History and Correlates of Smoking Cessation Behaviors Among Individuals With Current or Past Major Depressive Disorder Enrolled in a Smoking Cessation Trial

Abstract

Introduction Smoking among adults with major depressive disorder (MDD) is at least double that of the general U.S. population. More effective smoking cessation interventions for depressed smokers may be facilitated through a better understanding of the smoking and depression-related characteristics of this population. Methods We used baseline data from 300 participants enrolled in randomized clinical trial for smokers with current or past MDD. We described history of smoking cessation behaviors (i.e., quit attempts, quit motivation, and cessation treatment utilization) and used multivariate regression to identify demographic and depression-related correlates of these behaviors. Results Sixty-eight percent of participants reported at least one quit attempt in the past year, nearly 51% reported motivation to quit in the subsequent 30 days, and 83% reported prior use of a nicotine replacement therapy. A greater readiness to quit smoking was associated with increased age (p = 0.04) and lower cigarettes per day (p = 0.01). Greater use of smoking cessation medication was associated with greater education and nicotine dependence, minority race, and greater use of complementary reinforcers. (e.g., activities associated with increased reinforcing value of smoking; p’s < 0.05). Conclusions These data indicate that smokers with current or past MDD are highly motivated to quit smoking and have a history of engaging in efforts to quit. Interventions to promote smoking cessation behaviors should address younger and lighter smokers, who may perceive less risk from tobacco use, and efforts to promote smoking cessation medications and counseling should address minority smokers who are engaging in complementary reinforcers. Implications These data are inconsistent with the assumption that smokers with serious mental illness are not willing to quit smoking and suggest the need for studies that test behavioral interventions that address complementary reinforcers to treat tobacco use in this community.

Efficacy and safety of combination behavioral activation for smoking cessation and varenicline for treating tobacco dependence among individuals with current or past major depressive disorder: A 2 × 2 factorial, randomized, placebo‐controlled trial

“…attempts. There also was variability in motivation to quit [74]. Only 53.0% of participants endorsed planning to quit in the next 30 days.…”

“…A strength of our study is that our sample was racially and socio‐economically diverse and spanned varied psychiatric presentations: 49.0% of participants had current MDD, 44.3% had other DSM diagnoses (including substance use disorder), only 27.3% were being treated for depression, and 16% reported one or more past suicide attempts. There also was variability in motivation to quit [74]. Only 53.0% of participants endorsed planning to quit in the next 30 days.…”

Associations of dual use of tobacco cigarettes and e‐cigarettes, sleep duration, physical activity and depressive symptoms among middle‐aged and older Korean adults

“…Another study found that about 40% of adults with depressive symptoms were current smokers, compared with those who were not depressed; further, individuals with depressive symptoms were more than twice as likely to be current smokers (Goodwin et al, 2017 ). Depressive symptoms are a barrier to the success of smoking cessation interventions (Quinn et al, 2022 ). In our sample, approximately one‐fourth of current smokers started smoking by the age of 19.…”

Examining Factors Associated with E-Cigarette Use among Current Smokers

“…Assessing current smokers for depressive symptoms helps prevent withdrawal symptoms. Depressive symptoms are an obstacle to the success of smoking cessation interventions [ 31 ]. Longitudinal studies are needed to clearly confirm the causal relationship between e-cigarette use and depressive symptoms.…”