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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    • "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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