Nicotine dependence risk increased in bipolar disorder

Aug 23 2012

By Mark Cowen, Senior medwireNews Reporter

Adults with mood and anxiety disorders are significantly more likely to be smokers than the general population, a US study of data from the National Epidemiologic Survey of Alcohol and Related Conditions (NESARC) shows.

Renee Goodwin (University of Houston, Texas) and team also found that, among smokers with anxiety and mood disorders, the risk for nicotine dependence was greatest in those with bipolar disorder.

"A better understanding of the differential comorbidity of mental disorders with nondependent cigarette smoking or nicotine dependence may shed light on the etiology of nicotine dependence by distinguishing whether some mental disorders are more closely linked with addictive cigarette use versus nonaddictive cigarette use," write the authors in the American Journal on Addictions.

The team assessed associations between mood and anxiety disorders and smoking in a nationally representative sample of 43,093 individuals, aged at least 18 years, from the NESARC. Of these, 4880 had anxiety disorders and 4455 mood disorders.

Nondependent cigarette use and nicotine dependence were assessed using the Alcohol Use Disorder and Associated Disabilities Interview Schedule-DSM-IV.

After accounting for demographic variables and the presence of other mental health disorders, the researchers found that compared with the general population, the risk for nondependent cigarette use was significantly increased in adults with panic disorder (odds ratio [OR]=1.90), specific phobia (OR=1.35) major depression (OR=1.31), bipolar disorder (OR=1.30), or generalized anxiety disorder (OR=1.16).

Among the study population as a whole (smokers and nonsmokers), the risk for nicotine dependence was increased among respondents with panic disorder (OR=1.82), bipolar disorder (OR=1.71), specific phobia (OR=1.69), and major depression.

Among smokers with mood or anxiety disorders, the risk for nicotine dependence was greatest in adults with bipolar disorder (OR=2.38), followed by those with social phobia (OR=1.69), specific phobia (OR=1.69), or major depression (OR=1.65) compared with the general population of smokers.

Goodwin et al conclude: "Our findings highlight the importance of specifying the type of anxiety/mood disorder, as well as the level of frequency and dependence when drawing clinical implications or directions for future research on the relationship between mental disorders and cigarette use in the community."

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