NEW YORK (Reuters) -- Quitting cigarettes leads to less anxiety -- not more, according to new research reported in November's American Journal of Psychiatry.
Psychologists from St. George's Hospital Medical School in London, England, report finding no evidence of increased anxiety in patients who gave up smoking. In fact, they found a significant decrease in anxiety beginning in the first nicotine-free week. These results lead the researchers, Drs. Robert West and Peter Hajek, to suggest that smoking leads to "chronically increased anxiety and that giving up smoking improves the situation."
Heightened anxiety as part of nicotine withdrawal is noted in the DSM-IV, the official manual of psychiatric disorders. But the London-based psychologists point out that increased anxiety during smoking cessation has been observed in most but not all studies.
To investigate the issue further, the researchers studied 101 nicotine-dependent adult smokers who volunteered to try to quit the habit with the help of a smokers' clinic. Using standardized psychological tests, the researchers recorded anxiety levels before smoking cessation and at 24 hours and once a week for a month afterwards.
Seventy of the smokers managed not to relapse for the 4-week follow-up period. During their time in the program, volunteers were randomly assigned to receive either an experimental anti-smoking pill (one aimed at altering the biochemical cascade of events associated with nicotine withdrawal) and a look-alike placebo (inactive) pill. They also attended group discussions aimed at helping them kick the tobacco habit.
"There was no evidence of an increase in anxiety following smoking cessation. However, there was a significant decrease in anxiety from the first week of abstinence," the study authors state.
But could the treatment program itself -- including the pills -- have affected the anxiety scores? No, say the authors. As in other studies they conducted, "the drug had no effect on anxiety, other withdrawal ratings, or abstinence." In addition, the group sessions did not include relaxation or stress-reduction components.
"The results weaken the view that increased anxiety is a robust and central element of the nicotine withdrawal syndrome and suggest that giving up smoking is quite rapidly followed by a reduction in anxiety that may reflect removal of an anxiogenic (anxiety-causing) agent, nicotine," the authors conclude.
SOURCE: American Journal of Psychiatry (1997;154:1589-1592)
