Nicotine Withdrawal Induces Panic Response

Individuals addicted to nicotine can exhibit unique responses when they are deprived of a cigarette. Many people report being anxious, snappy, or moody when they try to quit smoking. All of these responses are common. But for people with panic disorder (PD), going without a cigarette may trigger a panic attack. According to a recent study conducted by Teresa M. Leyro of the Department of Psychiatry at the University of California in San Francisco, people with anxiety problems and a history of panic attacks in particular are more likely to smoke than people without a history of anxiety-related problems. However, few studies have looked at how nicotine cessation, an event that can cause tension and stress in individuals with no history of anxiety, affects those with a predisposition to panic.

Leyro enlisted 58 adult smokers and exposed them to bodily sensations designed to elicit fear or anxiety. The participants were comprised of individuals with and without a history of PD, and all reported smoking approximately 20 cigarettes a day. The experiment was conducted after they had gone without smoking for 12 hours to allow sufficient time for withdrawal symptoms to occur. Leyro discovered that the participants with severe PD and the most significant withdrawal had the highest rates of panic symptoms after the experiment.

These results suggest that individuals with PD may catastrophize their circumstances and be more sensitive to physical cues when in a heightened state of anxiety. Additionally, these same individuals took longer to recover from their panic than those with low withdrawal symptoms. However, Leyro also found that the participants without PD and with low levels of withdrawal had elevated panic symptoms, too. This could be due to the fact that in the absence of withdrawal symptoms, these individuals may have been overly stimulated by fearful or threatening emotions when they experienced the physical sensations. Leyro hopes that these findings open up avenues of further research. She added, “This line of inquiry can shed light on the etiology of panic psychopathology among smokers and ultimately inform the development of novel specialized interventions for this difficult-to-treat population.”

Leyro, T. M., Zvolensky, M. J. (2012). The interaction of nicotine withdrawal and panic disorder in the prediction of panic-relevant responding to a biological challenge. Psychology of Addictive Behaviors. Advance online publication. doi: 10.1037/a0029423

Related articles:
Three Steps for Dealing with Panic Attacks
Identifying and Treating Addiction and Substance Abuse Problems

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The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by Questions or concerns about the preceding article can be directed to the author or posted as a comment below.

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  • Nikki g

    Nikki g

    August 15th, 2012 at 11:29 AM

    This feeling of panic could be one big reason why so many smokers have such ahard time cutting out the habit. They try to stop, and they really do want to end that addiction, but ending it cuts off that supply of nicotine that they are used to, and then they go into this self induced panic mode. Then the only way that they know to end the panic is to what? of course, fire up a cigarette and physically they feel better again. But inside many of them are so angry with themselves because they can’t seem to make it over that hump and give it up altogether. Perhaps what more smoking cessation programs should begin to look at then are ways to help these smokers who are trying to give up the habit come up with better ways for managing those feelings of panic and offering them ways to reduce those feelings when they arise.

  • Matthew b

    Matthew b

    April 1st, 2019 at 6:52 PM

    My name is Matthew and I am a recovering alcoholic in progress the real quit smoking for the last 6 and 1/2 + years was the fact that I drowned myself in so much alcohol and I forgot about the withdrawal I knew it was a last ditch effort but it worked that just made my alcoholism worse although by over the years I’m done very well staying sober for extended periods of time farewell staying out the cigarettes without much effort but the only problem is I I’m dumped with all this crazy hypnotic drunk and hoopla I never really seems to go away and every time I forget the misery of the last binge it just gets worse every time and when I forget the pain I can’t recreate the Euphoria like I used to I’m 34 by the way

  • tru


    August 15th, 2012 at 1:32 PM

    So maybe instead of a nicotine patch they need to somehow come up with a patch with anti anxiety meds instead! Control release meds that will keep the panic at bay

  • Alli


    August 15th, 2012 at 3:48 PM

    Panic attacks, lung cancer, emphysema, stinky breath. .
    What on earth does any of this hold for me that says “hey maybe I should start smoking?”

    Duh!! Nothing!!

  • Matt


    June 21st, 2015 at 5:17 PM

    How is this comment relevant to the discussion at hand?

  • Jdub123


    October 28th, 2017 at 7:28 AM

    Your comment is the comment from a person who hasn’t had tobacco. It’s the buzz and relaxing euphoric feel people get when lighting up. Im sure most people wouldn’t do it if there was only negatives or pain associated with it.

  • lakisha spence

    lakisha spence

    August 16th, 2012 at 4:32 AM

    One thing that over the years I have noticed about heavy smokers is that not only is this a habit, but smoking has become their way of coping or dealing with anything remotely stressful that comes their way. They think that to deal, they have to have a cigarette! So no wonder they feel a sense of panic when they don’t have this security blanket of theirs anymore. They re expected to go without that one thing in their lives that has allowed them to cope with situations, even if it was not the healthiest way to go about handling that pressure. So to take that away without also providing them with different ways to manage that stress is very unreasonable. We all have to have something to fall back on. Many of us are lucky that ours is not a vice such as smoking or deinking, but let’s have a little compassion for those who do suffer from these addictions, and instead of laying out so much judgement, why not give some thoughts on ways that they could handle this a little more productively instead.

  • Ginny hunt

    Ginny hunt

    August 17th, 2012 at 10:49 AM

    Just thinking about throwing away the cigarettes for good makes me panic!

    I know I would be healthier and probably happier too, but. . . there you go. Not ready.

  • Amanda


    September 13th, 2019 at 2:12 PM

    I’m on day 6 and the anxiety and panic has just started. Praying it doesnt last long, because like it is stated to relieve it is to get some nicotine.

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