Study Finds Smoking by Teens May Cause Anxiety Disorders
AP 8nov00
Abstract

CHICAGO -- A study suggests teen smokers are prone to anxiety disorders in adulthood, adding to a growing body of research implicating cigarette use as a cause rather than a result of emotional upheaval.

The study of nearly 700 adolescents followed into early adulthood found that generalized anxiety, panic attacks and agoraphobia -- fear of public places -- were much more common in those who had smoked heavily in their teens.

Teens who smoked 20 or more cigarettes daily were more than 15 times more likely to develop panic disorder as adults, nearly seven times more likely to become agoraphobic and more than five times more likely to develop generalized anxiety disorder than teens who smoked less or not at all.

The findings were published in Wednesday's Journal of the American Medical Association. They follow a study in October's issue of the journal Pediatrics suggesting that smoking may be a cause of depression in teens.

The authors of both studies theorize that nicotine may upset the central nervous system. Smoking's damaging effect on the body's ability to use oxygen may also play a role, said the authors of the anxiety study, led by researcher Jeffrey Johnson at Columbia University.

Mr. Johnson and colleagues interviewed 688 teens age 16 on average in 1985-86, and again in 1991-93, when the participants were 22 on average.

The study was funded by the National Institute of Mental Health and the National Institute on Drug Abuse.

Association Between Cigarette Smoking and Anxiety Disorders During Adolescence and Early Adulthood 
Journal of the American Medical Association 8nov00 JAMA. 2000;284:2348-2351
Abstract
Jeffrey G. Johnson, PhD; Patricia Cohen, PhD; Daniel S. Pine, MD; Donald F. Klein, MD; Stephanie Kasen, PhD; Judith S. Brook, PhD

Context  Cigarette smoking is associated with some anxiety disorders, but the direction of the association between smoking and specific anxiety disorders has not been determined.

Objective  To investigate the longitudinal association between cigarette smoking and anxiety disorders among adolescents and young adults.

Design  The Children in the Community Study, a prospective longitudinal investigation.

Setting and Participants  Community-based sample of 688 youths (51% female) from upstate New York interviewed in the years 1985-1986, at a mean age of 16 years, and in the years 1991-1993, at a mean age of 22 years.

Main Outcome Measure  Participant cigarette smoking and psychiatric disorders in adolescence and early adulthood, measured by age-appropriate versions of the Diagnostic Interview Schedule for Children.

Results  Heavy cigarette smoking (20 cigarettes/d) during adolescence was associated with higher risk of agoraphobia (10.3% vs 1.8%; odds ratio [OR], 6.79; 95% confidence interval [CI], 1.53-30.17), generalized anxiety disorder (20.5% vs 3.71%; OR, 5.53; 95% CI, 1.84-16.66), and panic disorder (7.7% vs 0.6%; OR, 15.58; 95% CI, 2.31-105.14) during early adulthood after controlling for age, sex, difficult childhood temperament; alcohol and drug use, anxiety, and depressive disorders during adolescence; and parental smoking, educational level, and psychopathology. Anxiety disorders during adolescence were not significantly associated with chronic cigarette smoking during early adulthood. Fourteen percent and 15% of participants with and without anxiety during adolescence, respectively, smoked at least 20 cigarettes per day during early adulthood (OR, 0.88; 95% CI, 0.36-2.14).

Conclusion  Our results suggest that cigarette smoking may increase risk of certain anxiety disorders during late adolescence and early adulthood.

JAMA. 2000;284:2348-2351

Author Affiliations: Departments of Psychiatry, Columbia University and the New York State Psychiatric Institute (Drs Johnson, Cohen, Klein, and Kasen), and Community Medicine, The Mount Sinai Medical Center, New York, NY (Dr Brook); and Intramural Research Program, Program on Mood and Anxiety Disorders, National Institute of Mental Health, Bethesda, Md (Dr Pine).
 
Corresponding Author and Reprints: Jeffrey G. Johnson, PhD, Box 60, New York State Psychiatric Institute, 1051 Riverside Dr, New York, NY 10032 (e-mail: jjohnso@pi.cpmc.columbia.edu).

Funding/Support: This study was supported by grants MH-36971 (Dr Cohen) and K-20-MH-01391 (Dr Pine) from the National Institute of Mental Health and grant DA-03188 from the National Institute on Drug Abuse (Dr Brook).