Am J Psychiatry 1992; 149:464-469
Copyright © 1992 by American Psychiatric Association
Nicotine withdrawal symptoms and psychiatric disorders: findings from an epidemiologic study of young adults
N Breslau, MM Kilbey and P Andreski
Department of Psychiatry, Henry Ford Hospital, Ann Arbor, MI.
OBJECTIVE: Earlier, the authors reported on the association of nicotine
dependence with major depression and anxiety disorders in a group of young
adults. This report describes the occurrence of withdrawal symptoms and
their sociodemographic and psychiatric correlates in persons in that group
who tried unsuccessfully to abstain from smoking. METHOD: A random sample
of 1,007 members of a health maintenance organization, 21-30 years old,
were interviewed with a revised version of the NIMH Diagnostic Interview
Schedule. Data on nicotine withdrawal came from a subset of 239 smokers who
had tried unsuccessfully to quit or cut down on smoking. RESULTS: With two
exceptions, each of the DSM- III-R nicotine withdrawal symptoms was
reported by more than one-half of these smokers. Withdrawal symptoms were
more severe in white than in black smokers but were unrelated to sex,
educational level, or marital status. Persons with histories of major
depression or any anxiety disorder reported more severe withdrawal symptoms
than persons with neither of these disorders. Severity of withdrawal, or
any specific symptom, did not account for the association between major
depression and continued smoking. Furthermore, severity of withdrawal was
unrelated to continued smoking. CONCLUSIONS: While the long-term clinical
significance of nicotine withdrawal is unclear, the evidence indicates that
in the general population, abstinence from smoking is associated with a
variety of disturbances, including a craving for cigarettes, dysphoria, and
symptoms of irritability or nervousness. In this study disturbances were
more severe in persons with histories of major depression or anxiety
disorders.
