Smoking to Cope

FAYETTEVILLE, Ark. — People smoke for many reasons, and no matter what the reason, quitting is difficult. When people with posttraumatic stress symptoms use cigarettes to cope with anxiety and other negative feelings related to the trauma, it becomes even more difficult to stop smoking.

Two recent papers by University of Arkansas psychologist Matthew Feldner and colleagues shed light on the relationship between posttraumatic stress symptoms and smoking. Their research begins filling the significant gap in knowledge about the effects of trauma-related symptoms on smoking cessation.

In a paper published in the journal Addictive Behaviors, Feldner and colleagues examined how motives for smoking related to posttraumatic stress symptom levels, which is an important first step in developing effective smoking treatments for people who have experienced a traumatic event.

The researchers reported that individuals in their study with higher levels of posttraumatic stress symptoms were more likely to smoke to reduce negative feelings. These results supported earlier predictions in the field, which had suggested this would be an important motive for smoking among those with posttraumatic stress disorder, or PTSD.

Feldner worked with another group of colleagues to review research on the relationship between smoking and PTSD in a paper recently published in Clinical Psychology Review. Their work revealed a “striking and clinically important” gap in available treatments for smokers with PTSD. It’s a gap that is particularly serious, the researchers noted, given the evidence that “PTSD and associated characteristics may be central to smoking cessation problems.”

While more research is needed to understand the relationship between posttraumatic stress symptoms and smoking, understanding motives for smoking among people with PTSD has important implications for treatment. For instance, the researchers write, “smokers with posttraumatic stress problems may be in particular need of learning adaptive strategies for coping” with the negative feelings related to their trauma. The researchers point out that the results of long-term smoking — like withdrawal symptoms, health problems and illnesses — will only increase the negative feelings these smokers seek to avoid.

In both papers, the researchers called for more sophisticated methods to measure smoking behavior in relation to trauma symptoms and PTSD. Long-range studies that did not depend completely on after-the-fact reporting by participants could be particularly useful.

Feldner is an assistant professor of psychology in the J. William Fulbright College of Arts and Sciences and is director of the Intervention Sciences Laboratory.

“Posttraumatic Stress Symptoms and Smoking to Reduce Negative Affect: An Investigation of Trauma-Exposed Daily Smokers” was published in the spring 2007 issue of Addictive Behaviors. Authors are Feldner; Kimberly A. Babson, Intervention Sciences Laboratory, UA department of psychology; Michael J. Zvolensky, Anka A. Vujanovic, Laura E. Gibson and Amit Bernstein, all of the University of Vermont; Sarah F. Lewis, Meridian Behavioral Health Services; and Candice M. Monson, Veterans Affairs National Center for PTSD, Women’s Health Sciences Division, Boston University School of Medicine.

“Smoking, Traumatic Event Exposure, and Post-Traumatic Stress: A Critical Review of the Empirical Literature” by Feldner, Babson and Zvolensky was published in Clinical Psychology Review 27 (2007). The paper was supported by an Arkansas Biosciences Institute grant award to Feldner and research grants from the National Institute on Drug Abuse awarded to Zvolensky.