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Impact of Posttraumatic Stress Disorder on early smoking lapse and relapse during a self-guided quit attempt among community-recruited daily smokers
Abstract
The present investigation examined whether daily smokers with posttraumatic stress disorder (PTSD), as compared to daily smokers with either anxiety psychopathology or no current Axis I psychopathology, have decreased success in the early phases of a self-guided smoking quit attempt. Participants were 140 daily smokers (81 women; M (age) = 29.5; SD = 11.9; range = 18-65 years); approximately one-third of the sample met criteria for current PTSD (n = 47), one-third met criteria for other current anxiety disorders (without PTSD; n = 33), and one-third did not meet criteria for any current Axis I disorder (n = 60). Consistent with prediction, membership in the PTSD group, compared to membership in the other anxiety disorders group and the group with no current Axis I psychopathology, was associated with increased risk of lapse during the first week following quit day. Additionally, daily smokers with PTSD and other anxiety disorders were at significantly increased risk of relapse during the first week post-cessation compared to persons without Axis I psychopathology. However, the PTSD group and the other anxiety disorders group did not differ from one another in terms of relapse. Results suggest that PTSD is associated with increased risk of smoking lapse and relapse compared to smokers with no current Axis I psychiatric problems, and increased risk of early smoking lapse but not relapse, as compared to those with other anxiety disorders. Findings provide novel evidence that PTSD, and perhaps anxiety disorders more generally, may be important factors in reducing the odds of successful unaided quit attempts in the early phases of cessation.
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“Considerable research has assessed the impact of depression and anxiety on cessation outcomes, with a number of studies reporting that depression and anxiety place smokers at increased risk for cessation failure [9-14], with other studies suggesting that the evidence is inconclusive [6,15-18].”
From Acceptance and Commitment Therapy Wellness Program for Latine Adults Who Smoke and Have Psychological Distress: Protocol for a Feasibility Study (2023) · cites this paper as [14]
In the citing paper
“anxiety and depressive pathology significantly impair cessation success (Piper et al., 2010; Zvolensky et al., 2008; Leventhal & Zvolensky, 2015; Piper et al., 2011).”
From A qualitative study of the feasibility and acceptability of a smoking cessation program for people living with HIV and emotional dysregulation. (2019) · cites this paper as Zvolensky et al., 2008
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Leventhal, A. M., & Zvolensky, M. J. (2015) · Psychological Bulletin · doi:10.1037/bul0000003 · Cited by 524
Self-citationPiper, M. E., Cook, J. W., Schlam, T. R., Jorenby, D. E., & Baker, T. B. (2011) · Addiction · doi:10.1111/j.1360-0443.2010.03173.x · Cited by 189
“Finally, some research suggests that anxiety disorders may reduce quitting success [2,13], although the evidence is mixed on this point [9,12].”
BackgroundTobacco addiction and the dysregulation of brain stress systems
Bruijnzeel, A. W. (2012) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2012.02.015 · Cited by 181
“However, both the PTSD patients and the patients with other anxiety disorders were more likely to relapse than the control subjects and there was no difference in relapse rates between the PTSD patients and the patients with other anxiety disorders (Zvolensky et al., 2008).”
BackgroundZvolensky, M. J., Stewart, S. H., Vujanovic, A. A., Gavric, D., & Steeves, D. (2009) · Nicotine & Tobacco Research · doi:10.1093/ntr/ntn037 · Cited by 158
“Although effort has been made to address anxiety sensitivity ( Zvolensky, Lejuez, Kahler, & Brown, 2003 ; Zvolensky et al., 2008 ) and depressive problems ( Muñoz, Marín, Posner, & Pérez-Stable, 1997 ; Thorsteinsson et al., 2001 ) in smoking cessation treatments, integrated, multirisk factor…”
BackgroundSelf-citationAnhedonia, depressed mood, and smoking cessation outcome.
Leventhal, A. M., Piper, M. E., Japuntich, S. J., Baker, T. B., & Cook, J. W. (2013) · Journal of Consulting and Clinical Psychology · doi:10.1037/a0035046 · Cited by 125
“This is notable, given prior evidence implicating some anxiety and substance use disorders as risk factors for smoking relapse (Breslau, Peterson, Schultz, Andreski, & Chilcoat, 1996; Piper, Cook, Schlam, Jorenby, & Baker, 2011; Zvolensky et al., 2008).”
Metadata
- Authors
- Zvolensky, M., Gibson, L., Vujanovic, A., Gregor, K., Bernstein, A., Kahler, C., Legues, C. W., Brown, R., & Feldner, M.
- Affiliations
- University of Vermont (US)
- VA Palo Alto Health Care System (US)
- Brown University (US)
- University of Maryland, College Park (US)
- Butler Hospital (US)
- University of Arkansas at Fayetteville (US)
- Corresponding author
- Zvolensky, Michael
- ORCID
- Venue
- Nicotine & Tobacco Research
- Publisher
- Oxford University Press (OUP)
- Published
- 2008-08
- Volume
- 10
- Issue
- 8
- Pages
- 1415-1427
- ISSN
- 1462-2203 (ISSN-L)
- OpenAlex
- W2049931274
- Cited by
- 104
- References
- 0
- Citations by year
- 2025: 2 · 2024: 4 · 2023: 2 · 2021: 6 · 2020: 4 · 2019: 3 · 2018: 6 · 2017: 3 · 2016: 14 · 2015: 12 · 2014: 11 · 2013: 5 · 2012: 7
- FWCI
- 5.42
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Nicotine & Tobacco Research (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (5r01da018734-03)
- National Institute of Mental Health (MH 076629-01, R01MH076629)
- National Institute on Drug Abuse (DA 00101-01, R03DA016307, DA 16307-01, DA018734--01A1)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › 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, smoking cessation, smoking relapse, smoking lapse, anxiety disorders, daily smokers, psychiatric comorbidity, nicotine dependence
- MeSH terms
- Smoking Prevention, Adult, Aged, Anxiety, Female, Humans, Male, Middle Aged, Motivation, Risk Factors, Self Care, Severity of Illness Index, Smoking, Stress Disorders, Post-Traumatic, Stress, Psychological, Comorbidity, Smoking Cessation, Secondary Prevention
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