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Shevorykin A, Hyland BM, Robles D, Ji M, Vantucci D, Bensch L, Thorner H, Marion M, Liskiewicz A, Carl E, Ostroff JS, Sheffer CE. Tobacco use, trauma exposure and PTSD: a systematic review. Health Psychol Rev 2024:1-32. [PMID: 38711288 DOI: 10.1080/17437199.2024.2330896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Accepted: 03/11/2024] [Indexed: 05/08/2024]
Abstract
Tobacco use remains one of the most significant preventable public health problems globally and is increasingly concentrated among vulnerable groups, including those with trauma exposure or diagnosed with PTSD. The goal of this systematic review was to update and extend previous reviews. Of the 7224 publications that met the initial criteria, 267 were included in the review. Summary topic areas include conceptual frameworks for the relation between trauma or PTSD and tobacco use; associations between trauma exposure or PTSD and tobacco use; number and type of trauma exposures and tobacco use; PTSD symptoms and tobacco use; Treatment-related studies; and the examination of causal relations. Evidence continues to indicate that individuals exposed to trauma or diagnosed with PTSD are more likely to use tobacco products, more nicotine dependent and less likely to abstain from tobacco even when provided evidence-based treatments than individuals without trauma. The most commonly cited causal association proposed was use of tobacco for self-regulation of negative affect associated with trauma. A small proportion of the studies addressed causality and mechanisms of action. Future work should incorporate methodological approaches and measures from which we can draw causal conclusions and mechanisms to support the development of viable therapeutic targets.
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Affiliation(s)
- Alina Shevorykin
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Bridget M Hyland
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Daniel Robles
- Department of Psychology, Faculty of Science, University of Alberta, Edmonton, Canada
| | - Mengjia Ji
- Department of Psychology, The City College of New York (CUNY), New York, NY, USA
| | - Darian Vantucci
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Lindsey Bensch
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Hannah Thorner
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Matthew Marion
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Amylynn Liskiewicz
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Ellen Carl
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Jamie S Ostroff
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Christine E Sheffer
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
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Kearns NT, Carl E, Stein AT, Vujanovic AA, Zvolensky MJ, Smits JAJ, Powers MB. Posttraumatic stress disorder and cigarette smoking: A systematic review. Depress Anxiety 2018; 35:1056-1072. [PMID: 30192425 DOI: 10.1002/da.22828] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Revised: 07/16/2018] [Accepted: 07/23/2018] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Previous reviews of the PTSD and cigarette smoking literature showed high PTSD-smoking comorbidity and problematic smoking outcomes (Feldner et al., 2007, Clinical Psychology Review, 27, 14-45; Fu et al., 2007, Nicotine & Tobacco Research, 9, 1071-1084). However, past reviews also noted several prominent gaps in the literature, including a lack of etiological work examining underlying mechanisms and research on specialized PTSD-smoking treatments. The present review summarizes an extensive body of research conducted since the previous reviews targeting these areas of need. METHODS Literature searches identified 66 empirical studies specific to smoking and PTSD. RESULTS Smokers were approximately twice more likely to have PTSD than nonsmokers in the general population, and individuals with PTSD were approximately twice as likely to be current smokers. Smokers with PTSD evidenced more negative affect, trauma history, and comorbid psychiatric history, as well as quit attempts and higher relapse rates. PTSD symptoms were associated with expectations that smoking would reduce negative affect, which, in turn, was associated with increased smoking rate and nicotine dependence. Male sex was associated with nicotine dependence and PTSD avoidance, while the relationship between PTSD and smoking relapse due to withdrawal was stronger in females. Specialized, integrated PTSD and smoking cessation treatments showed promise in increasing quit success relative to standard care in randomized trials. CONCLUSIONS Rates of PTSD-smoking co-occurrence remain high. Notable gains have been made in relevant epidemiological and etiological research, although more work is needed in trauma-specific subpopulations. Several promising specialized treatments for comorbid smoking-PTSD have been developed and empirically tested but require replication.
