Anxious Smokers Have a Tougher Time Quitting

People with anxiety disorders are not only more likely to smoke, but they also find it more difficult to quit, Time reported Oct. 26.

A research team led by Megan Piper, PhD, assistant professor of psychology at the University of Wisconsin's Center for Tobacco Research and Policy, conducted baseline diagnostic interviews among 1,500 smokers enrolled in the center's smoking-cessation program. They found nearly one-third of enrollees met criteria for a past or current anxiety disorder — almost double the incidence in the general population. The most frequent diagnoses were panic disorder, social anxiety disorder, and generalized anxiety disorder.

The researchers also tracked the smokers' progress following enrollment. Treatment included six brief counseling sessions and pharmacotherapy with either placebo, bupropion, nicotine patch or lozenge, or a combination thereof.

Participants with anxiety disorders reported higher levels of nicotine dependence and were more likely to experience withdrawal symptoms — even before their quit-days. They were also less likely to be abstinent at six months regardless of the drug therapy they received.

According to Piper and colleagues, these results point to a stronger emotional versus physical component to smoking for people with anxiety; that is, they are more prone to use cigarettes to relieve discomfort or stress than just to address their nicotine addiction.

“The present research provides strong evidence that all three anxiety disorders tested have significant relationships with smoking outcomes,” the authors concluded. “Clinicians and researchers should assess anxiety disorder status if they wish to predict patients' withdrawal and likelihood of achieving abstinence.”

The article was published online Oct. 25 in the journal Addiction.