quit-smoking counseling

Researchers may now have a reason to explain why many smokers struggle to kick the butt.

According to a new study conducted by the University of Wisconsin Center for Tobacco Research and Intervention, smokers with a history of anxiety disorders are less likely to quit than other smokers.

The study found that more than a third of the 1,504 smokers who participated in the research had a history of anxiety disorders. Of the 1,504 participants, 455 had experienced a panic attack, 199 suffered from a social anxiety disorder and 99 had been diagnosed with a generalized anxiety disorder. Some reported having more than one anxiety-related diagnosis.

Other research has shown that up to 25 percent of the more than 50 million smokers in the US have been diagnosed with at least one anxiety disorder in their lifetime.

The study's lead author Megan Piper says it surprised her that the nicotine lozenge and patch - alone or in combination - failed to help patients with an anxiety history to quit smoking.

In the general population, the lozenge and patch - especially when combined - have been very effective in helping patients quit smoking. Bupropion (Zyban) alone, or in combination with the nicotine lozenge, also did not increase cessation rates among patients with a history of anxiety disorders.

"Further research is needed to identify better counseling and medication treatments to help patients with anxiety disorders to quit smoking," she said.

Study participants with anxiety disorders also reported higher levels of nicotine dependence and withdrawal symptoms prior to quitting. All smokers often experienced cravings, negative feelings and difficulty in concentrating immediately after finishing a cigarette, and these reactions were heightened because the smokers knew they were about to attempt to quit.

Participants with anxiety disorders also experienced more intense negative feelings on their 'quit day' than did the other smokers.

These findings suggest that clinicians should assess anxiety-disorder status when helping patients quit smoking. While anxiety medications alone have not boosted cessation rates, Piper is planning further research to test other quit-smoking counseling interventions and medications with patients who have had an anxiety diagnosis.

Smokers in the study were given free coaching and medication in Madison and Milwaukee. The study is published in the journal Addiction.