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Quitting smoking does not increase the risk of major depressive episodes among users of Internet smoking cessation interventions

Published online by Cambridge University Press:  23 July 2009

L. D. Torres ,
A. Z. Barrera ,
K. Delucchi ,
C. Penilla ,
E. J. Pérez-Stable  and
R. F. Muñoz
L. D. Torres
Affiliation:
Department of Psychiatry, University of California, San Francisco, CA, USA
A. Z. Barrera
Affiliation:
Department of Psychiatry, University of California, San Francisco, CA, USA
K. Delucchi
Affiliation:
Department of Psychiatry, University of California, San Francisco, CA, USA
C. Penilla
Affiliation:
Department of Psychiatry, University of California, San Francisco, CA, USA
E. J. Pérez-Stable
Affiliation:
Division of General Internal Medicine, Department of Medicine and Medical Effectiveness Research Center for Diverse Populations, University of California, San Francisco, CA, USA
R. F. Muñoz*
Affiliation:
Department of Psychiatry, University of California, San Francisco, CA, USA
*
*Address for correspondence: R. F. Muñoz, University of California, San Francisco, Department of Psychiatry at San Francisco General Hospital, 1001 Potrero Avenue, Suite 7M, San Francisco, CA94110, USA. (Email: ricardo.munoz@ucsf.edu)
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Abstract

Background

Limited evidence has suggested that quitting smoking increases the incidence of major depressive episodes (MDEs), particularly for smokers with a history of depression. Further evidence for this increase would have important implications for guiding smoking cessation.

Method

Spanish- and English-speaking smokers without a current MDE (n=3056) from an international, online smoking cessation trial were assessed for abstinence 1 month after their initial quit date and followed for a total of 12 months. Incidence of screened MDE was examined as a function of abstinence and depression history.

Results

Continued smoking, not abstinence, predicted MDE screened at 1 month [smoking 11.5% v. abstinence 7.8%, odds ratio (OR) 1.36, 95% confidence interval (CI) 1.04–1.78, p=0.02] but not afterwards (smoking 11.1% v. abstinence 9.8%, OR 1.05, 95% CI 0.77–1.45, p=0.74). Depression history predicted MDE screened at 1 month (history 17.1% v. no history 8.6%, OR 1.71, 95% CI 1.29–2.27, p<0.001) and afterwards (history 21.7% v. no history 8.3%, OR 3.87, 95% CI 2.25–6.65, p<0.001), although the interaction between history and abstinence did not.

Conclusions

Quitting smoking was not associated with increased MDE, even for smokers with a history of depression, although a history of depression was. Instead, not quitting was associated with increased MDE shortly following a quit attempt. Results from this online, large, international sample of smokers converge with similar findings from smaller, clinic-based samples, suggesting that in general, quitting smoking does not increase the incidence of MDEs.

Keywords

DepressionMDEself-medication hypothesissmokingsmoking cessationtobacco
Type
Original Articles
Information
Psychological Medicine , Volume 40 , Issue 3 , March 2010 , pp. 441 - 449
Copyright
Copyright © Cambridge University Press 2009

