Smoking Behavior and Alcohol Consumption in Individuals With Panic Attacks

Abstract

Individuals with anxiety often report greater smoking and drinking behaviors relative to those without a history of anxiety. In particular, smoking and alcohol use have been directly implicated among individuals experiencing panic attacks, diagnosed with panic disorder, or high on panic-relevant risk factors such as anxiety sensitivity. Less is known, however, about specific features of panic that may differentiate among those who do or do not use cigarettes or alcohol. The purpose of the current study was to replicate previous research findings of an association between panic symptomatology, cigarette smoking, and alcohol consumption, as well as extend findings by examining whether specific symptoms of panic attacks differentiated among those who do or do not use cigarettes or alcohol. Participants (n = 489) completed the Panic Attack Questionnaire-IV, a highly detailed assessment of panic attacks and symptoms, as well as self-report measures of smoking history and alcohol use. Consistent with previous research, participants who reported a history of panic attacks (n = 107) were significantly more likely to report current daily or lifetime daily cigarette smoking, and significantly greater hazardous or harmful alcohol use than participants with no panic history (n = 382). Although smoking and hazardous alcohol use were highly associated regardless of panic status, participants with panic attacks showed elevated hazardous alcohol use after controlling for daily or lifetime smoking. Surprisingly, although participants who reported having had at least one panic attack were more likely to smoke, panic attack symptoms, intensity, or frequency did not differentiate panickers who did or did not smoke. Furthermore, panic-related variables were not shown to differentially relate to problematic drinking among panickers. Implications for understanding the complex relationship between panic attacks and smoking and drinking behaviors are discussed.

Negative affect and smoking motives sequentially mediate the effect of panic attacks on tobacco-relevant processes

“…In addition to panic attacks being a relatively common phenomenon (3), empirical evidence suggests that panic attacks co-occur with smoking at rates that exceed those found in the general non-psychiatric population (7-9). In the National Comorbidity Survey, current smoking rates among adults with a history of panic attacks were significantly greater than those reported among respondents with no mental illness and quit rates were significantly lower (10).…”

“…In line with theoretical models of anxiety and smoking comorbidity (17), it was hypothesized that a history of panic attacks may impact smoking by first increased negative affect followed by increased negative reinforcement-based smoking motivation; that is, the indirect effects of the proposed mechanisms (negative affect and smoking motives) are theorized to sequential impact smoking processes. These effects were expected to be evident above and beyond the variance accounted for by gender, age, marital status, alcohol and cannabis use, depressive symptomology and tobaccorelated medical problems; factors often related to both smoking and panic attacks (9,17,26). …”

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“…Pētījumi par panikas simptomu saistību ar alkohola un citu atkarību izraisošo vielu lietošanu nav snieguši vienprātīgus secinājumus. Pieaugušo grupās ir pētījumi, kas norāda uz panikas simptomu saistību ar tabakas smēķēšanu (Mathew et al, 2011), citi šādu saistību neatklāj (Valentiner et al, 2004). Arī alkohola lietošanas saistība ar panikas simptomiem un traucējumiem nav viennozīmīga -ir pētījumi, kas neatklāj sakarības (Valentiner et al, 2004), un pētījumi, kas norāda uz ciešām sakarībām (Zimmer man et al, 2003;Mathew et al, 2011).…”

A laboratory-based test of the relation between adolescent alcohol use and panic-relevant responding.

“…In research with adult (e.g., Mathew et al, 2011) and adolescent (e.g., Zimmerman et al, 2003) samples, a positive relation between alcohol use and panic-spectrum problems has been observed. Indeed, with only two exceptions (i.e., Clark et al, 1995; Hayward et al, 1995), a high degree of co-occurrence has been identified in adolescent samples across qualitative (Gardner & Kutcher, 1993), laboratory-based (Blumenthal et al, 2012), and prospective designs (e.g., Goodwin et al, 2004).…”