While heavy smoking is often associated with posttraumatic stress
disorder, a University of Arkansas psychologist says there's a big gap
in available treatment.
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.
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