PTSD Predicts Smoking Cessation Failure in a Trauma-Exposed Population

Abstract

Objective

The objective of the study was to investigate whether a diagnosis of posttraumatic stress disorder (PTSD; full or partial) or specific PTSD symptom clusters predicted failure in quitting smoking in a trauma-exposed population. Methods: Participants were 310 smokers who attempted quitting smoking, either successfully (quitters, n = 213) or not (relapsers, n = 97), who lived in slums and were attending a family doctor program. Measurements included a general questionnaire covering sociodemographic characteristics, clinical status and life habits, and the Posttraumatic Stress Disorder Checklist – Civilian Version. Differences in sociodemographic, clinical and lifestyle characteristics between quitters and relapsers were compared using a chi-square test. Because of the small sample size, full and partial PTSD were collapsed into a single category. Results: Significant differences (p ≤ .15) between quitters and relapsers were found in age, body mass index (BMI), income, alcohol consumption, and in the presence of full/partial PTSD diagnosis and of all three symptom clusters separately. Four logistic regression models predicting smoking cessation were modeled to control for confounding factors and included as independent variables a full/partial PTSD diagnosis and the three posttraumatic symptom clusters. The avoidance/numbing cluster presented the strongest association with relapse status (ORa 2.04, 95% CI [1.15, 3.63], p = .015), followed by the full/partial PTSD (ORa 1.80, 95% CI [1.04, 3.14], p = .038). The re-experiencing and the hyperarousal clusters were non-significantly associated with smoking cessation (ORa 1.34, 95% CI [0.80, 2.31], ns and ORa 1.65, 95% CI [0.96, 2.84], ns, respectively). Conclusions: Full/partial PTSD and posttraumatic symptom clusters uniquely predict risk for smoking relapse and thus may be a useful therapeutic target in trauma-exposed smokers.

Keywords:

• PTSD
• posttraumatic stress disorder
• cigarette smoking
• smoking cessation
• alcohol use disorders
• slums

Disclosure statement

Authors Julciney Trindade Fortes, Fabiola Giordani Cano, Verônica Alcoforado Miranda, Hye Chung Kang, Leonardo F. Fontenelle, Mauro Vitor Mendlowicz, and Maria Luiza Garcia-Rosa declare that they have no conflicts of interest. No potential conflict of interest was reported by the author(s).

Additional information

Funding

Dr. Fontenelle is currently receiving [grant 303773/2011-1] from the Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) – Federal Government of Brazil, [grant E-26/103.252/2011] from the Fundação de Amparo à Pesquisa do Estado do Rio de Janeiro (FAPERJ), and an additional support (grant number not available) from D’Or Institute for Research and Education (IDOR).