Smoking and cardiovascular risk: Role of stress in the genesis of smoking behavior

Abstract

Smoking is an acknowledged - and significant - risk factor for cardiovascular disease (CVD). Research into the causes of smoking behavior is extensive, but few would disagree that smoking is a discretionary human behavior acquired through the operation of a combination of well-understood psychological mechanisms. This chapter considered the role of psychological stress in its many forms - and including psychological illness - in the genesis of smoking behavior. While the evidence is both widespread and various, the collective view is that stress plays a very clear role in the maintenance of smoking behavior, and in the frequency of tobacco consumption, in well-established adult smokers. More than this, however, there is growing evidence that psychological distress experienced in adolescence is causally related to the onset of smoking behavior in that age group. Public health programs to prevent smoking onset among adolescents - as part of continuing efforts to lower the incidence of CVD in adults - must therefore include components of stress reduction and management in addressing this crucial issue.