PTSD Predicts Smoking Cessation Failure in a Trauma-Exposed Population.

The objective of the study was to investigate whether a diagnosis of posttraumatic stress disorder (PTSD; full or partial) or specific PTSD symptom clusters predicted failure in quitting smoking in a trauma-exposed population. Participants were 310 smokers who attempted quitting smoking, either successfully (quitters,  = 213) or not (relapsers,  = 97), who lived in slums and were attending a family doctor program. Measurements included a general questionnaire covering sociodemographic characteristics, clinical status and life habits, and the Posttraumatic Stress Disorder Checklist - Civilian Version. Differences in sociodemographic, clinical and lifestyle characteristics between quitters and relapsers were compared using a chi-square test. Because of the small sample size, full and partial PTSD were collapsed into a single category. Significant differences ( ≤ .15) between quitters and relapsers were found in age, body mass index (BMI), income, alcohol consumption, and in the presence of full/partial PTSD diagnosis and of all three symptom clusters separately. Four logistic regression models predicting smoking cessation were modeled to control for confounding factors and included as independent variables a full/partial PTSD diagnosis and the three posttraumatic symptom clusters. The avoidance/numbing cluster presented the strongest association with relapse status (a 2.04, 95% CI [1.15, 3.63],  = .015), followed by the full/partial PTSD (a 1.80, 95% CI [1.04, 3.14],  = .038). The re-experiencing and the hyperarousal clusters were non-significantly associated with smoking cessation (a 1.34, 95% CI [0.80, 2.31], and a 1.65, 95% CI [0.96, 2.84], , respectively). Full/partial PTSD and posttraumatic symptom clusters uniquely predict risk for smoking relapse and thus may be a useful therapeutic target in trauma-exposed smokers.