About one in three people who experience extreme trauma later suffer from PTSD; the new study from Karestan Koenen and colleagues at the Harvard School of Public Health says that smoking is a major risk factor for developing PTSD.

"Nicotine stimulates some of the same neurobiological pathways -- the dopaminergic pathway associated with reward and fear -- implicated in stress and addiction," Koenen said. "Smoking may sensitize these pathways, so a subsequent severe stressor is more likely to give someone PTSD."

The researchers based their conclusions on a study of 6,744 pairs of male twins who had served in Vietnam; about half were identical twins.

Koenen said it was unclear whether quitting smoking would reduce PTSD risk, but urged the military to prevent smoking among soldiers and pay special attention to troops with a history of smoking who are exposed to combat stress.

The study appears in the November 2005 issue of the Archives of General Psychiatry.

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