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Research indicates that exposure to stressful life events (e.g., divorce, death of a loved one) is associated with nicotine dependence [8]. In addition, traumatic childhood events (e.g., sexual or physical abuse) are associated with high rates of cigarette smoking and nicotine dependence in adulthood [910]. For example, a comparison of current smokers to non-smokers (N=57) without other psychiatric disorders or SUDs indicated that current smokers were more likely to have experienced severe abuse as a child and individuals exposed to childhood trauma were four times more likely than individuals not exposed to childhood trauma to smoke cigarettes as an adult [11].

Smoking rates are also higher among individuals with PTSD than in the general population [12]. Three main reasons why nicotine dependence may be related to trauma exposure and PTSD include: (1) Individuals may use nicotine to cope with the stress of the traumatic events, which is supported by evidence in that nicotinic acetylcholine receptors (nAChRs) may modulate the function of pathways in the brain involved in the stress response