Predictors of Lapse in First Week of Smoking Abstinence in PTSD and Non-PTSD Smokers

Abstract

Results provide evidence of shorter time to first smoking lapse in PTSD, and add to evidence that early lapse occasions are more strongly related to trauma reminders, negative affect, and cravings in smokers with PTSD.

Nicotine Addiction and Psychiatric Disorders

“…In addition, following trauma, smoking initiation and daily smoking rates also increased (Breslau et al, 2003, 2004). PTSD patients also showed lower rates of quitting (Hapke et al, 2005; Lasser et al, 2000), suffered from worse nicotine withdrawal symptoms (Dedert et al, 2011), and as a result showed shorter times to first smoking lapse (Beckham, Calhoun, Dennis, Wilson, & Dedert, 2012) than non-PTSD population. Similarly, patients with social phobia have also demonstrated increased rates of smoking initiation (Sonntag, Wittchen, Höfler, Kessler, & Stein, 2000).…”

“…This is because while PTSD symptoms are reduced during nicotine intake (Beckham et al, 2005; Feldner et al, 2007; Greenberg et al, 2012; Thorndike et al, 2006), they resurface during abstinence (Dedert et al, 2011). Therefore, most PTSD patients reinitiate smoking to alleviate their symptoms (Beckham et al, 2012). However, while reinitiating smoking may help patients reduce their symptoms, Wilkinson and Gould’s (2013) results showing increased sensitivity to the effects of reintroduction of nicotine during nicotine withdrawal suggest that it may also enhance fear memories associated with new trauma and could prolong the course of the disorder.…”

“…While human studies suggest that smoking may alleviate the symptoms associated with anxiety disorders (Beckham et al, 2005; Feldner et al, 2007; Greenberg et al, 2012; Thorndike et al, 2006), nicotine abstinence worsens those symptoms (Dedert et al, 2011) and results in higher rates of reinitiation of smoking (Beckham et al, 2012; Hapke et al, 2005; Lasser et al, 2000). In line with these results, the animal studies using fear conditioning suggest that initial acute nicotine results in enhancement of hippocampus-dependent fear learning and impairment of fear extinction, whereas acute nicotine during nicotine withdrawal further enhances hippocampus-dependent fear memories, which may prolong the course of the disorder.…”

Cigarette smoking and 9/11-related posttraumatic stress disorder among World Trade Center Health Registry enrollees, 2003–12

“…PTSD can be an impediment to successful quitting (Fu et al, 2007;Morris et al, 2014). Smokers with PTSD are more likely to relapse than smokers without PTSD (Beckham et al, 2013;Zvolensky et al, 2008). Hapke et al, (2005) found that trauma exposed persons with PTSD were significantly less likely to quit than individuals with no history of traumatic exposure; there was no significant difference in the odds of quitting among trauma exposed persons without PTSD compared to individuals with no history of traumatic exposure.…”

Trauma Exposure and Cigarette Smoking: The Impact of Negative Affect and Affect-Regulatory Smoking Motives

“…Indeed, PTSD also appears to impair cessation success 6 . A recent study utilizing time sampling methodology found that smokers with PTSD had shorter time to lapse after a quit attempt relative to smokers without PTSD, and that those with PTSD were more likely to report negative affect as a situational factor (antecedent) to lapse 12 .…”