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Affiliation(s)
- Nathan T Kearns
- Department of Psychology, University of North Texas, Denton, Texas
| | - Emily Carl
- Institute of Mental Health Research, University of Texas at Austin, Austin, Texas
| | - Aliza T Stein
- Institute of Mental Health Research, University of Texas at Austin, Austin, Texas
| | | | | | - Jasper A J Smits
- Institute of Mental Health Research, University of Texas at Austin, Austin, Texas
| | - Mark B Powers
- Institute of Mental Health Research, University of Texas at Austin, Austin, Texas.,Trauma, Critical Care, and Cute Care Surgery Research, Baylor University Medical Center, Dellas, Texas
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Pericot-Valverde I, Elliott RJ, Miller ME, Tidey JW, Gaalema DE. Posttraumatic stress disorder and tobacco use: A systematic review and meta-analysis. Addict Behav 2018; 84:238-247. [PMID: 29753221 PMCID: PMC7285418 DOI: 10.1016/j.addbeh.2018.04.024] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Revised: 03/18/2018] [Accepted: 04/30/2018] [Indexed: 12/26/2022]
Abstract
Posttraumatic stress disorder (PTSD) and tobacco use are prevalent conditions that co-occur at striking rates in the US. Previous reviews examined prevalence and factors associated with cigarette smoking among individuals with PTSD but have not been summarized since 2007. Moreover, none explored rates and factors associated with the use of other tobacco products. This study aimed to systematically review the most recent literature examining the comorbidity of PTSD and tobacco use to provide prevalence rates, as well as summarize the literature exploring other factors associated with tobacco use among individuals with PTSD. Studies were identified using a systematic search of keywords related to tobacco use and PTSD within the following databases: PubMed, PsycINFO, Web of Knowledge, CINAHL, PsycARTICLES, and Cochrane Clinical Trials Library. The studies included in this review (N = 66) showed that the prevalence of current use of tobacco products in individuals with PTSD was 24.0% and the rate of PTSD among users of tobacco products was 20.2%. Additionally, results demonstrated that individuals with PTSD present with high levels of nicotine dependence and heavy use of tobacco products, as well as underscore the importance of negative emotional states as a contributing factor to tobacco use among individuals with PTSD. It is imperative that future studies continue monitoring tobacco use among individuals with PTSD while also assessing factors identified as having a prominent role in tobacco use among individuals with PTSD. These findings also demonstrate the need for more innovative approaches to reduce the pervasive tobacco use among individuals with PTSD.
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Affiliation(s)
- Irene Pericot-Valverde
- Vermont Center on Behavior and Health, University of Vermont, Burlington, VT, United States; Department of Psychiatry, University of Vermont, Burlington, VT, United States; Department of Psychological Science, University of Vermont, Burlington, VT, United States.
| | - Rebecca J Elliott
- Vermont Center on Behavior and Health, University of Vermont, Burlington, VT, United States; Department of Psychiatry, University of Vermont, Burlington, VT, United States
| | - Mollie E Miller
- Center for Alcohol and Addiction Studies, Brown University, Providence, RI, United States
| | - Jennifer W Tidey
- Center for Alcohol and Addiction Studies, Brown University, Providence, RI, United States
| | - Diann E Gaalema
- Vermont Center on Behavior and Health, University of Vermont, Burlington, VT, United States; Department of Psychiatry, University of Vermont, Burlington, VT, United States; Department of Psychological Science, University of Vermont, Burlington, VT, United States
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The Expression of Posttraumatic Stress Symptoms in Daily Life: A Review of Experience Sampling Methodology and Daily Diary Studies. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2016. [DOI: 10.1007/s10862-016-9540-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Bakhshaie J, Zvolensky MJ, Salazar A, Vujanovic AA, Schmidt NB. Anxiety Sensitivity and Smoking Behavior Among Trauma-Exposed Daily Smokers: The Explanatory Role of Smoking-Related Avoidance and Inflexibility. Behav Modif 2015; 40:218-38. [PMID: 26538275 DOI: 10.1177/0145445515612402] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Anxiety sensitivity (AS), defined as the extent to which individuals believe that anxiety-related sensations have harmful consequences, is associated with smoking processes and poorer clinical outcomes among trauma-exposed smokers. Yet the specific mechanisms underlying this association are unclear. Smoking-specific avoidance and inflexibility is a construct implicated in multiple manifestations of mood regulation that may underlie smoking behavior. The current study examined the explanatory role of smoking-specific avoidance and inflexibility in terms of the relation between AS and indices of smoking behavior among trauma-exposed smokers. The sample consisted of 217 treatment-seeking adult smokers (44% female; M age = 37.8; SD = 13.2; age range: 18-65 years), who were exposed to at least one lifetime Criterion A trauma event (Diagnostic and Statistical Manual of Mental Disorders [4th ed., text rev.; DSM-IV-TR] Criterion A for trauma exposure). Bootstrap analysis (5,000 re-samples) revealed that AS was indirectly related to the (a) number of cigarettes smoked per day, (b) number of years being a daily smoker, (c) number of failed quit attempts, and (d) heaviness of smoking index among trauma-exposed smokers through its relation with smoking-specific avoidance and inflexibility. These findings provide initial evidence suggesting that smoking-specific avoidance and inflexibility may be an important construct in better understanding AS-smoking relations among trauma-exposed smokers. Future work is needed to explore the extent to which smoking-specific avoidance and inflexibility account for relations between AS and other smoking processes (e.g., withdrawal, cessation outcome) in the context of trauma and smoking comorbidity.
