COPD Patients with History of Smoking Priory Have Stress and Anxiety


COPD is a lung disease with huge extra-pulmonary effects that could affect patients’ severity of the symptom. The condition causes blockage of airflow and problems related to breathing. The disease is highly prevalent in every corner of the world. The prevalence of this disease is different in different countries, but its prevalence rate is around 10% in people 40 years of age and above (Moylan et al., 2013). In first-world countries, the disease is claimed to cause about 4% of the total deaths and is a condition whose burden continues to elevate. Depression and anxiety are well-known significant COPD comorbidities. As a result, there has been increased research and clinical interest in reducing the considerable impact of these important comorbidities in patients with this disease (Yohannes & Alexopoulos, 2014).  This study provides an overview of how anxiety and depression are associated with COPD and the prevalence and impact of these conditions. Areas of need for future research are also mentioned. Through the analysis of information from other studies, this study finds that stress and anxiety result in smoking, contributing to COPD disease development. The anxiety and smoking relationship is complex, but cigarette smoke can reduce anxiety in some smokers, which is why most people smoke.

Problem Statement

Most individuals with COPD or chronic obstructive pulmonary disease experience anxiety at high levels. Studies reveal that COPD symptoms may indicate a threat to the brain. The brain could react by triggering a panic attack or causing stress. Most people with COPD have a significantly higher likelihood of anxiety (Yohannes & Alexopoulos, 2014). Notably, there is a relationship between depression and anxiety and COPD, but there is not much known concerning the possible mechanisms of this relationship. There lacks of clarity on how anxiety and stress result in smoking. Most studies fail to indicate any federal step that needs to be taken to prevent stress and disorder. Besides, studies fail to mention other diseases caused by stress and depression. Also, no study notes why some smokers live healthy, free from COPD. The current study examines whether stress and anxiety influence people to smoke, making them susceptible to COPD.

 Purpose of Study

The relationship between COPD, stress, and anxiety is likely to be bidirectional, as stress and anxiety may be both a consequence and a cause of COPD. However, the exact mechanisms linking stress and anxiety with COPD have not been well studied. The interrelationship between COPD, stress, anxiety, and smoking is unclear. Smoking elevates the severity and risk of COPD, making daily activities stressful and effortful (Laniado-Laborín, 2009). Anxiety or stress increases the risk of smoking in patients with COPD. Studies indicate that the relationships between COPD and anxiety or stress disorders could be primarily explained by factors, such as the previous history of nicotine dependence and cigarette smoking. However, stress and anxiety appear to result in smoking, resulting in COPD (Moylan et al., 2013). Therefore, these associations do not allow conclusions about whether stress and anxiety result in smoking which further results in COPD, or whether COPD results in stress and anxiety, which other influence smoking. Therefore these factors point out the need for further studies to come up with a better conclusion. The purpose of this study is to determine whether stress and anxiety result in smoking, which further leads to COPD. The study hypothesizes that stress and anxiety influence people to smoke, making them susceptible to COPD.

Review of the literature

Depression, anxiety, and stress are reported to be the most common comorbidities in smokers with COPD. Most people feel stress continuously, which affects their bodies in negative ways. For example, chronic stress can weaken their immune system, and notably, individuals who are stressed often feel depressed, irritable, and anxious. When a person is stressed, they might end up smoking to reduce stress levels. As a result, it may lead to chronic obstructive pulmonary disease frequent flare-ups symptoms. According to Llordés, 2014 chronic obstructive pulmonary disease is mainly caused by smoking cigarettes or long-term exposure to lung irritants. The study indicates that in every four people in America with COPD, 1 of them has never smoked cigarettes. However, smoking is linked to as many as eight out of ten COPD deaths and 38 percent of American adults diagnosed with COPD. Secondhand smoke exposure and smoking itself, especially during teenage and childhood, can slow lung development and growth. This increases the risk of COPD development in old age years. According to Goodwin, 2011 anxiety, depression, and smoking increase the death risk in individuals with COPD, but these factors’ combined effect is not well known. Some of the increased rates of depression risk factors include gender and living alone.

Women have a higher anxiety and depression rate, and depression rates are more substantial and severe than males. This applies to people living alone since they spend most of their time overthinking. For these reasons, these two groups of people are most likely to end up smoking, which increases their chances of developing COPD. Like other chronic diseases, chronic obstructive pulmonary disease has a huge impact on the psychological well-being of affected people. Individuals with this disease have a higher prevalence of anxiety and depression than the general population (Llordés et al., 2014). These patients have a higher risk of developing depression. In severe conditions, the anxiety and depression rates could even be more prevalent among people with COPD than those with other chronic diseases.


For this study, medical databases are searched, including information from five other essential studies that concentrated on the same topic. Terms such as “anxiety,” “anxiety disorder,” “stress,” “tobacco,” “smoke,” “cigarette”, “nicotine”, “oxidative stress”, and “COPD” were used in various combinations to identify essential papers for the study. The study does not limit the search by year of publication but only limits to publications done in the English language. All the bibliographies of selected papers are searched for relevant and applicable information. The study concentrates on determining COPD prevalence among smokers who report feeling stressed and depressed. The study’s target population includes all people over 45 with a history of smoking in their medical records.


Evidence from the reviewed studies indicates that people with increased anxiety and high-stress levels are more likely to smoke. The literature from these studies has revealed an association between increased anxiety symptoms or disorders and smoking of cigarettes, with childhood exposures potentially predisposing to increase anxiety responses in older days life. The reviewed studies have suggested that increased anxiety increases the risk of cigarette smoking. Nicotine creates an immediate relaxation sense, so individuals smoke, believing it reduces anxiety and stress. The feeling is not permanent and therefore gives way to withdrawal symptoms and cravings. On top of this, smoking increases the increased anxiety development risk.

The COPD presence is associated with older age and female sex. All respiratory symptoms are highly related to the COPD diagnosis as well as higher smoking. COPD is mainly caused by smoking cigarettes, although exposure to other lung irritants can also contribute to this disease in the long term.  Nicotine usage is highly related to COPD or chronic obstructive pulmonary disease. Smoking cigarette triggers flare-ups of COPD (Goodwin et al., 2011). Smoking damages the airways, the lining of the lungs, and air sacs. Injured lungs struggle to move enough air in and out, and therefore it is hard to breathe. Quitting smoking is the best thing to protect the lungs and stay away from COPD.  For successful smoking stopping, it is essential to understand the barriers smokers face that affects their efforts to quit smoking. To arrive at a successful smoking cessation that is lasting, it is good to ensure that the smoker has an internal motivation to decide to stop first. Psychological therapy, including counseling and cognitive behavioral therapy, may improve anxiety and depressive symptoms in patients with COPD. This helps in enjoying life and staying more active.