Smoke Gets in YourMind

Lungcancer,hypertension,heart disease,birth defects一we are all too familiar with the dangers of smoking. Butadd to that list a frightening new concern一mental

illness.According tosome controversial new findings,if smoking does not kill you,it may,quiteliterally,drive you to despair.

2.The tobaccoindustry openly pushes its product as something to lift your mood and sootheanxiety.But the short-term feel-good effect may mask the truth that smoking may

worsen or eventrigger anxiety disorders,panic attacks and depression,perhaps evenschizophrenia.

3.Cigarettes andmental illness have always tended to go together. An estimated 25 billionpeople smoke worldwide.Yet people who are depressed or anxious are twice as

likely to smoke,andup to 88 percent of those with psychotic disorders such as schizophrenia aresmokers.A recent American survey concluded that around half of all

cigarettes burn inthe fingers of those with mental illness.

4.But the bigquestion is why?The usual story is that the illness comes first. Mentally illpeople take up smoking,or smoke more,to alleviate some of their distress.Evenwhen

smoking seems tostart before the illness,most doctors believe that early but invisible symptomsof the disorder spark the desire to light up.But perhaps something more

sinister is goingon.

5.A growing numberof researchers claim that smoking is the cause,not the consequence of clinicaldepression and several forms of anxiety."We know a lot about the effects

of smoking onphysical health,and now we are also starting to see the adverse effects in newresearch on mental illness,"says Naomi Breslau,director of research at theHenry

Ford Health CareSystem in Detroit.

6.Breslauwas one of the first to consider this heretical possibility.The hint came fromstudies, published in 1998,which followed a group of just over ,000 youngadults for

a five-yearperiod.The 13 percent who began the study with major depression were aroundthree times more likely to progress from being light smokers to daily smokers

during the course ofthe study,though there was no evidence that depression increased the tendencyto take up smoking. But a history of daily smok-- ing before the study

commenced roughlydoubled the risk of developing major depression during the five-year period.Smoking,it seems,could pre-date illness.

7.At first Breslauconcluded that whatever prompts people to smoke might also make themdepressed.But as the results of other much larger studies began to back the

statistical link,shebecame more convinced than ever that what she was seeing were signs thatsmoking,perhaps the nicotine itself,could somehow affect the brain and cause

depression.

8.One of theselarger studies was led by Goodman,a pediatrician.She followed the health of twogroups of teenagers for a year. The first group of 8,704 adolescents were not

depressed,and mightor might not have been smokers,while the second group of 6,947 were highlydepressed and had not been smokers in the past month.After a year her

team found thatalthough depressed teenagers were more likely to have become heavysmokers,previous experimentation with smoking was the strongest predictor ofsuch

behaviour,not thedepression itself. What is more important is that teenagers who started outmentally fit but smoked at least one packet per week during the study were four

times more likely todevelop depression than their non一smoking peers.Goodman says that depression does not seem to startbefore cigarette use among teens."Current

cigarette useis,however,a powerful determinant of developing high depressive symptoms."

9.Breslau,too,findsthat smokers are as much as four times more likely to have an isolated panicattack and three times more likely to develop longer-term panic disorder than

non-smokers.It's ahard message to get across,because many smokers say they become anxious whenthey quit,not when they smoke.But Breslau saysthatBreslau'sstudy________than Goodman's but lasted longer.

A.have been provedto be misleading

B.but to theirmental health as well

C.taking up smoking

D.involved fewerpeople

E.they started tosmoke at an early age