Posted: 03/28/07

What's smokin'?
UVM researchers search for link between nicotine withdrawal and panic attacks.

Courtney Lamdin | contributing writer
clamdin@smcvt.edu

A UVM study at the Anxiety and Health Research Lab is studying the relationship between nicotine withdrawal and panic attacks. (Courtney Lamdin, photo)

The University of Vermont’s psychology department is currently conducting a smoking research study that aims to find a link between nicotine withdrawal and panic disorder.

Can tobacco make you whacko?

The Anxiety and Health Research Lab at UVM started the “Nicotine Withdrawal and Panic Responding” study in September 2006, led by graduate student Anka Vujanovic.

The federally funded project requires 90 smokers between the ages 18 and 65 to undergo a laboratory experiment in which anxiety symptoms are induced with a controlled inhalation of carbon dioxide-enriched air.

By eliciting these symptoms, Vujanovic hopes to find how smoking may be associated with anxiety disorders, specifically panic attacks, says experiment supervisor Dr. Michael Zvolensky.

“A lot of people with anxiety disorders use substances, and a lot of people who use substances have anxiety disorders,” Vujanovic says. “People with anxiety disorders go to substances to cope. It’s usually transactional.”

In 2004, 44.5 million, or 20.9 percent of American adults were smokers, according to the American Lung Association Web site. Forty million American adults ages 18 and older, or about 18.1 percent of people in this age group in a given year, have an anxiety disorder, according to the National Institute of Mental Health Web site.

Finding a causal relation could “raise a red flag” for clinicians and therapists who may not suspect the two factors could be interrelated, Vujanovic says. This could result in better, more individualized treatments for smokers or people with high anxiety, she says.

“This may seem far removed from a therapy office,” she says of the small Dewey Hall laboratory. However, the research conducted there is “one of the small links in the chain to helping people quit better,” Vujanovic says.

Today’s treatment programs aren’t very efficient, she says.

“We’re finding that a lot of [people] have anxiety problems, making it harder to quit,” says Marcel Bonn-Miller, another graduate student working in the lab. “If we can reduce or normalize anxiety before they try to quit, we’ll be more successful.”

Panic! at the laboratory

Researchers observed Holland, watching a surveillance monitor in an observation room. (Courtney Lamdin, photo)

St. Michael’s College junior and research participant Mike Holland says he hopes to eventually quit smoking. Currently, he smokes 10 to 15 cigarettes a day.

Holland gave up cigarettes for 12 hours for the the experiment, but mostly for the $35 stipend, he says.

After completing the tedious 60-page, double-sided questionnaire, Holland says he gained entrance to the lab: a small room furnished with a desk and chair, a video monitor and two surveillance cameras to allow researchers to observe the participants.

For 20 minutes, Holland was hooked up to physiological electrodes that measured his breathing rate, pulse, heart rate and palm sweating. A mask was placed over his mouth and nose to deliver the enriched air. Throughout the experiment, Holland was to rate, on a scale from zero to 100, statements about his feelings of anxiety, self-control and safety.

Holland could taste the enriched air as soon as Vujanovic switched it on, he says. He felt fine at first, rating his comfort levels at 100 points, but then the symptoms started.

“All of a sudden, it was like someone had hit a button,” he says. “I couldn’t breathe. I felt like I was suffocating.”

Holland jittered and felt the urge to get up and leave, but he continued with the experiment, he says.

“I started sweating very profusely like I was exercising,” Holland says. “I was scared.”

In an effort to control his symptoms, Holland stopped filling out the packet. After the enriched air stopped flowing and his panic subsided, he rated his self-control and safety levels in the 40s and 50s.

Holland ’s induced panic symptoms posed no long-term risk and could decrease the chance for a panic attack in the future, according to the study’s consent form.

Which came first, addiction or affliction?

Anxiety symptoms are induced with a controlled inhalation of carbon dioxide-enriched air. (Courtney Lamdin, photo)

Holland’s datum was added to the main computer database, which will provide for months of analyses once the study is complete, Vujanovic says. The end product will be her dissertation.

Vujanovic has completed 40 percent of her research and is enthusiastically looking for participants to finish the study by Jan. 1, 2008, she says.

People trying to quit smoking should participate in the study, Holland says.

“I’d recommend it to people so they can be put into that panic attack,” he says. “For some smokers, it might help them quit.”

As for Holland, the study made him more aware of his addiction because he was asked so many questions about it, he says.

He sees the connection between smoking and anxiety and has begun to question which factor came first, Holland says.

“I can’t tell anymore if smoking is caused because of stress or if smoking leads to stress,” he says. “You get stressed so you want a cigarette.”

Thinking that smoking can reduce anxiety may be a misconception, Vujanovic says.

“People think smoking calms them down,” she says, “but nicotine withdrawal symptoms can set in even minutes after people smoke. They may be smoking to regulate these symptoms.”