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Cited by 88Smoking Behavior and CessationPosttraumatic Stress Disorder ResearchSubstance Abuse Treatment and Outcomes

Posttraumatic stress disorder and cigarette smoking: A systematic review

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Kearns, Nathan T., Carl, Emily, Stein, Aliza T., Vujanovic, Anka A., Zvolensky, Michael J., Smits, Jasper A. J., Powers, Mark B.·2018·Depression and Anxiety
DOI 10.1002/da.22828
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Abstract

BACKGROUND: Previous reviews of the PTSD and cigarette smoking literature showed high PTSD-smoking comorbidity and problematic smoking outcomes (Feldner et al., 2007, Clinical Psychology Review, 27, 14-45; Fu et al., 2007, Nicotine & Tobacco Research, 9, 1071-1084). However, past reviews also noted several prominent gaps in the literature, including a lack of etiological work examining underlying mechanisms and research on specialized PTSD-smoking treatments. The present review summarizes an extensive body of research conducted since the previous reviews targeting these areas of need. METHODS: Literature searches identified 66 empirical studies specific to smoking and PTSD. RESULTS: Smokers were approximately twice more likely to have PTSD than nonsmokers in the general population, and individuals with PTSD were approximately twice as likely to be current smokers. Smokers with PTSD evidenced more negative affect, trauma history, and comorbid psychiatric history, as well as quit attempts and higher relapse rates. PTSD symptoms were associated with expectations that smoking would reduce negative affect, which, in turn, was associated with increased smoking rate and nicotine dependence. Male sex was associated with nicotine dependence and PTSD avoidance, while the relationship between PTSD and smoking relapse due to withdrawal was stronger in females. Specialized, integrated PTSD and smoking cessation treatments showed promise in increasing quit success relative to standard care in randomized trials. CONCLUSIONS: Rates of PTSD-smoking co-occurrence remain high. Notable gains have been made in relevant epidemiological and etiological research, although more work is needed in trauma-specific subpopulations. Several promising specialized treatments for comorbid smoking-PTSD have been developed and empirically tested but require replication.

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Cited by

Sorted by citations

Authors
Kearns, N. T., Carl, E., Stein, A. T., Vujanovic, A. A., Zvolensky, M. J., Smits, J. A. J., & Powers, M. B.
Affiliations
  • University of North Texas (US)
  • The University of Texas at Austin (US)
  • University of Houston (US)
  • Baylor University Medical Center (US)
Corresponding author
Powers, Mark B.
ORCID
Venue
Depression and Anxiety
Publisher
Wiley
Published
2018-09-07
Volume
35
Issue
11
Pages
1056-1072
ISSN
1091-4269 (ISSN-L)
DOI
10.1002/da.22828
OpenAlex
W2891131889
Cited by
88
References
13
Citations by year
2026: 12 · 2025: 10 · 2024: 12 · 2023: 5 · 2022: 11 · 2021: 16 · 2020: 16 · 2019: 6
FWCI
1.25
Type
journal article
Language
en
Open access
Licence
Locations
  • Depression and Anxiety (publishedVersion)
  • PubMed (publishedVersion)
Funders
National Institute on Drug Abuse (K01DA035930)
Topics
  • Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
  • Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
  • Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
Keywords
post-traumatic stress disorder, cigarette smoking, nicotine dependence, smoking cessation, smoking relapse, nicotine withdrawal, negative affect, sex differences, integrated treatment, trauma history
MeSH terms
Cigarette Smoking, Humans, Stress Disorders, Post-Traumatic, Tobacco Use Disorder, Comorbidity, Cognitive Behavioral Therapy

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