Differences between smokers and nonsmokers with anxiety disorders

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Abstract

Epidemiological data suggest that early smoking increases the risk for emergence of certain anxiety disorders (e.g., panic disorder, generalized anxiety disorder (GAD)), and that presence of certain anxiety disorders (e.g., social anxiety) increases the risk for later development of nicotine dependence. Although some studies report a high prevalence of smoking among anxiety disorders, the extent to which smokers with anxiety disorders differ from their nonsmoking counterparts remains uncertain. Differences between smokers and nonsmokers with anxiety disorders (N = 527) were examined with respect to multiple measures of theoretical and clinical interest. Compared to nonsmokers, smokers with anxiety disorders reported greater anxiety sensitivity, anxiety symptoms, agoraphobic avoidance, depressed mood, negative affect, stress and life interference; however, these differences were largely accounted for by panic disorder. No differences were found between smokers and nonsmokers regarding social anxiety, worry, obsessive–compulsive symptoms or positive affect. Differential patterns were observed when evaluating constructs within anxiety disorder diagnoses.

Section snippets

Participants and procedures

The initial sample included 598 patients with anxiety disorders seeking treatment at an urban outpatient anxiety clinic (i.e., the Center for Anxiety and Related Disorders; CARD) between September 1996 and October 1998, as previously reported by Baker-Morissette et al. (2004). Prior to being evaluated at CARD, participants completed a telephone screen to exclude current alcohol or substance abuse or dependence (ASAD), active psychosis and current suicidality. As part of their participation in a

Participants

T-tests were used to evaluate potential demographic differences between smokers and nonsmokers with anxiety disorders. As is commonly found in the broader literature, smokers were significantly younger than nonsmokers [30.9 vs. 33.8 years, respectively; t(525) = 2.2, P < .05] and were significantly less educated [14.6 years education (S.D. = 2.7) and 15.8 (2.4) years education, respectively; t(351) = 3.3, P < .01]. Smokers and nonsmokers were similar across other demographic characteristics. Across all

Discussion

Findings summarized here are consistent with epidemiological and clinical data suggesting that smokers and nonsmokers with anxiety disorders may differ in important ways. When collapsing across anxiety disorders, compared to nonsmokers with anxiety disorders, smokers with anxiety disorders were characterized by greater current symptoms including sensitivity to physical sensations of anxiety, anxiety symptoms, depressed mood/negative affect, stress, agoraphobic avoidance and life interference.

Acknowledgements

This research was supported by a NIDA grant awarded to Sandra B. Morissette (K23-DA-16376) and an NIMH grant awarded to Timothy A. Brown (R01-MH-39096). We would like to thank Markus Wiegel for his assistance with conducting the retrospective chart reviews of smoking status.

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