Anxious? Quit Smoking Now

Tobacco consumption may induce anxiety disorders

/ Author:  / Reviewed by: Chris Galloway, M.D.

(RxWiki News) Which came first: smoking or the anxiety disorder? Does smoking aggravate an existing anxiety disorder? Or is an existing anxiety disorder a risk factor for smoking?

A recent study reviewed 47 studies having to do with smoking and anxiety disorders.

This study's findings suggest that smoking may contribute to developing one of several anxiety disorders. And may lead to an unhealthy life.

"Talk to a therapist about quitting smoking."

Steven Moylan, PhD, clinical lecturer at the School of Medicine at Deakin University in Australia, led the investigation.

For this review, studies involving smoking rates, nicotine dependence and anxiety disorders were included for analysis.

Anxiety disorders included in the study were:

The studies were separated into three groups:

  • 14 studies focused on anxiety disorders playing a role in nicotine dependence or smoking
  • 7 studies focused on the role of smoking or nicotine dependence on anxiety disorders
  • 31 studies focused on on the relationships between smoking, nicotine dependence and anxiety disorders

One of the studies included showed increased rates of GAD were 4 percent for smokers vs. 2 percent for non-smokers. And rates of PD were 1.5 percent for smokers vs. 0.5 percent for non-smokers.

Another study included showed daily smokers were 1.42 times more likely to have PD than non-smokers and 1.23 times more likely to have GAD, respectively. 

These studies were large and general, therefore, there were limitations to the analysis. Limitations of these studies included:

  • Not taking substance use disorders into account with smoking behavior
  • Not taking other mental health disorders into account
  • Consistent definition of "smoking" (did one cigarette contribute to an anxiety disorder or 10?)
  • Age of onset of smoking, nicotine dependence and anxiety disorders were not clear across all studies

Authors said, “The most consistent evidence supports smoking and nicotine dependence as increasing the risk of panic disorder and generalized anxiety disorder.”

This study was published in October in BioMed Central.

Each contributing author has received funding from governmental, private foundations, pharmaceutical companies and universities. See the study link for a full list of declarations.

No conflicts of interest were reported.

Reviewed by: 
Review Date: 
October 29, 2012
Last Updated:
November 2, 2012