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Cigarette Smoking and the Onset and Persistence of Panic Attacks During Mid-Adulthood in the United States: 1994–2005

J Clin Psychiatry 2016;77(1):e21–e24

Objective: The current study examined the relationship between cigarette smoking (daily) and risk of onset and persistence of panic attacks over a 10-year period among adults in mid-adulthood in the United States and whether quitting smoking reduced the risk for panic attacks.

Method: Data were drawn from the Midlife Development in the United States Survey (N = 2,101), a nationally representative sample of adults aged 25 to 74 years at baseline (wave 1, 1994–1995) who were followed up 10 years later at wave 2 (2004–2006). Psychiatric diagnoses were based on the Composite International Diagnostic Interview Short-Form (CIDI-SF [based on DSM-III-R criteria]) scales. Logistic regressions were used to evaluate the associations between smoking status and the onset and persistence of panic attack after controlling for demographic characteristics and substance use problems.

Results: Daily smoking in 1994 (OR = 1.9 [95% CI, 1.1–3.3]) and persistent daily smoking in 1994 and 2005 (OR = 2.6 [95% CI, 1.4–4.8]) were associated with a significantly increased likelihood of panic attacks in 2005. Moreover, smoking abstinence significantly reduced the risk of new-onset panic attacks (OR = 0.6 [95% CI, 0.4–0.97]) and persistence of panic attacks (OR = 0.2 [95% CI, 0.1–0.5]).

Conclusions: The present data provide novel evidence that smoking is associated with an increased risk of panic attacks and that quitting smoking helps reduce such risk.