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26-01-2012 | Psychology | Article

Current smoking dependence associated with anxiety/mood disorders


Free abstract

MedWire News: Current nicotine addicts, but not former nondependent smokers, are at increased risk for anxiety and/or mood disorders, shows research.

Kristin Grover (University of Vermont, Burlington, USA) and colleagues investigated the relationships between anxiety and mood disorders and, first, nicotine dependence, and second, current versus former smoking. They aimed to "fill the gaps" in the literature on this subject.

"Exploring these knowledge gaps is important for understanding the relations between smoking and anxiety/mood disorders and for understanding why it is more difficult for people with these disorders to quit smoking than people without psychopathology," write the researchers in Addictive Behaviors.

They studied a cross-sectional sample of 43,093 participants in a US nationally representative survey. The respondents were considered to have used cigarettes if they had smoked 100 cigarettes or more in their lifetime, and dependence was assessed using the Alcohol Use Disorder and Associated Disabilities Interview Schedule-IV (AUDADIS-IV), which includes an extensive list of over 40 questions to judge nicotine dependence.

To be classed as dependent, the participants had to fulfill three of seven criteria, including: the need for more nicotine to achieve a desired effect; experiencing nicotine withdrawal symptoms; using more tobacco than the individual intended; unsuccessful attempts to cut down or feeling the need to cut down; long periods of time spent smoking; forced to give up other activities in favor of smoking; and continued use despite physical or psychiatric problems that may have been caused by nicotine.

Diagnoses were made according to the Diagnostic and Statistical Manual of Mental Disorders-IV. Anxiety and mood disorders assessed by AUDADIS-IV included primary major depression, mania, generalized anxiety disorder, and panic disorder with or without agoraphobia. The researchers did not include substance-induced disorders or those due to bereavement.

Analyzing these data, Grover and team found that current dependent smoking was associated with a significantly increased likelihood of the above-mentioned disorders, at odds ratios of 3.05 for depression, 3.88 for mania, 4.96 for panic disorder, and 3.34 for generalized anxiety disorder. There was no association between current nondependent smoking and these anxiety and mood disorders.

Former nondependent smoking, however, was associated with a significantly decreased likelihood of anxiety or mood disorders, but there was no association in terms of former dependent smoking.

This study was unable to identify the processes underlying these associations. Therefore, the researchers suggest future research should "focus on explanatory processes that govern mood regulation (eg, negative reinforcement, smoking motives, expectancies) and cognitive styles (eg, perceptions of quitting), as well as biologic variables that may underlie the co-occurrence of both nicotine dependence and anxiety/mood disorders."

By Chloe McIvor

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