Ad lib smoking in post-traumatic stress disorder: an electronic diary study

Area of Science:

• Psychiatry
• Behavioral Science
• Addiction Medicine

Background:

• Post-traumatic stress disorder (PTSD) is frequently comorbid with nicotine dependence.
• Understanding situational smoking triggers is crucial for developing effective cessation interventions for individuals with PTSD.

Purpose of the Study:

• To investigate the association between smoking and situational cues in individuals with and without PTSD.
• To compare smoking patterns and triggers between smokers with PTSD and those without PTSD.

Main Methods:

• Ambulatory monitoring over 1 week was used to collect data from 22 smokers with PTSD and 23 smokers without PTSD.
• Generalized estimating equations were employed to analyze 1,759 smoking and 1,088 nonsmoking situations, controlling for covariates.

Main Results:

• Smokers with PTSD reported higher stress and PTSD symptoms during daily activities compared to controls.
• For all participants, smoking was associated with nicotine dependence, craving, consumption of food and caffeine, and being outdoors.
• Smokers with PTSD were significantly more likely to smoke when experiencing PTSD symptoms, anxiety, and stress.
• Smokers with PTSD experienced a significant reduction in negative affect after smoking.

Conclusions:

• Situational factors, including PTSD symptoms, stress, and anxiety, are strongly associated with smoking in individuals with PTSD.
• Smoking may serve as a coping mechanism for negative affect in smokers with PTSD.
• These findings highlight the need for tailored smoking cessation strategies that address PTSD-specific triggers and emotional regulation for this population.