Cited by 270Smoking Behavior and CessationMental Health Treatment and AccessSubstance Abuse Treatment and Outcomes

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Cigarette Smoking and Incidence of First Depressive Episode: An 11-Year, Population-based Follow-up Study

Klungsøyr, Ole, Nygård, Jan F., Sørensen, Tom, Sandanger, Inger·2006·American Journal of Epidemiology

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Abstract

Smoking has been found to be associated with depression. Biologic hypotheses support causation in both directions. This study examined the association between cigarette smoking and a subsequent first depression. In 1990, 2,014 adults in Norway were interviewed about their lifestyle and mental health. A 2001 reinterview by trained interviewers defined the study cohort of 1,190 participants. The cases were those who experienced a first depression whose onset was estimated to occur during the follow-up period, based on retrospective assessment by the Composite International Diagnostic Interview (International Classification of Diseases, Tenth Revision). Cox regression was used to estimate the hazard rate of depression during follow-up. Alternative explanations for a direct causal influence from smoking on subsequent depression were assessed, and a sensitivity analysis was performed. The risk of depression was four times as high for heavy smokers compared with never smokers. A dose-response relation with an increasing hazard for past smokers and for an increasing number of cigarettes smoked per day for current smokers was found. Similarly, increasing smoking time was associated with increasing risk. Failure of other plausible alternatives to explain the observed association between smoking and depression might reflect a direct causal influence of smoking on depression.

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Authors: Klungsøyr, O., Nygård, J. F., Sørensen, T., & Sandanger, I.
Affiliations: University of Oslo (NO)
Corresponding author: Klungsøyr, Ole
ORCID: Klungsøyr, Ole
Nygård, Jan F.
Sørensen, Tom
Venue: American Journal of Epidemiology
Publisher: Oxford University Press (OUP)
Published: 2006-01-04
Volume: 163
Issue: 5
Pages: 421-432
ISSN: 0002-9262 (ISSN-L)
1476-6256
DOI: 10.1093/aje/kwj058
OpenAlex: W2152013172
Cited by: 269
References: 54
Citations by year: 2026: 2 · 2025: 3 · 2024: 9 · 2023: 6 · 2022: 5 · 2021: 14 · 2020: 28 · 2019: 12 · 2018: 9 · 2017: 9 · 2016: 7 · 2015: 21 · 2014: 17 · 2013: 16 · 2012: 17
FWCI: 10.94
Type: journal article
Language: en
Open access: closed
Locations: American Journal of Epidemiology (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Smoking Behavior and Cessation
Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
Keywords: cigarette smoking, depression, first-episode depression, dose-response relationship, smoking duration, heavy smoking, causal inference, mental health
MeSH terms: Adult, Aged, Aged, 80 and over, Depressive Disorder, Female, Follow-Up Studies, Humans, Male, Middle Aged, Norway, Prospective Studies, Surveys and Questionnaires, Risk Factors, Smoking, Time Factors, Incidence, Confidence Intervals, Proportional Hazards Models

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Cigarette Smoking and Incidence of First Depressive Episode: An 11-Year, Population-based Follow-up Study

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