FRIDAY, Jan. 22, 2021 (American Heart Association News)
“I think we’ve generated more questions on the subject than we have answers,” said Brian Hitsman, associate professor of preventive medicine at Northwestern University Feinberg School of Medicine in Chicago.
Anxiety disorders are the most common mental health issue in the U.S., affecting between 15% and 19% of the adult population and encompassing everything from phobias and panic attacks to intense fear of social situations and chronic worrying.
While U.S. smoking rates have dropped over the past 50 years, about 1 in 5 American adults – 50.6 million – still reported smoking, vaping or using other tobacco products in 2019, according to the latest data released in November from the Centers for Disease Control and Prevention. That data also showed 45% of people with severe anxiety use tobacco. Even for those with mild anxiety, 30% use tobacco. Yet for those who report little to no anxiety, only 18% use tobacco.
Other research shows higher rates of anxiety disorders among smokers than the general population. However, a study released last year in Current Psychiatry Reports said that despite “robust evidence” linking smoking and anxiety, there are “considerable discrepancies for the precise role of anxiety in smoking onset, severity, and cessation outcomes.”
“It’s this perpetual loop feeding into itself. You have anxiety contributing to smoking … and then you have people becoming addicted to nicotine and experiencing acute withdrawal with symptoms that mimic anxiety,” said Garey, a research assistant professor at the University of Houston.
“These things are so interrelated it’s hard to tease apart,” she said. “Ultimately, we need more rigorous research to really track the different factors over time to fully understand them.”
“It’s in their head that smoking is an effective way to manage their emotional distress, but it’s probably only making them feel better because it’s helping manage their nicotine withdrawal,” he said. “Smoking actually increases your heart rate and causes changes in the body that are opposite of relaxation.”
Whether tobacco use and anxiety rates have been affected by the COVID-19 pandemic is difficult to pinpoint. But Garey suspects they’re rising.
“So many factors that contribute to anxiety – financial burden, child care issues – are making it worse. And there’s also a concern about a greater severity of smoking, and people who’ve quit restarting,” she said.
Panic attacks are repeated attacks of fear that can last for several minutes.
Quitting smoking can be incredibly difficult for anyone, largely because of the presence of nicotine, a highly addictive drug the U.S. surgeon general once likened to heroin and cocaine. During the pandemic, people struggling with nicotine addiction might find it harder than usual to set up doctor’s appointments or counseling sessions.
Still, there are a wide variety of methods available to help.
Daily exercise, prescription medicine and nicotine replacement products such as gum, patches or lozenges can help battle the cravings that often accompany nicotine withdrawal, Garey said. She also recommended the National Cancer Institute’s free telephone counseling line 800-QUIT-NOW (800-784-8669).
“Smoking is such an automatic, time-consuming thing, so it can be so helpful to take a break, focus on the moment, and replace smoking with something healthy that you really enjoy.”
American Heart Association News covers heart and brain health. Not all views expressed in this story reflect the official position of the American Heart Association. Copyright is owned or held by the American Heart Association, Inc., and all rights are reserved. If you have questions or comments about this story, please email [email protected]
By Thor Christensen
American Heart Association News
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