Increased Smoking Cessation Among Veterans With Large Decreases in Posttraumatic Stress Disorder Severity

Area of Science:

• Mental Health
• Public Health
• Behavioral Science

Background:

• Posttraumatic stress disorder (PTSD) is linked to poor health behaviors, including smoking, increasing chronic disease risk.
• While PTSD improvement correlates with better health habits, its association with smoking cessation was previously unknown.

Purpose of the Study:

• To investigate if clinically meaningful improvement in PTSD symptoms is associated with smoking cessation among veterans.
• To determine the impact of PTSD symptom reduction on the likelihood of quitting smoking.

Main Methods:

• Utilized Veterans Health Affairs medical record data from 2008-2015 for patients with PTSD.
• Defined clinically meaningful PTSD improvement using PTSD Checklist (PCL) score decrease.
• Employed Cox proportional hazard models with entropy balancing to analyze the association between PTSD improvement and smoking cessation within two years.

Main Results:

• Clinically meaningful PTSD improvement was observed in 19.8% of participants.
• Patients with PTSD improvement were more likely to quit smoking (40.5%) compared to those without improvement (30.8%).
• After controlling for confounding factors, PTSD improvement significantly increased the likelihood of smoking cessation (HR=1.57).

Conclusions:

• Clinically meaningful improvement in PTSD symptoms is significantly associated with a higher likelihood of smoking cessation.
• Further research is warranted to explore targeted interventions or if PTSD symptom improvement alone suffices for smoking cessation.
• PTSD treatment may facilitate healthier behaviors, potentially reducing the risk of smoking-related diseases.