Based on available literature, in the present paper we review the clinic and neurobiologic links of tobacco smoking with anxiety disorders. People suffering from anxiety disorders are more likely to be daily tobacco smokers than the rest of the population, moreover tobacco smoking is prospectively associated with the risk of developing anxiety disorders. Smoking can influence the therapy outcome of the underlying anxiety disorder in different ways. The components of tobacco smoke (nicotine, monoamine oxidase inhibitors, polycyclic aromatic hydrocarbons, free radicals) play important role here. Long-term smoking causes changes in serotoninergic, noradrenergic and GABA-ergic neurotransmission, which is connected to worsening the symptoms of anxiety. Farmakokinetic interactions with antidepressant or anxiolytic medication seem to be also relevant, in scope of lowering the effects of specific medication due to tobacco smoking. Although patients may initially smoke while seeking the effects of anxiety relief, chronic smoking (tobacco dependence) has clear anxiogenic potential.

Key words: tobacco – anxiety disorders – nicotine – monoamine oxidase inhibitors – polycyclic aromatic hydrocarbons