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The Relationship between PTSD and Smoking

Rates of and the Connection between PTSD and Smoking

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Updated January 12, 2011

PTSD and smoking commonly co-occur. This may not be surprising given that many people in the United States smoke in general. In fact, it has been estimated that approximately 21% of adults in the United States (about 45 million people) currently smoke. Cigarette smoking is the leading preventable cause of death and disability in the United States. Approximately a third of all deaths from cancer in the United States each year (about 160,390) are the direct result of tobacco use. Since 1986, more women are dying of lung cancer than breast cancer; currently, almost twice as many women die from lung cancer than breast cancer. These statistics show that, without a doubt, smoking is a major health problem.

People who have an anxiety disorder may be particularly likely to smoke. In fact, out of all anxiety disorders, individuals with panic disorder and PTSD show the highest rates of smoking.

Smoking Rates in PTSD

Studies have found that, on average, approximately 45% of individuals with a current diagnosis of PTSD currently smoke. The rates are even higher when you consider whether someone with PTSD has smoked at any point in his or her lifetime. One study found that 58% of individuals with a current diagnosis of PTSD reported smoking at some point.

Separate from PTSD, it has also been found that people who have experienced traumatic events are more likely to smoke than people who have not had traumatic experiences (rates among adults ranging from 32% to 58%). Elevated smoking rates have been found across different types of traumatic events; however, research suggests that traumatic events are more likely to be associated with the development of PTSD. For example, interpersonal violence, such as a sexual assault), tends to be connected with higher smoking rates.

How Are PTSD and Smoking Related?

This question is difficult to answer as researchers are only beginning to conduct studies that examine the relationship between smoking and PTSD. However, there is some evidence that individuals with PTSD may smoke in an attempt to manage negative feelings or their PTSD symptoms.

There is also some evidence that smoking may increase the risk for the development of certain anxiety disorders, including PTSD. One study found that people who were dependent on nicotine were twice as likely to develop PTSD following exposure to a traumatic event.

Treatments for PTSD and Smoking

Currently, there are no established, specialized treatments for smoking in PTSD, although some are in development. However, individuals with PTSD may still benefit from more standard methods of quitting smoking. PTSD has been found to interfere with quit attempts; therefore, it may be important for individuals with PTSD who are trying to quit smoking to seek additional treatment for their PTSD symptoms.

Sources:

American Cancer Society (2007). Cancer facts and figures – 2007: American Cancer Society.

Beckham, J.C., Feldman, M.E., Vrana, S.R., Mozley, S.L., Erkanli, A., Clancy, C.P., & Rose, J.E. (2005). Immediate antecedents of cigarette smoking in smokers with and without posttraumatic stress disorder: A preliminary study. Experimental and Clinical Psychopharmacology, 13, 219-228.

Calhoun, P.S., Dennis, M.F., & Beckham, J.C. (2007). Emotional reactivity to trauma stimuli and duration of past smoking cessation attempts in smokers with posttraumatic stress disorder. Experimental and Clinical Psychopharmacology, 15, 256-263.

Centers for Disease Control and Prevention (2006). Fact sheet: Adult cigarette smoking in the United States: Current estimates. U.S. Department of Health and Human Services.

Feldner, M.T., Babson, K.A., & Zvolensky, M.J. (2007). Smoking, traumatic event exposure, and post-traumatic stress: A critical review of the empirical literature. Clinical Psychology Review, 27, 14-45.

Koenen, K.C., Hitsman, B., Lyons, M.J., Niaura, R., McCaffery, J., Goldberg, J. et al. (2005). A twin registry study of the relationship between posttraumatic stress disorder and nicotine dependence in men. Archives of General Psychiatry, 62, 1258–1265.

Morissette, S.B., Tull, M.T., Gulliver, S.B., Kamholz, B.W., & Zimering, R.T. (2007). Anxiety, anxiety disorders, tobacco use, and nicotine: A critical review of interrelationships. Psychological Bulletin, 133, 245-272.

U.S. Department of Health and Human Services (2004). The health consequences of smoking: A report of the Surgeon General. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease and Prevention and Health Promotion, Office on Smoking and Health.

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