Addiction and Anxiety: What the NESARC Study Tells Us About the Comorbidity Between Smoking and Generalized Anxiety Disorder
Dataset Selection
For this data analysis project, we chose the U.S. National Epidemiological Survey on Alcohol and Related Conditions (NESARC).
NESARC is ideal as a representative sample of the U.S. adult population and provides detailed data on mental health and substance use, allowing for robust testing of comorbidity hypotheses.
Association of Interest
The focus of my research is to explore the association between Generalized Anxiety Disorder (GAD) and Nicotine Dependence.
Topic 1: Nicotine Dependence (TABLIFEDX) Topic 2: Generalized Anxiety Disorder (GENAXLIFE)
Research Question and Hypothesis
Research Question: Are individuals with a lifetime reported history of Generalized Anxiety Disorder (GAD) (GENAXLIFE) more likely to have a lifetime diagnosis of Nicotine Dependence (TABLIFEDX) than those without a history of GAD?
Clear Hypothesis:
The presence of a lifetime diagnosis of Generalized Anxiety Disorder (GENAXLIFE = Yes) will be significantly associated with an Odds Ratio greater than 1.0 for a lifetime diagnosis of Nicotine Dependence (TABLIFEDX = Yes) in the NESARC population.
Literature Review
Search Terms Used
NESARC comorbidity anxiety nicotine dependence
Generalized Anxiety Disorder Nicotine Dependence association epidemiology
Summary of Findings (Patterns and Variables)
The epidemiological literature demonstrates a strong comorbidity, indicating that:
Pattern: Individuals with anxiety disorders exhibit significantly higher rates of nicotine dependence. The self-medication mechanism is a central hypothesis, where nicotine is used to modulate or reduce the tension and hyperexcitability characteristic of GAD.
Controlling for Variables: Researchers in the fields of public health and psychiatry consistently controlled for variables such as age and sex, as they are known to influence the prevalence of both disorders.
Key Reference (Example)
James M. Zech, Tapan A. Patel, Jesse R. Cougle, et al. (2025). Prevalence and Correlates of Alcohol, Cannabis, and Tobacco Use Disorder in DSM-5 Generalized Anxiety Disorder: Findings from the National Epidemiologic Survey on Alcohol and Related Conditions-III.
This recent NESARC-III research validates the focus on the high correlation between Tobacco Use Disorder (Dependência de Nicotina) and Generalized Anxiety Disorder, strongly supporting the proposed hypothesis involving the variables GENAXLIFE and TABLIFEDX.
The focus of our analysis requires the use of five variables from the NESARC dataset. The Dependent variable is the diagnosis of lifetime Nicotine Dependence (TABLIFEDX). The Main Independent Variable is the Diagnosis of Generalized Anxiety Disorder (GENAXLIFE). In addition, we will include variables such as age (AGE), sex (SEX), and race/ethnicity (ETHRACE2A) in the model to control for potential demographic confounding factors.