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References

APA (2000). Diagnostic and Statistical Manual of Mental Disorders, 4th edn, text rev. American Psychiatric Association: Washington, DC.Google Scholar
Audrain-McGovern, J, Lerman, C, Wileyto, EP, Rodriguez, D, Shields, PG (2004). Interacting effects of genetic predisposition and depression on adolescent smoking progression. American Journal of Psychiatry 161, 1224–1230.CrossRefGoogle ScholarPubMed
Blalock, JA, Robinson, JD, Wetter, DW, Schreindorf, LS, Cincirpini, PM (2008). Nicotine withdrawal in smokers with current depressive disorders undergoing intensive smoking cessation treatment. Psychology of Addictive Behaviors 22, 122–128.CrossRefGoogle ScholarPubMed
Bock, BC, Goldstein, MG, Marcus, BH (1996). Depression following smoking cessation in women. Journal of Substance Abuse 8, 137–144.CrossRefGoogle ScholarPubMed
Breslau, N, Peterson, EL, Schultz, LR, Chilcoat, HD, Andreski, P (1998). Major depression and stages of smoking. A longitudinal investigation. Archives of General Psychiatry 55, 161–166.CrossRefGoogle ScholarPubMed
Brown, RA, Lewinsohn, PM, Seeley, JR, Wagner, EF (1996). Cigarette smoking, major depression, and other psychiatric disorders among adolescents. Journal of the American Academy of Child and Adolescent Psychiatry 35, 1602–1610.CrossRefGoogle ScholarPubMed
Burgess, ES, Brown, RA, Kahler, CW, Niaura, R, Abrams, DB, Goldstein, MG, Miller, IW (2002). Patterns of change in depressive symptoms during smoking cessation: who's at risk for relapse. Journal of Consulting and Clinical Psychology 70, 356–361.CrossRefGoogle ScholarPubMed
Corrao, MA, Guindon, GE, Cokkinides, V, Sharma, N (2000). Building the evidence base for global tobacco control. Bulletin of the World Health Organization 78, 884–890.Google ScholarPubMed
Covey, LS, Glassman, AH, Stetner, F (1990). Depression and depressive symptoms in smoking cessation. Comprehensive Psychiatry 31, 350–354.CrossRefGoogle ScholarPubMed
Covey, LS, Glassman, AH, Stetner, F (1997). Major depression following smoking cessation. American Journal of Psychiatry 154, 263–265.Google ScholarPubMed
Covey, LS, Glassman, AH, Stetner, F, Rivelli, S, Stage, K (2002). A randomized trial of sertraline as a cessation aid for smokers with a history of major depression. American Journal of Psychiatry 159, 1731–1737.CrossRefGoogle ScholarPubMed
Dierker, LC, Avenevoli, S, Stolar, M, Merikangas, KR (2002). Smoking and depression: an examination of mechanisms of comorbidity. American Journal of Psychiatry 159, 947–953.CrossRefGoogle ScholarPubMed
Eysenbach, G (2005). The law of attrition. Journal of Medicine Internet Research 7, e11.CrossRefGoogle ScholarPubMed
Fergusson, DM, Goodwin, RD, Horwood, LJ (2003). Major depression and cigarette smoking: results of a 21-year longitudinal study. Psychological Medicine 33, 1357–1367.CrossRefGoogle ScholarPubMed
Glassman, AH, Covey, LS, Stetner, F, Rivelli, S (2001). Smoking cessation and the course of major depression: a follow-up study. Lancet 357, 1929–1932.CrossRefGoogle ScholarPubMed
Graham, AL, Papandonatos, GD, Bock, BC, Cobb, NK, Baskin-Sommers, A, Niaura, R, Abrams, DB (2006). Internet- vs. telephone-administered questionnaires in a randomized trial of smoking cessation. Nicotine and Tobacco Research 8, s49–s57.CrossRefGoogle Scholar
Hasin, DS, Goodwin, RD, Stinson, FS, Grant, BF (2005). Epidemiology of major depressive disorder: results from the National Epidemiologic Survey on Alcoholism and Related Conditions. Archive of General Psychiatry 62, 1097–1106.CrossRefGoogle ScholarPubMed
Heatherton, TF, Kozlowski, LT, Frecker, RC, Fagerstrom, KO (1991). The Fagerstrom Test for Nicotine Dependence: a revision of the Fagerstrom Tolerance Questionnaire. British Journal of Addiction 86, 1119–1127.CrossRefGoogle ScholarPubMed
Herrero, J, Meneses, J (2004). Short Web-based versions of the perceived stress (PSS) and Center for Epidemiological Studies-Depression (CESD) scales: a comparison to pencil and paper responses among Internet users. Computers in Human Behavior 22, 830–846.CrossRefGoogle Scholar
Hughes, JR, Keely, JP, Niaura, RS, Ossip-Klein, DJ, Richmond, RL, Swan, GE (2003). Measures of abstinence in clinical trials: issues and recommendations. Nicotine and Tobacco Research 5, 13–25.CrossRefGoogle ScholarPubMed
Kahler, CW, Brown, RA, Ramsey, SE, Niaura, R, Abrams, DB, Goldstein, MG, Mueller, TI, Miller, IW (2002). Negative mood, depressive symptoms, and major depression after smoking cessation treatment in smokers with a history of major depressive disorder. Journal of Abnormal Psychology 111, 670–675.CrossRefGoogle ScholarPubMed
