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Cigarette smoking, nicotine dependence and anxiety disorders : a systematic review of population-based, epidemiological studies

Moylan, Steven, Jacka, Felice N., Pasco, Julie A. and Berk, Michael 2012, Cigarette smoking, nicotine dependence and anxiety disorders : a systematic review of population-based, epidemiological studies, BMC medicine, vol. 10, no. 123, pp. 1-14.

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Title Cigarette smoking, nicotine dependence and anxiety disorders : a systematic review of population-based, epidemiological studies
Author(s) Moylan, Steven
Jacka, Felice N.
Pasco, Julie A.
Berk, Michael
Journal name BMC medicine
Volume number 10
Issue number 123
Start page 1
End page 14
Total pages 14
Publisher BioMed Central
Place of publication London, England
Publication date 2012
ISSN 1741-7015
Keyword(s) agoraphobia
anxiety disorder
cigarette smoking
epidemiology
generalized anxiety disorder
nicotine dependence
obsessive-compulsive disorder
panic disorder
post-traumatic stress disorder
specific phobia
Summary Background Multiple studies have demonstrated that rates of smoking and nicotine dependence are increased in individuals with anxiety disorders. However, significant variability exists in the epidemiological literature exploring this relationship, including study design (cross-sectional versus prospective), the population assessed (random sample versus clinical population) and diagnostic instrument utilized.

Methods We undertook a systematic review of population-based observational studies that utilized recognized structured clinical diagnostic criteria (Diagnostic and Statistical Manual of Mental Disorders (DSM) or International Classification of Diseases (ICD)) for anxiety disorder diagnosis to investigate the relationship between cigarette smoking, nicotine dependence and anxiety disorders.

Results In total, 47 studies met the predefined inclusion criteria, with 12 studies providing prospective information and 5 studies providing quasiprospective information. The available evidence suggests that some baseline anxiety disorders are a risk factor for initiation of smoking and nicotine dependence, although the evidence is heterogeneous and many studies did not control for the effect of comorbid substance use disorders. The identified evidence however appeared to more consistently support cigarette smoking and nicotine dependence as being a risk factor for development of some anxiety disorders (for example, panic disorder, generalized anxiety disorder), although these findings were not replicated in all studies. A number of inconsistencies in the literature were identified.

Conclusions Although many studies have demonstrated increased rates of smoking and nicotine dependence in individuals with anxiety disorders, there is a limited and heterogeneous literature that has prospectively examined this relationship in population studies using validated diagnostic criteria. The most consistent evidence supports smoking and nicotine dependence as increasing the risk of panic disorder and generalized anxiety disorder. The literature assessing anxiety disorders increasing smoking and nicotine dependence is inconsistent. Potential issues with the current literature are discussed and directions for future research are suggested.
Notes This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Language eng
Field of Research 119999 Medical and Health Sciences not elsewhere classified
Socio Economic Objective 970111 Expanding Knowledge in the Medical and Health Sciences
HERDC Research category C1 Refereed article in a scholarly journal
Copyright notice ©2012, Moylan et al.
Persistent URL http://hdl.handle.net/10536/DRO/DU:30048514

Document type: Journal Article
Collections: School of Medicine
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Every reasonable effort has been made to ensure that permission has been obtained for items included in DRO. If you believe that your rights have been infringed by this repository, please contact drosupport@deakin.edu.au.