Biological mechanisms underlying the relationship between stress and smoking: State of the science and directions for future work
Open accessAbstract
Theories of addiction implicate stress as a crucial mechanism underlying initiation, maintenance, and relapse to cigarette smoking. Examinations of the biological stress systems, including functioning of the hypothalamic-pituitary-adrenal (HPA) axis and the autonomic nervous system (ANS), have provided additional insights into the relationship between stress and smoking. To date, convergent data suggests that chronic cigarette smoking is associated with alterations in HPA and ANS functioning; however, less is known about the role of HPA and ANS functioning in smoking initiation and relapse following cessation. In order to organize existing findings and stimulate future research, the current paper summarizes the available literature on the roles of HPA axis and ANS functioning in the relationship between stress and cigarette smoking, highlights limitations within the existing literature, and suggests directions for future research to address unanswered questions in the extant literature on the biological mechanisms underlying the relationship between stress and smoking.
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Nicotine affects dopamine release, providing temporary pleasure and reinforcing the perception that smoking alleviates mental health symptoms, despite actually worsening these symptoms in the long-term.
“Nicotine affects dopamine release, providing temporary pleasure and reinforcing the perception that smoking alleviates mental health symptoms, despite actually worsening these symptoms in the long-term [12, 13, 14, 15].”
From Can an Acceptance and Commitment Therapy-Based Smartphone App Help Individuals with Mental Health Disorders Quit Smoking? (2024) · cites this paper as [14]
Section 2.1 (page unavailable) reports that nicotine increases dopamine release in reward circuits, and section 2.2 reports short-lived positive subjective effects of cigarettes. Section 4.5 describes smoking as a possible way of coping with stress, but does not establish that dopamine-driven pleasure creates a perception of relief from mental health symptoms. The paper also does not establish that smoking worsens those symptoms in the long term. (LLM, conf=0.86)
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“…studies have suggested that some forms of psychopathology, including depression in particular, are associated with an increased risk of relapse among smokers (Glassman et al., 1993; Glassman et al., 1988); however, little research has examined the role of HPA axis functioning in this relationship.”
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- Authors
- Richards, J. M., Stipelman, B. A., Bornovalova, M. A., Daughters, S. B., Sinha, R., & Lejuez, C. W.
- Affiliations
- University of Maryland, College Park (US)
- National Cancer Institute (US)
- University of South Florida (US)
- Yale University (US)
- Corresponding author
- Richards, Jessica M.
- Venue
- Biological Psychology
- Publisher
- Elsevier BV
- Published
- 2011-09
- Volume
- 88
- Issue
- 1
- Pages
- 1-12
- ISSN
- 0301-0511 (ISSN-L)
- PMC
- PMC3171592
- OpenAlex
- W1965829047
- Cited by
- 132
- References
- 179
- Citations by year
- 2026: 10 · 2025: 11 · 2024: 11 · 2023: 7 · 2022: 12 · 2021: 15 · 2020: 9 · 2019: 12 · 2018: 3 · 2017: 6 · 2016: 12 · 2015: 8 · 2014: 5 · 2013: 10 · 2012: 1
- FWCI
- 0.55
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Biological Psychology (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Digital Commons - University of South Florida (University of South Florida) (submittedVersion)
- Funders
- National Institute on Drug Abuse (R01DA015375, R01DA026424, F31DA027242)
- Topics
- Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Keywords
- stress, cigarette smoking, hypothalamic-pituitary-adrenal axis, autonomic nervous system, smoking initiation, smoking cessation, relapse, addiction, biological mechanisms
- MeSH terms
- Autonomic Nervous System, Humans, Hypothalamo-Hypophyseal System, Nicotine, Pituitary-Adrenal System, Smoking, Stress, Psychological
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