title: Greater elevation in risk for nicotine dependence per pack of cigarettes smoked among those with an anxiety disorder.
abstract: OBJECTIVE
  Recent work shows that the time from the initial use of nicotine, cannabis, and alcohol to the onset of dependence on these substances is shorter ("telescoped") in anxiety-disordered individuals. Previously, we hypothesized that telescoping may result from a shared neurobiology underlying both anxiety disorders and dependence. This hypothesis implies that telescoping occurs because individuals with an anxiety disorder transition to dependence with less overall drug exposure ("dependence susceptibility"). To investigate this further, we examined an estimate of the amount smoked (rather than the time transpired) from smoking initiation milestones to the onset of nicotine dependence in those with and without an anxiety disorder.
  
  
  METHODS
  We used the subset of respondents in the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) Wave 1 who reported having smoked at least 100 cigarettes (N = 18,013). All data were based on face-to-face interviews.
  
  
  RESULTS
  Individuals with any anxiety disorder transitioned to nicotine dependence after smoking fewer total cigarettes than did individuals with no anxiety disorder. Furthermore, those with more than one anxiety disorder transitioned to nicotine dependence after smoking fewer cigarettes than did those with one anxiety disorder only. Several potentially confounding covariates were controlled for in these analyses.
  
  
  CONCLUSIONS
  Dependence susceptibility is a novel concept with the potential to inform theoretical accounts of and prevention strategies for substance dependence among those with an anxiety disorder. In addition to nicotine, our theory and past data suggest that dependence susceptibility for other addictive substances (e.g., alcohol) also would be found among those with an anxiety disorder.
authors.affiliation: Department of Psychiatry, University of Minnesota-Twin Cities Campus, Minneapolis, Minnesota. kushn001@umn.edu
authors.forename: Matt G
authors.initials: MG
authors.lastname: Kushner
authors.forename: Kyle R
authors.initials: KR
authors.lastname: Menary
authors.forename: Eric W
authors.initials: EW
authors.lastname: Maurer
authors.forename: Paul
authors.initials: P
authors.lastname: Thuras
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001008:Anxiety Disorders / Q000150:complications / Q000523:psychology*; D017831:Diagnosis, Dual (Psychiatry) / Q000523:psychology; D004198:Disease Susceptibility / Q000523:psychology*; D005260:Female; D006306:Health Surveys / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D012307:Risk Factors; D012907:Smoking / Q000523:psychology*; D014029:Tobacco Use Disorder / Q000150:complications / Q000523:psychology*