What happens to anxiety levels on giving up smoking?
OBJECTIVE
DSM-IV lists increased anxiety as a nicotine withdrawal symptom. Increased anxiety has been reported to follow smoking cessation in most but not all studies. Indeed, there is some evidence for a reduction in anxiety, compared with precessation levels, after the first few weeks of abstinence. This study reports data from 101 smokers who attempted to stop smoking and who satisfied DSM-III-R criteria for nicotine dependence.


METHODS
Unlike most studies in this area, a strict criterion of lapse-free abstinence was adopted. It is argued that lapses during an attempt at cessation may underlie a transient increase in anxiety. Anxiety was measured both by a single rating typical in withdrawal studies and by the State-Trait Anxiety Inventory--State Form X. Patients were rated 2 weeks and 1 week before cessation, immediately before cessation, 24 hours after cessation, and 1, 2, 3, and 4 weeks after cessation.


RESULTS
Seventy patients were abstinent for the 4-week follow-up period. There was no evidence of an increase in anxiety following smoking cessation. However, there was a significant decrease in anxiety from the first week of abstinence.


CONCLUSIONS
The results weaken the view that increased anxiety is a robust and central element of the nicotine withdrawal syndrome and suggest that giving up smoking is quite rapidly followed by a reduction in anxiety that may reflect removal of an anxiogenic agent, nicotine.
West
R
R
St. George's Hospital Medical School, University of London, England.
Hajek
P
P
D000293:Adolescent; D000328:Adult; D000368:Aged; D001007:Anxiety / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D016540:Smoking Cessation; D000074606:Smoking Prevention; D013375:Substance Withdrawal Syndrome / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D014029:Tobacco Use Disorder / Q000150:complications* / Q000175:diagnosis