A disproportionate number of persons with panic disorder (PD) smoke cigarettes compared to individuals with other anxiety disorders and people in the general population. Currently, there is little theoretical or empirical understanding as to how smoking impacts those with PD. The present descriptive psychopathology study provided a test of the pathoplastic relationship between smoking and PD by investigating the additive negative impact of smoking on PD in terms of emotional, functional, and physical health impairment indices. Patients with PD who regularly smoke (PDSM) were compared to PD alone (N=122) in a cross-sectional analysis. As expected, persons with PDSM reported significantly more severe and intense anxiety symptoms and social impairment compared to persons with PD alone. No differences were evident for panic attacks or physical illness variables. These findings are discussed in relation to Pathoplastic models of dysfunction.