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.

Download full-text


Available from: Daniel S Pine, Sep 30, 2015
139 Reads
  • Source
    • "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). "
    [Show abstract] [Hide abstract]
    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
  • Source
    • "The same occurs with anxiety disorders. For example, Johnson et al. (2000) "
    [Show abstract] [Hide abstract]
    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.
  • Source
    • "Interestingly, social anxiety symptoms predicted increases in craving during nicotine deprivation, but not during nicotine satiation (via cigarettes), suggesting that social anxiety might not only contribute to maintenance of smoking behaviors but also have differential effects depending on smoking status/nicotine state. With respect to SAD, smoking, and their temporal relationship, Johnson et al. (2000) found that tobacco use did not prospectively confer increased risk for the development of SAD. However, reciprocal relationships between social anxiety and risk for nicotine dependence have been reported (e.g., Dierker et al., 2001; Sonntag et al., 2000). "
    [Show abstract] [Hide abstract]
    ABSTRACT: Despite the often social nature of smoking, relatively little research has been conducted on the relationship between smoking and social anxiety disorder (SAD). Participants (N=99) included 34 smokers without current mental health disorders, 37 smokers with SAD, and 28 smokers who met criteria for other anxiety disorder diagnoses (e.g., panic disorder or generalized anxiety disorder, but not SAD). Nicotine and placebo patches were administered to participants in a counterbalanced manner across two assessment days. Urge and craving were assessed before and after a 5-h nicotine absorption/deprivation period. Compared to smokers without current mental health disorders, smokers with SAD did not report greater nicotine dependence, but did endorse greater motivation to use nicotine to avoid negative outcomes. In addition, after controlling for demographic variables, smoking characteristics, pre-deprivation urge and craving, and other anxiety/depression symptoms, social anxiety symptoms uniquely predicted urge and craving in the placebo patch condition; however, social anxiety had no influence on urge and craving in the nicotine patch condition. These findings suggest that one potential reason that smokers with SAD may have worse cessation outcomes is that they may experience higher levels of craving and urge to smoke during quit attempts. Thus, during a quit attempt, particularly in the absence of nicotine replacement therapy, smokers with SAD are likely to benefit from additional treatment aimed at managing or reducing their social anxiety symptoms.
    Drug and alcohol dependence 02/2014; 135:59-64. DOI:10.1016/j.drugalcdep.2013.11.002 · 3.42 Impact Factor
Show more