Dec 15, 2021

New study shows nicotine dependence increases the risk of developing PTSD

An image of cigarettes and chains, symbolizing nicotine dependence

Post-Traumatic Stress Disorder can have devastating effects on the wellbeing of those that suffer from it, amplifying the effects of trauma and disrupting their lives. A new paper from PhD Candidate Christine Ibrahim, her supervisor Dr. Bernard Le Foll, and collaborator Dr. Ahmed Hassan has uncovered an unexpected risk factor: nicotine dependence. We spoke to Ms. Ibrahim about their findings, the relationship between nicotine dependence and PTSD, and the implications for treatment and prevention.

Christine Ibrahim
Christine Ibrahim

What is Post-Traumatic Stress Disorder?

CI: Post-traumatic stress disorder (PTSD) can occur when people directly experience or witness a traumatic event. These events range from war combat, serious accidents, physical or sexual assault, to natural disasters and many more. PTSD is characterized by physical or emotional reactions to the event long after the event occurred and can include flashbacks, nightmares, avoidance, and negative thoughts or feelings in reaction to the event. These symptoms can create significant distress and can impact social, work, or other importance aspects of one’s life.

 What motivated this research?

CI: A lot of research shows an association between smoking and PTSD, but not much research about why this association existed.  With Drs Le Foll and Hassan, we decided to access NESARC, a large national survey in the United States, that has the data to address this question.

Dr. Bernard Le Foll
Dr. Bernard Le Foll

What was the most important finding of this study, in your opinion?

CI: This research suggests that nicotine dependence specifically increased the risk of developing PTSD after trauma exposure. The relationship with smoking, regardless of dependence, was insignificant. Because of this, we investigated why dependence specifically was a risk factor, and we found that withdrawal was one of the reasons.

How does this change treatment in the future?

CI: With increased awareness that nicotine dependence is a risk factor for PTSD, people who have been exposed to trauma should consider seeking treatment for their dependence and their trauma to decrease the chance that their trauma develops into PTSD.

Ahmed Hassan
Dr. Ahmed Hassan

Any next steps?

CI: A next step would be to further investigate what is causing this association between nicotine dependence and PTSD. Although we found withdrawal as one mediator of the effect, there could be many more. For example, there are genetic risk factors for both nicotine dependence and PTSD. It would be interesting to see if the risk still holds when we consider genetics.

 What is the major take home message for the public?

CI: The major take home message for the public is not to underestimate the effect nicotine has on your wellbeing. With regards to substances, nicotine is not seen in the media as frequently as other substances. However, this should not undermine the severity of nicotine dependence, because not only does it have negative health effects on a person, but with this research we also see that it can even increase a person’s risk of developing a serious psychiatric disorder.

ImPACT logo: Psychiatry articles that change treatment

ImPACT Committee includes Krista Lanctôt, Alastair Flint, Meng-Chuan Lai and Simone Vigod.

Ibrahim C, Le Foll B, Hassan AN. The effect of nicotine dependence on the risk of developing post-traumatic stress disorder: Results from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). Nicotine Tob Res. 2021 Nov 3:ntab229. doi: 10.1093/ntr/ntab229