetylcholine receptors (nAChRs) in brain regions involved in emotion processing such as the hippocampus. However, the direction of nicotine's effects on these behaviors is determined by several factors that include the length of administration, hippocampus-dependency of the fear learning task, and source of anxiety (novelty-driven vs. social anxiety). Overall, the studies reviewed here suggest that nicotine alters behaviors related to fear and anxiety and that nicotine contributes to the development, maintenance, and reoccurrence of anxiety disorders. Copyright © 2015. Published by Elsevier Inc.
    Biochemical pharmacology 07/2015; 97(4). DOI:10.1016/j.bcp.2015.07.029 · 5.01 Impact Factor
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    • "Psychological comorbidities for which cigarette smoking may be used to cope with or manage psychological symptoms may be the most problematic for smoking outcomes (Gehricke et al., 2007). A growing body of research suggests that Social Phobia (SP), a highly prevalent disorder for which 12.1% of the population meets diagnostic criteria (Ruscio et al., 2008), exhibits this relationship with tobacco use such that SP symptoms predict the initiation of cigarette smoking (Johnson et al., 2000), nicotine dependence (Sonntag, Wittchen, Höfler, Kessler, & Stein, 2000), and poor cessation outcomes (Lasser et al., 2000; Ruscio et al., 2008). Moreover, there are significantly greater rates of smoking among individuals with SP than among individuals without psychological comorbidities; specifically, 54.0% of individuals with SP are lifetime smokers and 35.9% of individuals with SP are current smokers (Lasser et al., 2000; Ruscio et al., 2008). "
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    ABSTRACT: Individuals with social phobia (SP) represent a large group with elevated rates of cigarette smoking and cessation rates lower than that of individuals without psychopathology. For individuals with SP, cigarette smoking may be used to reduce social anxiety in anticipation of and during social situations. However, no study to date has experimentally examined this association. The aim of the current study was to experimentally examine the relationship between cigarette smoking and SP as a function of induced social stress. We recruited daily smokers ages 18-21 who scored in either a clinical or normative range on the Social Interaction Anxiety Scale (SIAS). Participants included 54 smokers (42.6% female, 77.8% White, age M(SD)=19.65(1.18), CPSD M(SD)=7.67(4.36), 46.30% high SP) who attended two sessions: one social stress session and one neutral session. Results indicated that high SP smokers experienced significant decreases in negative affect (NA) following smoking a cigarette when experiencing social stress. This effect was specific to high SP smokers under social stress and was not observed among individuals' average in SP or when examining changes in positive affect. For individuals with SP, cigarette smoking may be maintained due to changes in NA associated with smoking specifically in the context of social stress. These results speak to the importance of targeted cessation interventions that address the nature of smoking for individuals with SP. Copyright © 2014 Elsevier Ltd. All rights reserved.
    Addictive Behaviors 04/2015; 43:66-71. DOI:10.1016/j.addbeh.2014.12.012 · 2.76 Impact Factor
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    • "The same occurs with anxiety disorders. For example, Johnson et al. (2000) "
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    ABSTRACT: Smoking is the leading cause of morbidity and mortality in developed countries. More than 58,000 people die prematurely in Spain due to tobacco use. Psychology offers effective psychological treatments for tobacco dependence, but these treatments are not always used and they are not widely known about. In this article, the effectiveness of psychological treatment is analysed together with various barriers that impede its greater use, especially due to the competition with pharmaceutical products and the undervaluation of the psychological treatment by different sectors, in the same way that happens with other disorders (e.g., depression). We propose a number of strategies to improve the impact of our treatments and to make them more visible, because psychological treatment is a first line treatment for smokers. Key words: Tobacco, Smoking, Psychological treatment, Efficacy.
    Papeles del Psicologo 03/2015; 35(3):161-168.
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