Smoking as a complex but critical covariate in neurobiological studies of
posttraumatic stress disorders: a review
Ann M. Rasmusson1*,
Marina R. Picciotto2,
Suchitra Krishnan-Sarin2
1 Department of Psychiatry, Yale University School of Medicine, New
Haven, CT, USA. VA National Center for PTSD Clinical Neuroscience Division, West
Haven, CT, USA
2 Department of Psychiatry, Yale University School of Medicine, New
Haven, CT, USA. Yale Transdisciplinary Tobacco Use Research Center, New Haven,
CT, USA
* To whom correspondence should be addressed.
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Abstract |
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As smoking rates in the general population continue to fall in response to new
information and changing social values, the continued high rate of smoking among persons
with psychiatric disorders has caught the attention of society at many levels: public
health officials, medical and mental health care providers, and concerned family members
alike. As a consequence, research studies aimed at quantifying the problem and
understanding its cause have increased dramatically over the past several years. The
following review first examines epidemiological studies that have revealed a
bidirectional causal relationship between tobacco dependence and posttraumatic stress
disorder (PTSD), one of several mental health disorders in which tobacco dependence
remains prevalent and resistant to intervention. Second, we use a translational
neuroscience perspective to discuss possible neurobiological mediators of the
relationship between PTSD and tobacco dependence, hoping to spur further human and
animal research that will elucidate pathogenetic mechanisms involved and inspire novel
treatment interventions. Finally, to enable more effective clinical research in this
area, we provide an overview of effective scientific methods for assessing and managing
'smoking status' as an experimental variable in clinical research studies of PTSD as
well as other mental health disorders.
Key Words:
smoking, nicotine, PTSD, HPA axis, fear conditioning, passive avoidance, transgenic mice, nicotinic receptors, stress, cortisol, neurosteroids
