Associations between posttraumatic stress disorder symptom clusters and cigarette smoking
Open accessAbstract
Understanding the relationship between Posttraumatic stress disorder (PTSD) and cigarette smoking has been difficult because of PTSD's symptomatic heterogeneity. This study examined common and unique lifetime cross-sectional relationships between PTSD symptom clusters [Re-experiencing (intrusive thoughts and nightmares about the trauma), Avoidance (avoidance of trauma-associated memories or stimuli), Emotional Numbing (loss of interest, interpersonal detachment, restricted positive affect), and Hyperarousal (irritability, difficulty concentrating, hypervigilance, insomnia)] and three indicators of smoking behavior: (1) smoking status; (2) cigarettes per day; and (3) nicotine dependence. Participants were adult respondents in the National Epidemiologic Survey of Alcohol and Related Conditions with a trauma history (n = 23,635). All four symptom clusters associated with each smoking outcome in single-predictor models (ps <. 0001). In multivariate models including all of the symptom clusters as simultaneous predictors, Emotional Numbing was the only cluster to retain a significant association with lifetime smoking over and above the other clusters, demographics, and Axis-I comorbidity (OR = 1.30, p < .01). While Avoidance uniquely associated with smoking status and nicotine dependence in multivariate models, these relations fell below significance after adjusting for demographics and comorbidity. No clusters uniquely associated with cigarettes per day. Hyperarousal uniquely related with nicotine dependence over and above the other clusters, demographics, and Axis-I comorbidity (OR = 1.51, p < .001). These results suggest the following: (a) common variance across PTSD symptom clusters contribute to PTSD's linkage with smoking in the American population; and (b) certain PTSD symptom clusters may uniquely associate with particular indicators of smoking behavior. These findings may clarify the underpinnings of PTSD-smoking comorbidity and inform smoking interventions for trauma-exposed individuals.
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The presence of PTSD symptoms such as hyperarousal and emotional numbing is a predictor for nicotine dependence, and these symptoms are reduced by nicotine intake.
“Furthermore, several studies have shown that the presence of PTSD symptoms, such as hyperarousal and emotional numbing, is a predictor for nicotine dependence and these symptoms are reduced by nicotine intake (Beckham et al., 2005; Feldner et al., 2007; Greenberg et al., 2012; Thorndike, Wernicke, Pearlman, & Haaga, 2006).”
From Nicotine addiction and psychiatric disorders (2015) · cites this paper as Greenberg et al., 2012
PTSD symptoms are reduced during nicotine intake.
“while PTSD symptoms are reduced during nicotine intake (Beckham et al., 2005; Feldner et al., 2007; Greenberg et al., 2012; Thorndike et al., 2006)”
From Nicotine addiction and psychiatric disorders (2015) · cites this paper as Greenberg et al., 2012
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- Authors
- Greenberg, J. B., Ameringer, K. J., Trujillo, M. A., Sun, P., Sussman, S., Brightman, M., Pitts, S. R., & Leventhal, A. M.
- Affiliations
- University of Southern California (US)
- Venue
- Psychology of Addictive Behaviors
- Published
- 2012
- Volume
- 26
- Issue
- 1
- Pages
- 89-98
- ISSN
- 0893-164X (ISSN-L)
- 1939-1501
- PMC
- PMC3307596
- OpenAlex
- W2018168033
- Cited by
- 41
- References
- 47
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 3 · 2021: 2 · 2020: 3 · 2019: 2 · 2018: 4 · 2017: 1 · 2016: 2 · 2015: 6 · 2014: 10 · 2013: 2 · 2012: 2
- FWCI
- 4.83
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- Psychology of Addictive Behaviors (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (DA026831; DA025041)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Keywords
- post-traumatic stress disorder, cigarette smoking, nicotine dependence, PTSD symptom clusters, re-experiencing, avoidance, emotional numbing, hyperarousal, trauma exposure, smoking cessation interventions, comorbidities
- MeSH terms
- Adolescent, Adult, Cross-Sectional Studies, Emotions, Female, Health Surveys, Humans, Male, Middle Aged, Smoking, Stress Disorders, Post-Traumatic, Veterans, Comorbidity
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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