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Cited by 197Posttraumatic Stress Disorder ResearchSmoking Behavior and CessationMigration, Health and Trauma

A twin registry study of the relationship between posttraumatic stress disorder and nicotine dependence in men

Koenen, Karestan C., Hitsman, Brian, Lyons, Michael J., Niaura, Raymond, McCaffery, Jeanne, Goldberg, Jack, Eisen, Seth A., True, William +1 more·2005·Archives of General Psychiatry
DOI 10.1001/archpsyc.62.11.1258
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Abstract

CONTEXT: Recent studies indicate a strong association between posttraumatic stress disorder (PTSD) and nicotine dependence (ND). However, the explanation for the association remains unclear. OBJECTIVE: To test competing explanations for the association between PTSD and ND. DESIGN, SETTING, AND PARTICIPANTS: Analysis of data on 6744 members of the Vietnam Era Twin Registry, a national registry of all male-male twin pairs who served in the military during the Vietnam era interviewed in 1991-1992. MAIN OUTCOME MEASURES: Risk of PTSD and ND using the Diagnostic Interview Schedule for the DSM-III-R. RESULTS: The prevalence of ND was elevated among trauma-exposed individuals (52.0%) and those with PTSD (71.7%) compared with unexposed individuals (40.5%). This association was significant for ND and for trauma without PTSD (odds ratio, 1.31; 95% confidence interval [CI], 1.18-1.45) and for PTSD (odds ratio, 2.34; 95% CI, 1.92-2.84) and was not entirely explained by shared risk factors. Shared genetic effects explained 63% of the PTSD-ND association; the remaining covariance was explained by individual-specific environmental effects. Using survival analysis with time-dependent covariates, ND was associated with a substantially increased risk of PTSD among trauma-exposed men (hazard ratio, 1.98; 95% CI, 1.61-2.42). Trauma (hazard ratio, 1.49; 95% CI, 1.35-1.64) and PTSD (hazard ratio, 1.36; 95% CI, 1.14-1.61) were less strongly but significantly associated with increased risk of ND onset after controlling for shared risk factors. CONCLUSIONS: Most of the PTSD-ND association is explained by shared genetic effects. However, there is a substantial, robust PTSD-ND association not explained by shared risk factors. Multiple explanations for the association were supported; however, the strongest association was consistent with preexisting ND increasing the risk of PTSD onset. These data suggest that male veterans with a history of ND may be at increased risk for PTSD. Further research on the biological mechanisms underlying PTSD-ND comorbidity is needed.

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  • Prior smoking is associated with increased susceptibility to develop PTSD in the event of a trauma and with increased risk of panic attacks and development of panic disorders.

    “Consistent with the high rates of nicotine dependence in patients with anxiety disorders, prior smoking has been found to be associated with increased susceptibility to develop PTSD in the event of a trauma (Koenen et al., 2005), an increased risk of panic attacks and development of panic disorders (Goodwin, Lewinsohn, & Seeley, 2005).”

    From Nicotine addiction and psychiatric disorders (2015) · cites this paper as Koenen et al., 2005

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Authors
Koenen, K. C., Hitsman, B., Lyons, M. J., Niaura, R., McCaffery, J., Goldberg, J., Eisen, S. A., True, W., & Tsuang, M.
Affiliations
Harvard University (US)
ORCID
Venue
Archives of General Psychiatry
Publisher
American Medical Association (AMA)
Published
2005-11-01
Volume
62
Issue
11
Pages
1258
ISSN
0003-990X (ISSN-L)
DOI
10.1001/archpsyc.62.11.1258
OpenAlex
W2168392948
Cited by
197
References
49
Citations by year
2026: 1 · 2025: 3 · 2024: 2 · 2023: 4 · 2022: 2 · 2021: 7 · 2020: 25 · 2019: 4 · 2018: 9 · 2017: 11 · 2016: 15 · 2015: 15 · 2014: 20 · 2013: 6 · 2012: 7
FWCI
12.34
Type
journal article
Language
en
Open access
closed
Locations
  • Archives of General Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • National Institute of Mental Health (F31MH011954, K08MH070627)
  • National Institute on Drug Abuse (K08DA017145)
  • National Cancer Institute (P50 CA84719, P50CA084719)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
  • Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
  • Social Sciences › Psychology › Clinical Psychology › Migration, Health and Trauma
Keywords
post-traumatic stress disorder, nicotine dependence, comorbidities, Vietnam Era Twin Registry, twin pairs, shared genetic effects, trauma exposure, male veterans, smoking
MeSH terms
Adult, Combat Disorders, Diseases in Twins, Humans, Life Change Events, Male, Middle Aged, Military Personnel, Psychiatric Status Rating Scales, Registries, Sex Factors, Stress Disorders, Post-Traumatic, Tobacco Use Disorder, United States, Veterans, Prevalence, Survival Analysis, Diagnostic and Statistical Manual of Mental Disorders, Vietnam Conflict

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