title: Nicotine withdrawal in U.S. smokers with current mood, anxiety, alcohol use, and substance use disorders.
abstract: BACKGROUND
  The current study examined tobacco withdrawal symptoms and withdrawal-related discomfort and relapse in smokers with and without current mood disorders, anxiety disorders, alcohol use disorders (AUD), and substance use disorders (SUD).
  
  
  METHODS
  The subsample of current daily smokers (n=8213) from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC, Wave 1, 2001-2002, full sample n=43,093) were included in these analyses. Cross-sectional data compared smokers with and without current psychiatric disorders on withdrawal symptoms using logistic regression models. The effects of having a co-morbid psychiatric disorder and AUD/SUD compared to a psychiatric disorder alone on nicotine withdrawal were also examined.
  
  
  RESULTS
  Participants with a current mood disorder, anxiety disorder, AUD, or SUD were more likely to report withdrawal symptoms and reported more withdrawal symptoms than those without current disorders. Having a current mood disorder, anxiety disorder, or SUD was also associated with increased likelihood of withdrawal-related discomfort and relapse. There were no significant interactions between psychiatric disorders and AUDs/SUDs on withdrawal symptoms or behavior.
  
  
  CONCLUSIONS
  Participants with a current Axis I disorder were more likely to experience tobacco withdrawal symptoms and withdrawal-related discomfort and relapse. Having a co-morbid psychiatric disorder and AUD/SUD did not synergistically increase the experience of withdrawal-related symptoms or relapse. It is important to identify Axis I disorders in smokers and provide these smokers with more intensive and/or longer treatments to help them cope with withdrawal symptoms and prevent relapse.
authors.affiliation: Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06519, USA. andrea.weinberger@yale.edu
authors.forename: Andrea H
authors.initials: AH
authors.lastname: Weinberger
authors.forename: Rani A
authors.initials: RA
authors.lastname: Desai
authors.forename: Sherry A
authors.initials: SA
authors.lastname: McKee
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000437:Alcoholism / Q000150:complications* / Q000523:psychology*; D001008:Anxiety Disorders / Q000150:complications* / Q000523:psychology*; D017831:Diagnosis, Dual (Psychiatry); D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019964:Mood Disorders / Q000150:complications* / Q000523:psychology*; D011569:Psychiatric Status Rating Scales; D012008:Recurrence; D012907:Smoking / Q000523:psychology*; D016540:Smoking Cessation / Q000523:psychology*; D013375:Substance Withdrawal Syndrome / Q000150:complications* / Q000523:psychology*; D019966:Substance-Related Disorders / Q000150:complications* / Q000523:psychology*; D055815:Young Adult