Maryland's Tobacco Resource Center - Linking Professionals to Best Practices

Agoraphobia

Agoraphobia is a mental illness characterized by an extreme unrelenting anxiety or panic experienced as a result of being present in an undesirable situation, with respect to the individual.1 Often it is accompanied by an unjustified fear that escape from the situation would either be extremely difficult or even embarrassing; which directly leads to increased levels of anxiety. As a result, individuals who experience these symptoms have a strong tendency to avoid the situations that would increase their anxiety. The most common form is avoidance of public places, particularly crowds or large gatherings of strangers.1 However, avoidance is not always the most ideal way to cope with the anxiety as excessive evasion of a situation tends to further increase levels of anxiety. In addition, many situations are simply unavoidable; including occupational, educational, medical, or legal situations that require their presence. Under these conditions where avoidance is not an option, individuals with Agoraphobia may resort to tobacco to manage their symptoms.

 

Diagnosed with AgoraphobiaPercentage
U.S. population5.4
Current smokers38.4
Lifetime smokers58.9

Agoraphobia and Smoking

All things considered, it is understandable that almost 60% of Americans diagnosed with Agoraphobia have been smokers at some point in their life.2 Similar to other anxiety disorders, individuals with Agoraphobia tend to have higher rates of smoking associated with higher anxiety provoking situations. Typically there is a distinct relationship between the number of cigarettes smoked and qualitatively higher rates of anxiety. There is some concern that the relationship of Agoraphobia and cigarette smoking starts early on, a recent study correlated an elevated risk of developing Agoraphobia with heavy smoking habits of adolescents.3 Although individuals diagnosed with Agoraphobia have high rates of smoking, they are just as determined to quit as the general population. Roughly 34.5% of lifetime smokers with Agoraphobia have successfully quit and would now label themselves as ‘non-smokers.2 As impressive as this sounds, well over half of the Agoraphobic population are still dealing with co-morbidity issues from both their mental illness as well as their dependence on tobacco.

References: 
  1. United States Library of Medicine, PubMed Health (2010, March 30). Panic Disorder with Agoraphobia. Retrieved October 3, 2011, from http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001921/
  2. Zvolensky, M. J., Feldner, M. T., Leen-Feldner, E. W., & McLeish, A. C. (2005). Smoking and panic attacks, panic disorder, and agoraphobia: A review of the empirical literature. Clinical Psychology Review, 25(6), 761-789. doi:10.1016/j.cpr.2005.05.001
  3. Johnson, J. G., Cohen, P., Pine, D.S., Klein, D.F., Kasen, F., Brook, J.S. (2000). Association between cigarette smoking and anxiety disorders during adolescence and early childhood. Journal of the American Medical Association. 284(18):2348-2351. doi: 10.1001/jama.284.18.2348