title: Nicotine withdrawal exacerbates fear reactivity to CO₂-induced bodily sensations among smokers.
abstract: BACKGROUND
  Independent lines of research suggest that smoking increases the prospective risk of panic disorder. Studies that have examined the hypothesized link between nicotine withdrawal and panic have typically employed light smokers or lacked optimal control groups. Our laboratory team previously found, for example, that smokers who abstained from cigarettes for 12 hr demonstrated greater fear reactivity to a CO(2) rebreathing challenge than nonsmokers. However, the absence of a smoking-as-usual group limited our ability to draw conclusions about the potential role of nicotine withdrawal.
  
  
  METHODS
  We exposed 27 heavy smokers who abstained from smoking for 12 hr and 27 heavy smokers who smoked as usual to a 5-min CO(2) rebreathing challenge.
  
  
  RESULTS
  More intense prechallenge nicotine withdrawal symptoms (regardless of group status) were associated with more severe panicky symptoms and a stronger urge to escape during the challenge, even after we controlled for prechallenge anxiety and daily cigarette use. Unexpectedly, group status did not predict challenge reactivity.
  
  
  CONCLUSIONS
  Smokers who regularly experience intense withdrawal symptoms, regardless of length of smoking abstinence, may be at heightened risk for experiencing panic attacks.
authors.affiliation: Department of Psychology, Carleton College, Northfield, MN 55057, USA. kabrams@carleton.edu
authors.forename: Kenneth
authors.initials: K
authors.lastname: Abrams
authors.forename: Kate
authors.initials: K
authors.lastname: Leger
authors.forename: Laura
authors.initials: L
authors.lastname: Schlosser
authors.forename: Anne
authors.initials: A
authors.lastname: Merrill
authors.forename: Molly
authors.initials: M
authors.lastname: Bresslour
authors.forename: Avantika
authors.initials: A
authors.lastname: Jalan
mesh_terms: D000328:Adult; D002245:Carbon Dioxide; D005239:Fear / Q000187:drug effects / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D009538:Nicotine / Q000009:adverse effects*; D016584:Panic Disorder / Q000139:chemically induced* / Q000523:psychology; D012044:Regression Analysis; D012677:Sensation / Q000187:drug effects; D012907:Smoking / Q000523:psychology*; D016540:Smoking Cessation / Q000523:psychology; D013375:Substance Withdrawal Syndrome / Q000523:psychology*; D011795:Surveys and Questionnaires; D014029:Tobacco Use Disorder / Q000150:complications / Q000523:psychology; D055815:Young Adult
chemical_list: D002245:Carbon Dioxide; D009538:Nicotine