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Affiliation(s)
| | - Michael J Zvolensky
- University of Houston, TX, USA Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, TX, USA
| | | | - Anka A Vujanovic
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston, TX, USA
| | - Norman B Schmidt
- Department of Psychology, Florida State University, Tallahassee, FL, USA
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Vrana SR, Calhoun PS, Dennis MF, Kirby AC, Beckham JC. Acoustic startle and prepulse inhibition predict smoking lapse in posttraumatic stress disorder. J Psychopharmacol 2015; 29:1070-6. [PMID: 26253620 PMCID: PMC4586071 DOI: 10.1177/0269881115598319] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Most smokers who attempt to quit lapse within the first week and are ultimately unsuccessful in their quit attempt. Nicotine withdrawal exacerbates cognitive and attentional problems and may be one factor in smoking relapse. The startle reflex response and prepulse inhibition (PPI) of the response are sensitive to arousal and early attentional dysregulation. The current study examined whether startle response and PPI are related to early smoking lapse, and if this differs in people with and without posttraumatic stress disorder (PTSD). Participants with (N = 34) and without (N = 57) PTSD completed a startle reflex and PPI assessment during (1) ad lib smoking (2) on the first day of abstinence during a quit attempt. Most (88%) participants lapsed within the first week of the quit attempt. PTSD status predicted shorter time to lapse. Larger startle magnitude and greater PPI predicted a longer duration before smoking lapse. When diagnostic groups were examined separately, greater PPI predicted a longer successful quit attempt only in participants with a PTSD diagnosis. The startle reflex response and PPI may provide an objective, neurophysiological evaluation of regulation of arousal and early attentional processes by nicotine, which are important factors in smoking cessation success.
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Affiliation(s)
- Scott R. Vrana
- Virginia Commonwealth University, 508 Fulton St., Durham, NC, 27705
| | - Patrick S. Calhoun
- Durham VA Medical Center, 508 Fulton St., Durham, NC, 27705,MidAtlantic Research Education and Clinical Center, 508 Fulton St., Durham, NC, 27705,Duke University School of Medicine, Department of Psychiatry & Behavioral Sciences, Durham, NC, 27708
| | - Michelle F. Dennis
- Durham VA Medical Center, 508 Fulton St., Durham, NC, 27705,MidAtlantic Research Education and Clinical Center, 508 Fulton St., Durham, NC, 27705,Duke University School of Medicine, Department of Psychiatry & Behavioral Sciences, Durham, NC, 27708
| | | | - Jean C. Beckham
- Durham VA Medical Center, 508 Fulton St., Durham, NC, 27705,MidAtlantic Research Education and Clinical Center, 508 Fulton St., Durham, NC, 27705,Duke University School of Medicine, Department of Psychiatry & Behavioral Sciences, Durham, NC, 27708
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Attention Deficit Hyperactivity Disorder symptoms and smoking trajectories: race and gender differences. Drug Alcohol Depend 2015; 148:180-7. [PMID: 25616515 PMCID: PMC4437797 DOI: 10.1016/j.drugalcdep.2015.01.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2014] [Revised: 12/31/2014] [Accepted: 01/03/2015] [Indexed: 01/28/2023]
Abstract
PURPOSE This study examined the influence of Attention Deficit Hyperactivity Disorder (ADHD) symptoms severity and directionality (hyperactive-impulsive symptoms relative to inattentive symptoms) on trajectories of the probability of current (past month) smoking and the number of cigarettes smoked from age 13 to 32. Racial and gender differences in the relationship of ADHD symptoms and smoking trajectories were also assessed. METHODS A subsample of 9719 youth (54.5% female) was drawn from the National Longitudinal Study of Adolescent to Adult Health (Add Health). Cohort sequential design and zero-inflated Poisson (ZIP) latent growth modeling were used to estimate the relationship between ADHD directionality and severity on smoking development. RESULTS ADHD severity's effect on the likelihood of ever smoking cigarettes at the intercept (age 13) had a greater impact on White males than other groups. ADHD severity also had a stronger influence on the initial number of cigarettes smoked at age 13 among Hispanic participants. The relationships between ADHD directionality (hyperactive-impulsive symptoms relative to inattentive symptoms) and a higher number of cigarettes smoked at the intercept were stronger among Hispanic males than others. Gender differences manifested only among Whites. CONCLUSION ADHD severity and directionality had unique effects on smoking trajectories. Our results also highlight that the risk of ADHD symptoms may differ by race and gender.
