Generalized Anxiety Disorder

People with generalized anxiety disorder (GAD) go through the day filled with exaggerated worry and tension, even though there is little or nothing to provoke it. They anticipate disaster and are overly concerned about health issues, money, family problems, or difficulties at work or school.

Generalized anxiety disorder is characterized by excessive anxiety and worry, in addition to the difficulty of the individual to control that worry. The intensity, duration or frequency of the anxiety is extremely out of proportion with respect to the context and the actual impact of the anticipated event.1 Although individuals diagnosed with this mental disorder do not report an ‘excess’ of worry, they do identify the worries as consistent, persisting, difficult to control and disruptive to normal daily functioning. Many individuals now diagnosed with Generalized Anxiety Disorder report having high levels of anxiety and nervousness all their lives. In fact, more than half of these individuals report having symptoms of the disorder during childhood or early adolescence.1 Dealing with many of these unfamiliar symptoms could result in an increase of stress levels; which without proper treatment might lead these fragile adolescents to look for ways to self-medicate.

Diagnosed with GADPercentage
U.S. population4.8
Current smokers46.0
Lifetime smokers68.4

Generalized Anxiety Disorder and Smoking

Cigarette smoking among adolescents remains a major public health concern in the society that we live in and given the frequent persistence of this behavior into adulthood, these behaviors result in significant health risks for the population.

  • Adolescent smoking is highly co-morbid with psychiatric and substance use disorders and adolescent smokers with psychiatric co-morbidity may be especially at risk for persistence of smoking into adulthood.2
  • In a recent study of psychiatrically hospitalized adolescents, results showed a correlation between the age of symptom onset and the age of smoking initiation.3
  • For generalized anxiety disorders, as well as most anxiety disorders, the 1-year prevalence in children ages 9-17 is roughly 13%.4   
  • In this particular study, they found that 58.5% of these adolescents have been daily smokers before the age of 18 and smoked an average of 14.3 cigarettes per day.3

In a similar study where researchers were attempting to explain the associations between anxiety disorders and smoking, it was found that 67.8% of individuals diagnosed with GAD reported smoking regularly prior to the age at which they developed the disorder.5 The complex relationship between general anxiety disorder and smoking is not yet fully understood, but it is apparent that the are associations between the two may be developing during adolescence. 



1. American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text rev.). Washington, DC: Author2. Brown, R. A., Lewinsohn, P. M., Seeley, J. R., & Wagner, E. F. (1996). Cigarette smoking, major depression, and other psychiatric disorders among adolescents. Journal of the American Academy of Child & Adolescent Psychiatry, 35(12), 1602-1610.3. MacPherson, L., Strong, D. R., Kahler, C. W., Abrantes, A. M., Ramsey, S. E., & Brown, R. A. (2007). Association of post-treatment smoking change with future smoking and cessation effects among adolescents with psychiatric comorbidity. Nicotine & Tobacco Research, 9(12), 1297-1307.4. Shaffer, D., Fisher, P., Dulcan, M. K., & Davies, M. (1996). The NIMH Diagnostic Interview Schedule for Children Version 2.3 (DISC-2.3): Description, acceptability, prevalence rates, and performance in the MECA study. Journal of the American Academy of Child & Adolescent Psychiatry, 35(7), 865-877.5. Cougle, J. R., Zvolensky, M. J., Fitch, K. E., & Sachs-Ericsson, N. (2010). The role of comorbidity in explaining the associations between anxiety disorders and smoking. Nicotine & Tobacco Research, 12(4), 355-364.