UW-CTRI Researcher Jessica Cook is a co-author on a published paper concluding that many troops smoke because they believe nicotine will greatly alleviate their post-traumatic stress disorder (PTSD) symptoms, when in actuality smoking makes them worse long-term. 

This misguided belief makes troops with severe PTSD less likely to think they can handle life without cigarettes, and therefore these troops have a lower belief that they can quit than most smokers who don’t have PTSD. 

Veterans aren’t alone. Research shows 45 percent of Americans with PTSD smoke, more than double the rate of the general population. Troops suffering from post-traumatic stress are the least likely group to quit smoking, even when compared to smokers with other mental-health disorders.

While integrating evidence-based smoking cessation treatment into mental health-care at VA hospitals improves quit-smoking rates relative to specialty smoking cessation clinics, its effects on cessation are marginal. For example, in one 2010 study involving 943 veterans with PTSD at 10 VA hospitals, even under integrated care, 90 percent failed to quit smoking long term. 

Jessica and colleagues found that higher nicotine dependence (confirmed by FTND scores) was positively associated with overall PTSD symptom severity and the desire to numb or avoid these symptoms. “These findings will not necessarily translate to their ability to quit, but they could,” Jessica said.

The authors suggest that interventions designed to help veterans tolerate and cope with stress may also help smokers see that they can live without nicotine. 
Timothy Carmody, of the San Francisco VA Medical Center, was the lead author on the paper, published Jan. 23 in the journal Nicotine and Tobacco Research. 

The RAND Corp. research organization estimated nearly 20 percent of recent veterans, or 300,000 people, have symptoms of PTSD or major depression. According to the AP, researchers at the VA Puget Sound Health Care System in Seattle have PTSD therapists conducting smoking cessation therapy in the same visit. In a pilot study, those patients receiving integrated care were five times more likely to quit cigarettes than PTSD patients sent to separate smoking programs. This type of integrated care for smoking cessation is being rolled out into VA PTSD treatment clinics across the country, including the Madison VA Medical Center, led by Jessica.