Up in Smoke: The Effect of PTSD on Smoking Behaviors in College Students

The transition from high school to college is one of the most dramatic transitions a person will make in their lifetime. Students who go away to college experience unsupervised freedom, in addition to exposure to new and exciting things. Many college students experiment with new activities, new relationships, and new risky behaviors during their first year away from home. Alcohol consumption, drug use, and smoking are among the most common activities that first-year students are exposed to. Although many teens may have already been introduced to some of these activities in high school, the frequency of them tends to be more visible, tolerated, and prevalent in the college environment. Cigarette smoking is one behavior that can have long-term negative health consequences. Understanding the factors that contribute to smoking escalation during the first year in college can help researchers design effective and applicable cessation interventions.

Post-traumatic stress (PTSD) has long been linked with negative coping strategies. For students with a history of PTSD symptoms, the added social, financial, and academic pressure of entering college may exacerbate the stressful symptoms of PTSD and result in higher rates of smoking. To test this theory, Jennifer P. Read of the Department of Psychology and the University at Buffalo of the Statue University of New York recently assessed 346 self-reported smokers as they entered their freshman year of college. She evaluated their levels of PTSD and their smoking frequency prior to the beginning of fall classes, and five more times throughout their first academic year.

Read discovered that the transition from high school to college directly increased smoking frequency in all of the students, with or without PTSD. Upon further examination she found that the students without PTSD saw a slight increase in smoking during the fall semester but then a decline during the spring semester. In contrast, the participants with PTSD saw the same increase in the fall, but significant and steady increases throughout the spring. These findings suggest that the students with PTSD may rely more heavily on smoking as a coping mechanism as their college experience unfolds. Read added, “Taken together, this suggests that it may be how those with PTSD manage the challenges of the college environment over time that is relevant for smoking behavior.” She hopes that these findings help identify first-year college students at risk for negative coping strategies such as smoking.

Read, J. P., Wardell, J. D., Vermont, L. N., Colder, C. R., Ouimette, P., White, J. (2012). Transition and change: prospective effects of posttraumatic stress on smoking trajectories in the first year of college. Health Psychology. Advance online publication. doi: 10.1037/a0029085

Related articles:
Mental Health Issues to Be Aware of in Your 20s
Social Anxiety Can Be a Hidden Problem in College
How Schools Could Prevent Depression

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  • Tara d

    Tara d

    August 24th, 2012 at 10:35 AM

    I remember my first year of college and wanting so desperately wanting to fit in with the cool crowd, so I took up smoking. Hey, that was when it was still considered cool to pull out a pack of Marlboro’s and not insanely stupid. What I am getting at is that I in no way had PTSD, had never had anything remotely terrible happen to me- the worst was a few bad hair days in high school! But this is something that you do when you get to college to try to impress or fit in, and no matter what kind of environment you were raised in chances are that this is something you will try when you first move away from home. I am fortunate in that it never really became habitual for me so that when I graduated and wa sready to stop, I quit just like that. But I think that if you think that it has to be a child with some kind of traumatic past who will start smoking to cope when he gets to college that’s leaving out an entire segment of the population who could also be at risk to start smoking too.

  • Minson


    August 24th, 2012 at 2:39 PM

    Started smoking in my freshman year and it really did make me and my friends feel like it got our pressure off our shoulders.It felt like a great thing to help us cope with stress and problems.It was almost like we could burn and send away our worries up in smoke.Shift to senior year and each one of us saw just how nasty cigarettes were and discouraged our junior friends from doing the same mistake we did.It was not our stress and worries that was going up in smoke,it was our health!And I hope nothing bad happens to any of us due to the two or so years of smoking but I really regret that when I look back at my college life.

  • A.Carter


    August 24th, 2012 at 11:35 PM

    While it is not difficult to understand that those with PTSD would lean more towards smoking, my question is-they are looking for a coping technique for their PTSD but why does smoking become that coping technique?Is it because these young adults are not aware of the real and healthy coping techniques?Are they unaware or is it sheer peer pressure?

  • mae


    August 25th, 2012 at 4:31 AM

    There is nothing that I want to use LESS as a coping mechanism than a cigarette! Give me a good glass of wine anytime!

  • Rosalyn


    August 25th, 2012 at 10:24 PM

    This calls for targeted anti-smoking campaigns especially for those with PTSD. And if it is difficult or not known as to which students in a college have PTSD I think this excessive smoking vulnerability will help us find out!

  • Desert Snow

    Desert Snow

    August 26th, 2012 at 11:23 AM

    “Read discovered that the transition from high school to college directly increased smoking frequency in all of the students, with or without PTSD.”

    This is something to be paid attention to. After all the awareness campaigns and drives we still have so many youngsters turn to smoking, even though it is proven beyond doubt that smoking is extremely injurious to health. What is the reason? Are we really this stupid or is it the money that talks? Money from Big Tobacco!

  • mason


    August 27th, 2012 at 5:57 PM

    So it helps you cope with a big ole problem- better than staying all stressed out and worried all the time. Plenty of time to think about quitting when you are out of school and making some funds and have better things going on in life. College is the ultimate time to enjoy life- so why not have a smoke now and then? We know it’s bad, yeah, but so are lots of other things that we never hear people getting chastised for. I think that for the most part I speak for many fellow smokers by saying that for once I wish people would just lay off of us, we know this is n’t the best thing in the world to do but it sure ain’t the worst either. So let us deal with our pressure in our way, you deal with yours in your way, and leave it at that. I’ll quit when I’m ready.

  • Jonah


    August 28th, 2012 at 4:23 AM

    Hey Mason, there are some other ways you can blow off steam other than lighting up a cigarette, man. How about getting involved in intramurals or some other campus activity? Anything like that would be a WHOLE lot better pressure reliever as well as help undo some of that damage that you are doing to your body by holding on to all that stress and then perceiving to work through it with a smoke. Man, smoking raises the blood pressure (not so good for someone with all of that stress in life to begin with!) and it leads to other breathing problems and cancer. Looking at all of that, who wouldn’t you want to comes up with a healthier plan for living?

  • fit-to-freak


    August 23rd, 2013 at 3:18 AM

    lol so much bullshit on this page- people acting as though it’s super easy to pick good coping mechanisms when you have ptsd. Oh and a campaign targeting students with ptsd, that’s great cause it’s not like we don’t get enough shit already. People are so invested in judging what survivors turn to (alcohol, drugs, self harm) but they don’t care about actually helping us. Jesus christ, murals, Jonah? Well, gosh, clearly you just have everything figured out, why didn’t I think of that?? Wtf, do you really think the real issue at play here is people with ptsd not caring about a ‘healthier living’? If you guys actually give a damn about students with ptsd using drugs to cope, maybe you should start by working on the rates of rape and sexual assault on campus. Or at least forcing colleges to be more supportive of students with mental health disabilities. Ya’ll are so full of it.

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