The Role of Anxiety in Smoking Onset, Severity, and Cessation-Related Outcomes: a Review of Recent Literature

Curr Psychiatry Rep. 2020 Jun 6;22(8):38. doi: 10.1007/s11920-020-01160-5.

Abstract

Purpose of review: Anxiety is one of the most common mental health conditions globally and co-occurs with smoking at a markedly high rate. The present review offers a narrative overview of the most recent research on the role of anxiety in smoking onset, maintenance, and cessation-related outcomes. Additionally, given the rise in electronic cigarette use, we review the emerging literature on the influence of anxiety on e-cigarette use.

Recent findings: Evidence across studies varied as to the role of anxiety or anxiety symptoms in smoking behavior. The most consistent findings suggested that those with anxiety are more likely to be a smoker, supporting a high rate of co-occurrence across these conditions. Less consistent evidence was observed for the association between anxiety and onset, indicators of severity, and cessation outcomes. Although there is robust evidence for an association between smoking and anxiety, there were considerable discrepancies for the precise role of anxiety in smoking onset, severity, and cessation outcomes. Future work utilizing more sophisticated methodologies is needed to identify causal relations as well as putative moderators and mediators of the anxiety-smoking relation.

Keywords: Anxiety; Cigarettes; Comorbidity; Dependence; E-cigarettes; Smoking.

Publication types

  • Review

MeSH terms

  • Anxiety / epidemiology
  • Anxiety Disorders / epidemiology
  • Electronic Nicotine Delivery Systems*
  • Humans
  • Smoking
  • Smoking Cessation*