Investigating the Relationship between Smoking and Panic Disorder: A Cross-Sectional Study among US Adults

Background. Previous research on panic risk factors within the US population has been limited. This cross-sectional study is aimed at exploring the association between smoking and panic among adults in the United States. Methods. We conducted an analysis of data from the National Health and Nutrition Examination Survey. Results. The study included 2,222 participants. Those diagnosed with panic disorder were more likely to be female, unmarried, have lower income, engage in higher rates of smoking, and exhibit greater alcohol consumption. Participants who smoke cigarettes occasionally indicated a significant increase in panic disorder (unadjusted OR 95% CI: 4.396 [2.032-9.513]; P < 0.001). The significance of our results remained even after performing the multivariate analysis (full-adjusted OR 95% CI: 2.89 [1.30-6.42]). Furthermore, participants who never smoked cigarettes demonstrated strong and significantly low odds for panic disorder, regardless of adjustment (unadjusted OR 95% CI: 0.180 [0.055-0.591]). There was no association between pipe and cigar smoking and panic disorder in both unadjusted and full-adjusted models. Conclusion. This study highlights that smoking remains a significant risk factor for panic disorder, even after accounting for potential confounding variables. Further prospective longitudinal research should be done to investigate the causality between smoking and panic disorder.