Kendler, KS, Neale, MC, Maclean, CJ, Heath, AC, Eaves, LJ, Kessler, RC (1993). Smoking and major depression. A causal analysis. Archives of General Psychiatry 50, 36–43.CrossRefGoogle ScholarPubMed
Kessler, RC, Zhao, S, Blazer, DG, Swartz, M (1997). Prevalence, correlates, and course of minor depression and major depression in the National Comorbidity Survey. Journal of Affective Disorders 45, 19–30.CrossRefGoogle ScholarPubMed
Klungsøyr, O, Nygård, JF, Sørensen, T, Sandanger, I (2006). Cigarette smoking and incidence of first depressive episode: an 11-year, population-based follow-up study. American Journal of Epidemiology 163, 421–432.CrossRefGoogle ScholarPubMed
Lasser, K, Boyd, JW, Woolhandler, S, Himmelstein, DU, McCormick, D, Bor, DH (2000). Smoking and mental illness: a population-based prevalence study. Journal of the American Medical Association 284, 2606–2610.CrossRefGoogle ScholarPubMed
Lerman, C, Caporaso, N, Main, D, Audrain, J, Boyd, NR, Bowman, ED, Shields, PG (1998). Depression and self-medication with nicotine: the modifying influence of the dopamine D4 receptor gene. Health Psychology 17, 56–62.CrossRefGoogle ScholarPubMed
Lewinsohn, PM, Hoberman, HM, Rosenbaum, M (1988). A prospective study of risk factors for unipolar depression. Journal of Abnormal Psychology 97, 251–264.CrossRefGoogle ScholarPubMed
Munafò, MR, Hitsman, B, Rende, R, Metcalfe, C, Niaura, R (2008). Effects of progression to cigarette smoking on depressed mood in adolescents: evidence from the National Longitudinal Study of Adolescent Health. Addiction 103, 162–171.CrossRefGoogle ScholarPubMed
Muñoz, RF (1998). The Mood Screener (http://www.medschool.ucsf.edu/latino/manuals.aspx). Accessed 28 July 2008.Google Scholar
Muñoz, RF, Barrera, AZ, Delucchi, K, Penilla, C, Torres, LD, Pérez-Stable, EJ (in press). Worldwide Internet smoking cessation trial yields 20% abstinence rates at one year. Nicotine and Tobacco Research.Google Scholar
Muñoz, RF, McQuaid, JR, González, G, Dimas, J, Rosales, V (1999). Depression screening in a women's clinic: using automated Spanish- and English-language voice recognition. Journal of Clinical and Clinical Psychology 67, 502–510.CrossRefGoogle Scholar
Murray, CJ, Lopez, AD (1997). Global mortality, disability, and the contribution of risk factors: Global Burden of Disease Study. Lancet 349, 1436–1442.CrossRefGoogle ScholarPubMed
Murray, CJ, Lopez, AD (1999). On the comparable quantification of health risks: lessons from the Global Burden of Disease Study. Epidemiology 10, 594–605.CrossRefGoogle ScholarPubMed
Piasecki, TM, Niaura, R, Shadel, WG, Abrams, D, Goldstein, M, Fiore, M, Baker, T (2000). Smoking dynamics in unaided quitters. Journal of Abnormal Psychology 109, 74–86.CrossRefGoogle ScholarPubMed
Radloff, LS (1977). The CES-D Scale: a self-report depression scale for research in the general population. Applied Psychological Measurement 1, 385–401.CrossRefGoogle Scholar
Solomon, DA, Keller, MB, Leon, AC, Mueller, TI, Lavori, PW, Shea, MT, Coryell, W, Warshaw, M, Turvey, C, Maser, JD, Endicott, J (2000). Multiple recurrences of major depressive disorder. American Journal of Psychiatry 157, 229–233.CrossRefGoogle ScholarPubMed
Spitzer, RL, Williams, JB, Kroenke, K, Linzer, M, deGruy, FV III, Hahn, SR, Brody, D, Johnson, J (1994). Utility of a new procedure in diagnosing mental disorders in primary care: The PRIME-MD 1000 Study. Journal of the American Medical Association 272, 1749–1756.CrossRefGoogle ScholarPubMed
Stage, KB, Glassman, AH, Covey, LS (1996). Depression after smoking cessation: case reports. Journal of Clinical Psychiatry 57, 467–469.CrossRefGoogle ScholarPubMed
Tsoh, JY, Humfleet, GL, Muñoz, RF, Reus, VI, Hartz, DT, Hall, SM (2000). Development of major depression after treatment for smoking cessation. American Journal of Psychiatry 157, 368–374.CrossRefGoogle ScholarPubMed
Üstün, TB, Ayuso-Mateos, JL, Chatterji, S, Mathers, C, Murray, CJ (2004). Global burden of depressive disorders in the year 2000. British Journal of Psychiatry 184, 386–392.CrossRefGoogle ScholarPubMed
Vázquez, FL, Muñoz, RF, Blanco, V, López, M (2008). Validation of Muñoz's Mood Screener in a nonclinical Spanish population. European Journal of Psychological Assessment 24, 57–64.CrossRefGoogle Scholar
Velicer, WF, Prochaska, JO, Rossi, JS, Snow, MG (1992). Assessing outcome in smoking cessation studies. Psychological Bulletin 111, 23–41.CrossRefGoogle ScholarPubMed
Wu, LT, Anthony, JC (1999). Tobacco smoking and depressed mood in late childhood and early adolescence. American Journal of Public Health 89, 1837–1840.CrossRefGoogle ScholarPubMed