Academic journal article Journal of Cognitive Psychotherapy

The Effect of Mood, Anxiety, and Alcohol Use Disorders on Smoking Cessation in Cancer Patients

Academic journal article Journal of Cognitive Psychotherapy

The Effect of Mood, Anxiety, and Alcohol Use Disorders on Smoking Cessation in Cancer Patients

Article excerpt

Smoking is highly prevalent in individuals with psychiatric disorders. The relationship between smoking and anxiety disorders has received less attention than that of depression and substance use disorders, despite the fact that anxiety disorders are the most common of mental illnesses across the globe. In this study, we investigated the relationship between psychiatric disorders, including anxiety, depression, alcohol abuse, and comorbid combinations of these primary Axis I disorders and smoking cessation, in a cohort of 1,425 cancer patients who were participating in a smoking cessation clinical program. Patients were followed prospectively and assessed for abstinence status at the end of treatment and at 6-month posttreatment. Treatment involved six to eight behavioral smoking cessation counseling sessions over a 12- to 16-week period, and up to 12 weeks of smoking cessation pharmacotherapy. We hypothesized that patients with current anxiety disorders as well as other psychiatric disorders would have lower smoking cessation rates than those with no psychiatric disorders. There were no differences in abstinence rates between patients with anxiety disorders and those with no psychiatric disorders at end of treatment or 6 months. Patients with major depression or alcohol abuse had lower cessation rates than patients with no psychiatric disorders at 6 months. Findings suggest that both major depression and alcohol abuse may adversely affect treatment outcome in cancer patients. However, these findings should be considered within the limitations of observational studies that involve comparisons between nonrandomly assigned groups.

Keywords: smoking cessation; anxiety; depression; alcohol

Smoking is highly prevalent in individuals with psychiatric disorders. Recent epidemiologic data show that smoking prevalence was 40.1% among adults who had mental illness within the previous 12 months, compared to 21.3% in adults who reported no mental illness in the previous 12 months (Lawrence, Mitrou, & Zubrick, 2009), a level that is similar to that of the general U.S. population (Centers for Disease Control and Prevention, 2005). Among individuals with current major depression and alcohol abuse or dependence, the smoking rate is estimated to be 45% and 56%, respectively (Lasser et al., 2000). Rates of nicotine dependence are higher in smokers with depression and alcohol use disorders than those with no psychiatric disorder (Grant, Hasin, Chou, Stinson, & Dawson, 2004; Pratt & Brody, 2010), and smokers with these disorders are less likely to quit (Breslau, Peterson, Schultz, Andreski, & Chilcoat, 1996; Pratt & Brody).

The relationship between smoking and anxiety disorders has received less attention than that of depression and substance use disorders, despite the fact that anxiety disorders are the most common of mental illnesses across the globe (World Health Organization World Mental Health Survey Consortium, 2004). It has been estimated that approximately 38% of individuals with an anxiety disorder are current smokers, and that among all current adult smokers, 23% meet criteria for an anxiety disorder within the past 12 months (Lawrence et al., 2009). Smoking rates for each of the anxiety disorders are approximately double the rates of nonpsychiatrically disordered smokers (21.3%) and range from 45.2% for panic, 45.2% for generalized anxiety, 42.0% for agoraphobia, 40.0% for posttraumatic stress disorder, and 35% for social phobia (Lawrence et al.).

The presence of anxiety disorders is related to nicotine dependence, withdrawal, and history of unsuccessful quit attempts (Breslau, Kilbey, & Andreski, 1991; Cougle, Zvolensky, Fitch, & Sachs-Ericsson, 2010). Current anxiety disorders have been shown to increase the risk of transition to nicotine dependence among daily smokers (Breslau, Novak, & Kessler, 2004). The presence of anxiety disorders has also been found to increase symptoms of nicotine withdrawal in a doseresponse fashion (John, Meyer, Rumpf, & Hapke, 2004). …

Search by... Author
Show... All Results Primary Sources Peer-reviewed

Oops!

An unknown error has occurred. Please click the button below to reload the page. If the problem persists, please try again in a little while.