Smoking Cessation and Panic Attacks: A Report of 2 Cases

Letter to the Editor

Sir: Several studies report an association between smoking and panic attacks and suggest that in panic disorder patients, cigarette smoking precedes the onset of the first panic attack. Although there is evidence that smoking cessation can reduce the incidence of panic attacks, there is little evidence that smoking cessation is a risk factor for new-onset panic attacks. We report 2 cases of anxiety attacks after acute smoking abstinence that met DSM-IV criteria for panic attacks in nicotinedependent cigarette smokers participating in an 8-week doubleblind, placebo-controlled smoking cessation trial with selegiline hydrochloride.