Cited by 41Posttraumatic Stress Disorder ResearchSmoking Behavior and CessationSleep and related disorders

Associations between posttraumatic stress disorder symptom clusters and cigarette smoking

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Greenberg, Jodie B., Ameringer, Katherine J., Trujillo, Michael A., Sun, Ping, Sussman, Steve, Brightman, Molly, Pitts, Stephanie R., Leventhal, Adam M.·2012·Psychology of Addictive Behaviors

Abstract

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
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
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

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