Smoking, smoking cessation, and major depression

Abstract

A relationship between cigarette smoking and major depressive disorder was suggested in previous work involving nonrandomly selected samples. We conducted a test of this association, employing population-based data (n = 3213) collected between 1980 and 1983 in the St Louis Epidemiologic Catchment Area Survey of the National Institute of Mental Health. A history of regular smoking was observed more frequently among individuals who had experienced major depressive disorder at some time in their lives than among individuals who had never experienced major depression or among individuals with no psychiatric diagnosis. Smokers with major depression were also less successful at their attempts to quit than were either of the comparison groups. Gender differences in rates of smoking and of smoking cessation observed in the larger population were not evident among the depressed group. Furthermore, the association between cigarette smoking and major depression was not ubiquitous across all psychiatric diagnoses. Other data are cited indicating that when individuals with a history of depression stop smoking, depressive symptoms and, in some cases, serious major depression may ensue.

The co-occurrence of smoking and a major depressive episode among mothers 15 months after delivery

“…Among adults, depressed individuals are more likely to smoke than are those without depression (Lasser et al, 2000, Glassman et al, 1990, and smokers have higher levels of depressive symptoms than nonsmokers (Pomerleau et al, 2003). These observations are consistent with the conditions having a shared neurobiological basis (Tizabi et al, 2000) and pharmacologic treatment (Lineberry et al, 1990, Ahluwalia et al, 2002.…”

Elucidating the Association Between Depressive Symptoms, Coronary Heart Disease, and Stroke in Black and White Adults: The REasons for Geographic And Racial Differences in Stroke (REGARDS) Study

“…Depressive symptoms have been shown to be associated with smoking,28 medication noncompliance,29 and physical inactivity30 as well as diabetes,31 obesity,32 hypertension,33 and inflammation 34. We added to the literature by demonstrating that these factors and others such as antidepressant use35 and corrected QT interval36 do not appear to fully explain the association between depressive symptoms and incident CVD death and stroke in otherwise healthy persons.…”

Influence of nicotine on positive affect in anhedonic smokers

“…Such fi ndings might suggest that regular smoking increases positive emotional responding to environmental rewards, regardless of whether nicotine is (Cook et al 2004a,b;Cacioppo and Gardner 1999;Clark and Watson 1988;Watson et al 1988a,b), our data indicate that nicotine's infl uence on positive affect was largely independent of changes in negative affect. Nicotine's selective infl uence on low positive affect may be especially clinically salient considering that anhedonia is an important feature of depression (Berenbaum and Oltmanns 1992), a psychiatric disorder that frequently co-occurs with smoking (Glassman et al 1990). Although negative affect has been posited as a mechanism maintaining smoking in depression-prone smokers (Carmody 1992), defi cient positive affect may be an additional pathway infl uencing comorbidity between nicotine dependence and depression.…”

“…The self-medication hypothesis that posits that persistent negative affect is relieved by the pharmacological effects of smoking has received particular interest as an explanation for the high prevalence of depression among smokers (Glassman et al 1990). Relatively overlooked, however, is the possibility that nicotine regulates defi cient positive affect, another affective vulnerability associated with depression.…”