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Selya AS, Updegrove N, Rose JS, Dierker L, Tan X, Hedeker D, Li R, Mermelstein RJ. Nicotine-dependence-varying effects of smoking events on momentary mood changes among adolescents. Addict Behav 2015; 41:65-71. [PMID: 25306388 PMCID: PMC4252301 DOI: 10.1016/j.addbeh.2014.09.028] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2014] [Revised: 07/28/2014] [Accepted: 09/17/2014] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Theories of nicotine addiction emphasize the initial role of positive reinforcement in the development of regular smoking behavior, and the role of negative reinforcement at later stages. These theories are tested here by examining the effects of amount smoked per smoking event on smoking-related mood changes, and how nicotine dependence (ND) moderates this effect. The current study examines these questions within a sample of light adolescent smokers drawn from the metropolitan Chicago area (N=151, 55.6% female, mean 17.7years). INSTRUMENTS Ecological momentary assessment data were collected via handheld computers, and additional variables were drawn from a traditional questionnaire. METHODS Effects of the amount smoked per event on changes in positive affect (PA) and negative affect (NA) after vs. before smoking were examined, while controlling for subject-averaged amount smoked, age, gender, and day of week. ND-varying effects were examined using varying effect models to elucidate their change across levels of ND. RESULTS The effect of the amount smoked per event was significantly associated with an increase in PA among adolescents with low-to-moderate levels of ND, and was not significant at high ND. Conversely, the effect of the amount smoked was significantly associated with a decrease in NA only for adolescents with low levels of ND. CONCLUSIONS These findings support the role of positive reinforcement in early stages of dependent smoking, but do not support the role of negative reinforcement beyond early stages of smoking. Other potential contributing factors to the relationship between smoking behavior and PA/NA change are discussed.
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Affiliation(s)
- Arielle S Selya
- Psychology Department, 207 High St., Wesleyan University, Middletown, CT 06459, USA.
| | - Nicole Updegrove
- Psychology Department, 207 High St., Wesleyan University, Middletown, CT 06459, USA.
| | - Jennifer S Rose
- Psychology Department, 207 High St., Wesleyan University, Middletown, CT 06459, USA.
| | - Lisa Dierker
- Psychology Department, 207 High St., Wesleyan University, Middletown, CT 06459, USA.
| | - Xianming Tan
- The Research Institute of the McGill University Health Centre, 2155 Guy St., 5th Floor, Montreal, Quebec H3H 2R9, Canada.
| | - Donald Hedeker
- Institute for Health Research and Policy, 1747 West Roosevelt Road, University of Illinois at Chicago, Chicago, IL 60608, USA.
| | - Runze Li
- The Methodology Center, 204 E. Calder Way, Suite 400, Penn State University, University Park, PA 16801, USA; Department of Statistics, 323 Thomas Building, University Park, PA 16802, USA.
| | - Robin J Mermelstein
- Institute for Health Research and Policy, 1747 West Roosevelt Road, University of Illinois at Chicago, Chicago, IL 60608, USA.
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Walz LC, Nauta MH, Aan Het Rot M. Experience sampling and ecological momentary assessment for studying the daily lives of patients with anxiety disorders: a systematic review. J Anxiety Disord 2014; 28:925-37. [PMID: 25445083 DOI: 10.1016/j.janxdis.2014.09.022] [Citation(s) in RCA: 102] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2013] [Revised: 06/30/2014] [Accepted: 09/29/2014] [Indexed: 12/17/2022]
Abstract
Anxiety disorders are highly prevalent. Symptoms may occur unpredictably (e.g., panic attacks) or predictably in specific situations (e.g., social phobia). Consequently, it may be difficult to assess anxiety and related constructs realistically in the laboratory or by traditional retrospective questionnaires. Experience sampling methods (ESM) and ecological momentary assessment (EMA) can deepen the understanding of the course of anxiety disorders by frequently assessing symptoms and other variables in the natural environment. We review 34 ESM/EMA studies on adult panic disorder, generalized anxiety disorder, social phobia, post-traumatic stress disorder, and obsessive-compulsive disorder, as well as anxiety disorders in youth. Benefits of ESM/EMA for the study of anxiety disorders include generating insight into the temporal variability of symptoms and into the associations among daily affect, behaviors, and situational cues. Further, ESM/EMA has been successfully combined with ambulatory assessment of physiological variables and with treatment evaluations. We provide suggestions for future research, as well as for clinical applications.
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Affiliation(s)
- Laura C Walz
- Experimental Psychopathology and Psychotherapy Program, Department of Psychology, University of Groningen, The Netherlands
| | - Maaike H Nauta
- Experimental Psychopathology and Psychotherapy Program, Department of Psychology, University of Groningen, The Netherlands
| | - Marije Aan Het Rot
- Experimental Psychopathology and Psychotherapy Program, Department of Psychology, University of Groningen, The Netherlands; School of Behavioral and Cognitive Neurosciences, University of Groningen, The Netherlands.
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