Smoking may increase risk of panic attack

NEW YORK, Dec 14 (Reuters Health) -- Daily smokers are more likely than nonsmokers to experience a panic attack for the first time, according to the results of a new study. However, kicking the habit appears to reduce the added risk, the researchers report.

Each year about one third of all adults have at least one panic attack. During an attack, a person may experience a number of symptoms, including shortness of breath, dizziness, rapid heartbeat, sweating, nausea, and chest pain.

Although smoking has been linked to an increased risk of certain psychiatric disorders, such as depression, there has been little research into the relationship between smoking and panic attacks, according to the authors of the current study, Dr. Naomi Breslau, of the Henry Ford Health System in Detroit, Michigan, and Dr. Donald F. Klein, of the College of Physicians and Surgeons at Columbia University in New York.

To see if a connection exists, the researchers relied on interviews conducted with two groups of people. The first survey included 1,007 people, aged 21 to 30 years, who were members of a Michigan health maintenance organization (HMO), while the other group was a national sample of 4,411 people aged 15 to 54 years.

In both groups, daily smokers were much more likely to have experienced a first occurrence of panic attack, Breslau and Klein report in the December issue of the Archives of General Psychiatry. In the HMO group, daily smokers had triple the risk of nonsmokers, while in the national sample, their risk was almost twice as high. However, quitting smoking did lower the risk somewhat.

The relationship appears to only go one way, however, the investigators note. Nonsmokers who had panic attacks were not at an increased risk of beginning to smoke, according to the report.

This is the first study to show a link between smoking and panic attacks, Breslau told Reuters Health in an interview. While the results of this study do not explain how smoking might lead to panic attacks, the Michigan researchers said that smoking's effect on the lungs might be to blame. Smokers who develop respiratory problems -- even mild ones -- that affect their breathing might get the false sensation that they are suffocating, she explained. This might lead to a panic attack, according to Breslau.

There are other possible explanations, however, she added, noting that the effect of nicotine on the brain may also play a role in raising the risk of panic attacks.

SOURCE: Archives of General Psychiatry 1999;56:1141-1147.

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