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Depressed Smokers Have A Tougher Time Quitting Compared to Non-Depressed Smokers

December 16, 2010

Psychiatry, Smoking, Brain, SmokeQuitting smoking is hard enough. But when you add a bout of depression to the mix quitting becomes even harder. Previous research has found that 11% to 12% of smokers are depressed, compared to 5% to 6% of the general non-smoking population. Kiandra Hebert, PhD, and colleagues recently learned that depressed smokers who are attempting to quit smoking have higher rates of depression and lower rates of quitting when compared to non-depressed smokers who are attempting to quit.

Hebert and colleagues reviewed the data of 861 smokers who called the California Smokers’ Helpline in 2007. The California Smokers’ Helpline, funded by the California Department of Public Health, is a helpline for smokers looking for more information on how to quit smoking cigarettes and/or chewing tobacco. The patient population included current smokers and recent quitters >18 years of age, English speaking, and not pregnant. The patients answered the Patient Health Questionnaire mood module (PHQ-9) and the Social Functioning Questionnaire (SFQ). The PHQ-9 assessed the patients for MDD and the SFQ assessed the level of impairment in the smokers’ daily lives. Seventeen patients were excluded because they missed >2 responses on the PHQ-9.

Overall, ~24% of helpline callers had MDD and ~17% of callers had mild depression. Approximately 29% of patients on Medicaid had MDD and ~17% of patients on Medicaid had minor depression. The callers with MDD were also heavy smokers. The researchers also found that 74% of the callers designated with MDD had social functioning impairment, compared to ~45% of mild depression callers and ~22% of callers with minimal depressive symptoms.

Hebert and colleagues followed up with all of the participants 2 months after the initial call with a response rate of 78%. Although the depression rates remained about the same, over 50% of the callers had attempted to quit since the initial call. Approximately 56% of MDD callers had attempted to quit, compared to ~64% of mild depression callers and ~56% of minimal depression callers. From there, the quit rates were 18.5% for MDD callers, 31.4% for mild depression callers, and 28.4% for minimal depression callers.

There were limitations to the study, but Hebert and colleagues believe that these patients could potentially benefit from an integrated health care model that would treat both the depression and smoking cessation simultaneously. This would allow physicians to formulate a treatment plan that addresses both issues at once, and it would also allow one physician to treat both conditions.

Funding for this research was provided by a supplemental grant to the UCSD Cancer Center from the National Cancer Institute and the California Department of Health Services, Tobacco Control Section, under contract no. 05-45834. (Am J Prev Med. 2011;40[1]:47-53.) —Christopher Naccari

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From → Psychiatry

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