Stress coping mechanisms in smoking psoriatics

Abstract

Background

The link between emotional stress and smoking has previously been investigated and results have suggested that smoking is used as a way of dealing with stress. There are many studies indicating the relationship between smoking and psoriasis or emotional stress and psoriasis. However, to our knowledge, the link between smoking associated with emotional stress and psoriasis has not been shown before. Our aim was to investigate psoriatic patients' abilities to cope with stress, the relationship between coping strategies and smoking habit.

Methods

Ninety-nine individuals with psoriasis (57 females, and 42 males, mean age: 37.4 years) were included in this study. Sociodemographic information including age, sex, smoking habit, etc., was obtained; Psoriasis Area Severity Index (PASI) scores were recorded. The Fagerstrom Test for Nicotine Dependence was used on smoking patients to evaluate smoking habit or the degree of nicotine dependence. The Ways of Coping Questionnaire and Dermatology Life Quality Index were filled out by all patients. Data were assessed by comparing psoriatic smokers with nonsmokers and statistically analysis was carried out with the SPSS 11.5 program.

Results

Forty patients (40.4%) were smokers. When comparing the two groups' mechanisms of coping with stress, smokers and nonsmokers coped with stress in similar ways. The seeking social support scores from the Ways of Coping Questionnaire were significantly lower in smokers than nonsmokers (p < 0.05), while the Fagerstrom Test for Nicotine Dependence scores were correlated with distrustful approach sub-scores, and PASI only correlated with smokers. The Dermatology Life Quality Index scores were correlated with the PASI and distrustful approach scores in all patients.

Conclusion

Smoking and nonsmoking psoriatic patients had similar stress coping strategies, except the subgroup seeking social support, and usually used positive ways of coping with stress. Psoriatic patients who smoke might employ smoking to avoid stressful situations. They would benefit from education on adopting healthy stress management and, in turn, developing mature stress coping mechanisms. Future prospective studies are required to address the exact causal link between smoking, psoriasis and psychiatric comorbidity, including stress coping mechanisms.