Teenagers who smoke cigarettes run a higher risk of developing panic attacks and anxiety disorders, according to research published Tuesday.
"Teenagers who smoked a pack a day were five times more likely to have generalized anxiety disorder, five times more likely to have agoraphobia (fear of going out in public) and more than 12 times as likely to have panic disorder during early adulthood," said Jeffrey Johnson of Columbia University and the New York State Psychiatric Institute.
At the same time, the report from Johnson and colleagues said teenagers who had anxiety disorders to begin with were not more likely to seek relief by taking up smoking--a finding that makes it more likely there is a cause-effect relationship between smoking and the disorders.
Previous research has reported a link, but it was not clear which came first--smoking or the propensity toward having such disorders before the smoking started, the report said.
"These are the first findings from a community-based longitudinal study to demonstrate that heavy cigarette-smoking during adolescence is associated with increased risk for agoraphobia, generalized anxiety disorder and panic disorder during early adulthood," said the study, published in this week's Journal of the American Medical Assn.
The findings were based on a look at 976 randomly sampled families from upstate New York, including 688 teenagers who were interviewed in 1985 and 1986 at a mean age of 16 and again in 1991 and 1993, when their mean age was 22.
Although the mechanism that may cause anxiety disorders in cigarette smokers has not been determined, previous research has indicated that impaired respiration and the presumed anxiety-generating effects of nicotine may play a role.