Association between cigarette smoking and anxiety disorders during adolescence and early adulthood

JAMA. 2000 Nov 8;284(18):2348-51. doi: 10.1001/jama.284.18.2348.


Context: Cigarette smoking is associated with some anxiety disorders, but the direction of the association between smoking and specific anxiety disorders has not been determined.

Objective: To investigate the longitudinal association between cigarette smoking and anxiety disorders among adolescents and young adults.

Design: The Children in the Community Study, a prospective longitudinal investigation.

Setting and participants: Community-based sample of 688 youths (51% female) from upstate New York interviewed in the years 1985-1986, at a mean age of 16 years, and in the years 1991-1993, at a mean age of 22 years.

Main outcome measure: Participant cigarette smoking and psychiatric disorders in adolescence and early adulthood, measured by age-appropriate versions of the Diagnostic Interview Schedule for Children.

Results: Heavy cigarette smoking (>/=20 cigarettes/d) during adolescence was associated with higher risk of agoraphobia (10.3% vs 1.8%; odds ratio [OR], 6.79; 95% confidence interval [CI], 1.53-30.17), generalized anxiety disorder (20.5% vs 3.71%; OR, 5.53; 95% CI, 1.84-16.66), and panic disorder (7.7% vs 0.6%; OR, 15.58; 95% CI, 2.31-105.14) during early adulthood after controlling for age, sex, difficult childhood temperament; alcohol and drug use, anxiety, and depressive disorders during adolescence; and parental smoking, educational level, and psychopathology. Anxiety disorders during adolescence were not significantly associated with chronic cigarette smoking during early adulthood. Fourteen percent and 15% of participants with and without anxiety during adolescence, respectively, smoked at least 20 cigarettes per day during early adulthood (OR, 0.88; 95% CI, 0.36-2.14).

Conclusion: Our results suggest that cigarette smoking may increase risk of certain anxiety disorders during late adolescence and early adulthood. JAMA. 2000;284:2348-2351.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Anxiety Disorders / diagnosis
  • Anxiety Disorders / epidemiology
  • Anxiety Disorders / etiology*
  • Confidence Intervals
  • Female
  • Humans
  • Longitudinal Studies
  • Male
  • Odds Ratio
  • Risk Factors
  • Smoking / adverse effects*