TUESDAY, Nov. 7 (HealthScout) -- Young people who smoke are likely to become adults with anxiety disorders, a new study finds, and experts believe it's because the habit can leave them literally gasping for breath.

Nearly a quarter of a million girls will start smoking in the coming year.The study, which followed 688 teen-agers for six years, found that those who smoked a pack or more a day had a substantially increased risk of mental problems such as agoraphobia (the fear of open places) and panic disorder. The study by researchers at the New York State Psychiatric Institute and Columbia University appears in the Nov. 8 Journal of the American Medical Association. Previous studies have shown that adult smokers are more likely to have anxiety disorders, says Patricia Cohen, a principal research scientist at the institute, but it has been uncertain whether an anxiety disorder causes some people to reach for a cigarette or whether the smoking causes the mental problem. "According to our data, the effect is clear. It goes from cigarette smoking in adolescence to adult anxiety disorders. Adolescents who smoked did not have an elevated incidence of anxiety disorders in adolescence, but they did when they became adults," she says. Dr. Donald Klein, head of research at the institute, suggests one plausible mechanism for the relationship is that respiratory problems contribute to panic disorders. The teenagers in the study were first interviewed in 1985 and 1986, when their average age was 16. They were interviewed again in 1991 and 1992, when their ages averaged 22. Think you're calming your nerves? In the first interviews, the incidence of anxiety disorders among teenagers who smoked at least a pack a day was 6 percent. In the later interviews, 68 of the 104 (or 65 percent) now-young-adult participants who smoked a pack or more a day reported having anxiety disorders. To single out the effect of smoking, the researchers asked about others factors that could be associated with anxiety disorders, such as alcohol and drug use, difficult childhood, temperament, depression and educational level. "After controlling for covariates, adolescents who smoked 20 cigarettes or more per day were at elevated risk for agoraphobia [6.8 times greater risk], generalized anxiety disorder [5.5 times greater risk] or panic disorders [15.5 times greater risk] during early adulthood," the report says. Further studies are needed to determine specific physical and psychological factors that increase the risk of cigarette smoking and anxiety disorders, Cohen says. "This study does break new ground," says Matthew Meyers, chairman of the Campaign for Tobacco-Free Kids. "First, it identifies a very serious health problem that occurs almost immediately, not over 20 years, like lung cancer. Second, it has long been a myth that smoking is a way to calm your nerves and settle yourself. This blows a hole in the only explanation that many give for why they smoke." Surveys show that about a third of teenagers smoke, a number that has remained consistent over the years, Meyers says. That rate is higher than the rate in the general population, and "in the United States, there are 1 million new teenage smokers every year," he says. The study could be used as ammunition against that trend, say the Columbia researchers. By telling teens about the mental problems they might face, "it may be possible to increase the effectiveness of interventions that are designed to persuade young people to stop smoking cigarettes and to avoid initiating cigarette use." What To Do Are you a young smoker? This study says the habit just might give you health problems sooner, not at some point in life that you may think is an eternity away. If you're thinking of giving up the habit, you'll have a lot of company next week. Nov. 16 is the 24th annual Great American Smokeout. Keep your goal simple: Just get through the day without firing one up and worry about Friday on Friday. The Campaign for Tobacco-Free Kids has more about smoking and youth.

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