Smoking behaviors across anxiety disorders

doi:10.1016/j.janxdis.2003.07.003

Journal of Anxiety Disorders

Volume 18, Issue 1, 2004, Pages 7-18

https://doi.org/10.1016/j.janxdis.2003.07.003 Get rights and content

Abstract

The purpose of this study was to test the theory put forth by Zvolensky et al. [Clin. Psychol. Sci. Pract. 10 (2003) 29] that smoking is specifically associated with panic disorder (PD) and not more generally associated with other anxiety disorders. Smoking behaviors were examined across three anxiety disorders: panic disorder with or without agoraphobia, social phobia (SP), and obsessive–compulsive disorder (OCD). A greater proportion of the PD group (40.4%) reported smoking compared to the SP (20%) and OCD (22.4%) groups. Those in the PD group were also more likely than those in the other groups to report being a heavy smoker (greater than 10 cigarettes daily). No significant interaction between diagnosis and smoking status was found for any of the symptom measures. However, participants who smoked had significantly higher scores than nonsmokers on a number of scales, including measures of depression, general anxiety, and distress. Differences in anxiety sensitivity between smokers and nonsmokers approached significance. These findings provide support for Zvolensky et al.’s [Clin. Psychol. Sci. Pract. 10 (2003) 29] theoretical conceptualization and suggest a specific link between smoking and panic disorder. Further investigation is warranted to determine the causal direction of this association.

Section snippets

Smoking behaviors across anxiety disorders

Cigarette smoking is a pertinent issue to the field of mental health as it has been well established that smoking is more common among psychiatric patients, including individuals with mood and anxiety disorders, than among the general public (e.g., Amering et al., 1999; Breslau, Kilbey, & Andreski, 1991; Breslau, Peterson, Schultz, Chilcoat, & Andreski, 1998; Glassman, 1993; Hughes, Hatsukami, Mitchell, & Dahlgren, 1986).

Studies have found a link between an elevated prevalence of smoking and

Participants

A total of 155 participants were included in the study. To enter the study, participants had to have a primary diagnosis of PD, SP, or OCD, as determined by the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID; First, Spitzer, Gibbon, & Williams, 1996). In addition, participants were excluded if criteria were met for one of the other two disorders (e.g., those in the PD group did not have SP or OCD). The PD group consisted of 52 participants (57.7% female); the SP group consisted

Participant characteristics

One way analysis of variance (ANOVA) indicated no significant difference between the three groups with respect to age, F(2,149)=2.70, ns, with mean ages for each group as follows: PD (M=38.62, S.D.=9.19), SP (M=34.14, S.D.=10.39), OCD (M=35.59, S.D.=10.37). Chi-square analyses indicated that the three groups differed significantly with respect to sex, χ² (2,N=155)=6.49, P<.05. The OCD group had a significantly higher proportion of females than did the SP group, and the PD group did not differ

Discussion

The first aim of this study was to test the theory put forth by Zvolensky et al. (2003) that smoking is specifically associated with panic disorder, and not more generally associated with other anxiety disorders such as social phobia. The second aim of this study was to examine the relationship of smoking and measures of psychological symptoms and impairment, more broadly. Overall, the results showed two main findings. First, a greater proportion of individuals with a diagnosis of panic

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Smoking behaviors across anxiety disorders

Abstract

Section snippets

Smoking behaviors across anxiety disorders

Participants

Participant characteristics

Discussion

Comprehensive Psychiatry

Behavior Therapy

Comprehensive Psychiatry

European Psychiatry

Advances in Renal Replacement Therapy

Journal of Anxiety Disorders

Psychiatry Research

Behaviour Research and Therapy

European Psychiatry

Psychometric properties of the 42-item and 21-item versions of the Depression Anxiety Stress Scales (DASS) in clinical groups and community sample

Psychological Assessment

Illness intrusiveness in individuals with panic disorder, obsessive–compulsive disorder, or social phobia

Journal of Nervous and Mental Disease

Structure of Illness Intrusiveness Rating Scale in Anxiety Disorders

Journal of Psychopathology and Behavioral Assessment

Nicotine dependence, major depression, and anxiety in young adults

Archives of General Psychiatry

Smoking and panic attacks: an epidemiologic investigation

Archives of General Psychiatry

Major depression and stages of smoking: a longitudinal investigation

Archives of General Psychiatry

Psychometric Properties of the Depression Anxiety Stress Scales (DASS) in clinical samples

Behaviour Research and Therapy

Norepinephrine and epinephrine release and adrenergic mediation of smoking-associated hemodynamic and metabolic events

New England Journal of Medicine

Nicotine and panic attacks

American Journal of Psychiatry