New research has found that the effects of nicotine on the brain are similar to…
PTSD Sufferers Have Higher Risk for Nicotine Addiction
Posttraumatic stress disorder is a life-impairing mental health disorder that occurs in individuals who have problems turning off the body’s natural “fight-or-flight” response in the aftermath of dangerous, life-threatening or seemingly life-threatening events. People affected by PTSD have an increased tendency for smoking cigarettes and develop the symptoms of a diagnosable substance use disorder. In a study published in January 2014 in the journal Addictive Behaviors, researchers from three U.S. institutions explored the underlying connections that directly and indirectly link smoking, substance use disorder and PTSD.
Most people exposed to dangerous or life-threatening events go through a relatively brief period of emotional instability and then return to good health as their brains and bodies readjust over time. However, some people continue to experience the emotional and behavioral changes associated with heavy or prolonged activation of the “fight-or-flight” response, even after any actual threat has long since faded away. If these changes continue to appear more than 30 days after a traumatic event (or first appear more than 30 days after such an event), doctors can officially diagnose the presence of posttraumatic stress disorder. Symptoms typically associated with this disorder include a mental/emotional reliving of a traumatizing event, a sharp increase in moods and emotions that seriously decrease a sense of well-being, a strong urge to keep away from any reminders of a traumatizing event and a state of excessive sensory arousal characteristic of an ongoing “fight-or-flight” reaction.
Smoking and Substance Use Disorder
Independent of any association with PTSD, people affected by a substance use disorder (the accepted term for abuse- or addiction-related problems with either drugs or alcohol) smoke more often than the rest of the adult population. For example, while roughly 19 percent of U.S. adults smoke cigarettes, about 56 percent of adults with diagnosable alcohol-related problems smoke. The smoking rate among adults with diagnosable drug-related problems is almost 70 percent. While smoking in general has grown less common over the last 20 years, its popularity among individuals affected by substance abuse and substance addiction has not dropped significantly. Smoking has a tremendous negative impact on the health of people diagnosed with a substance use disorder. In fact, these individuals have a greater chance of dying from smoking-related complications than from drug- or alcohol-related complications.
What’s the Connection?
In the study published in Addictive Behaviors, researchers from Kent State University, Northeastern Ohio Medical University and Oriana House used an examination of 227 adults to investigate the connection between PTSD, smoking and substance use disorder. All of these individuals used cigarettes, had a diagnosis for substance use disorder and had been exposed to situations known for their ability to trigger the onset of PTSD. Each participant completed a series of questionnaires designed to address such issues as the appearance of PTSD-related symptoms, the typical rate of cigarette consumption, the presence of any symptoms of nicotine addiction and any preexisting expectations that cigarette use produces more benefits than harms.
The researchers concluded that PTSD and cigarette use/nicotine addiction are not directly connected to each other. However, they also concluded that these two conditions are indirectly linked in people with serious drug- or alcohol-related problems in a couple of ways. For instance, people affected by both substance use disorder and PTSD often turn to cigarettes when seeking to avoid unwanted emotional states. In addition, PTSD/substance use disorder sufferers looking to avoid unpleasant emotions or make themselves feel better have increased risks for developing a nicotine addiction, as do PTSD/substance use disorder sufferers looking to diminish a sense of boredom.
Significance and Considerations
At the time the study published in Addictive Behaviors was conducted, PTSD was classified with a group of mental health conditions called anxiety disorders. In May 2013, the American Psychiatric Association moved the disorder into a newly established, separate category of conditions, known as trauma- and stressor-related disorders. The authors of the study believe that most people affected by both PTSD and substance use disorder smoke because they think that smoking can help them ease the impact or frequency of unpleasant, trauma-related emotions, thoughts or feelings. They also believe that awareness of this motivation for cigarette use can help any professional hoping to successfully employ common smoking-cessation techniques when working with patients/clients diagnosed with PTSD and drug- or alcohol-related issues.