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Two Decades of Smoking Cessation Treatment Research on Smokers with Depression: 1990-2010

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Weinberger, A. H., Mazure, C. M., Morlett, A., McKee, S. A.·2013·Nicotine & Tobacco Research
DOI 10.1093/ntr/nts213PMC PMC3693502
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Abstract

introduction: Adults with depression smoke at higher rates than other adults leaving a large segment of this population, who already incur increased health-related risks, vulnerable to the enormous harmful consequences of smoking.Yet, the impact that depression has on smoking cessation is not clear due to the mixed results of past research.The primary aims of this review were to synthesize the research examining the relationship of depression to smoking cessation outcomes over a 20-year period, to examine the gender and racial composition of these studies, and to identify directions for future research.Methods: Potential articles published between January 1, 1990 and December 31, 2010 were identified through a MEDLINE search of the terms "clinical trial," "depression," and "smoking cessation."68 studies used all three terms and met the inclusion criteria.Results: The majority of studies examined either a past diagnosis of major depression or current depression symptoms.Within the few studies that examined the interaction of gender and depression on smoking cessation, depression had a greater impact on treatment outcomes for women than men.No study reported examining the interactive impact of race and depression on treatment outcomes.Conclusions: Although attention to the relationship of depression and smoking cessation outcomes has increased over the past 20 years, little information exists to inform a treatment approach for smokers with Current Major Depressive Disorder, Dysthymia, and Minor Depression and few studies report gender and racial differences in the relationship of depression and smoking cessation outcomes, thus suggesting major areas for targeted research. inTRoDuCTionThe detrimental effects of cigarettes on the health of individuals and on costs to society are well-documented.Cigarette smoking is the single largest preventable cause of morbidity and mortality in Western countries.Tobacco use negatively impacts the health of every bodily system (USDHHS, 2004) and approximately 440,000 adults in the United States die each year from smoking-related illnesses.The annual economic cost of tobacco use to the United States is $196 billion (CDC, 2008). Smoking and Depressive DisordersMajor Depressive Disorder (MDD) is one of the most common psychiatric illnesses in the United States with a lifetime prevalence of 16.2% and a 12-month prevalence of 5-9% (Kessler et al., 2003;Pratt & Brody, 2008;Ziedonis et al., 2008).Dysthymia and Minor Depression, like MDD, are also chronic mood disorders that affect a significant number of adults, cause substantial distress and impairment, and have important clinical implications.Dysthymia is defined by a depressed mood experienced for the majority of the time for at least 2 years along with additional symptoms of depression (e.g., sleep disturbance, low energy, low self-esteem; APA, 1994).Dysthymia is associated with significant impairment and a more severe course of later MDD (Keller, 1994;Klein & Santiago, 2003).Minor Depression, also referred to as subclinical, subthreshhold, or subsyndromal depression (Pincus, Davis, & McQueen, 1999), is included in the DSM-IV-TR (APA, 2002) as a Depressive Disorder Not Otherwise Specified and is defined by the report of symptoms of depression that are fewer in number than those needed for a diagnosis of MDD (APA, 2002).Minor Depression is associated with functional consequences (e.g., work and role impairment) that can equal those experienced with MDD (Ayuso-Mateos, Nuevo, Verdes, Naidoo, & Chatterji, 2010;

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  • The negative effect of depression on cessation is stronger for women.

    “there is evidence across all ages that the negative effect of depression on cessation is stronger for women [16, 17].”

    From Depression and smoking cessation: evidence from a smoking cessation clinic with 1-year follow-up (2017) · cites this paper as [16]

  • The present findings extend the evidence on the association between depression and subsequent smoking abstinence by focusing on the current level of depression diagnosed using a validated and well-established measure and by including mild depression as well as more severe depression.

    “The present findings extend the evidence on the association between depression and subsequent smoking abstinence by focusing on the current level of depression diagnosed using a validated and well-established measure and by including mild depression as well as more severe depression [16].”

    From Depression and smoking cessation: evidence from a smoking cessation clinic with 1-year follow-up (2017) · cites this paper as [16]

  • Many studies exclude smokers using antidepressants, so it remains unclear if they respond as well to smoking cessation treatments as other smokers.

    “Many studies explicitly exclude smokers using antidepressants; thus, it remains unclear if smokers taking antidepressants respond as well to smoking cessation treatments as other smokers [16].”

    From Depression and smoking cessation: evidence from a smoking cessation clinic with 1-year follow-up (2017) · cites this paper as [16]

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Research works printed but not linked: 4

  1. Ahluwalia, J. S., Richter, K. P., Mayo, M. S., & Resnicow, K. (1999). Quit for Life: A randomized trial of culturally sensi- tive materials for smoking cessation in African Americans. Journal of General Internal Medicine, 14 (Suppl 2), 6.
  2. Blondal, T., Gudmundsson, L. J., Tomasson, K., Jonsdottir, D., Hilmarsdottir, H., Kristjansson, F., et al. (1999). The effects of fluoxetine combined with nicotine inhalers in smok- ing cessation. Addiction, 94(7), 1007-1015. doi:10.1046/ j.1360-0443.1999.94710076.x · DOI
  3. Lerman, C., Kaufmann, V., Rukstalis, M., Patterson, F., Perkins, K., Audrain-McGovern, J., et al. (2004). Individualizing nicotine replacement therapy for the treatment of tobacco dependence. Annals of Internal Medicine, 140, 426-433.
  4. Uyar, M., Filiz, A., Bayran, N., Elbek, O., Herken, H., Topcu, A., et al. (2007). A randomized trial of smoking cessation. Saudi Medical Journal, 28(6), 922-926.

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Authors
Weinberger, A. H., Mazure, C. M., Morlett, A., & McKee, S. A.
Affiliations
Yale University (US)
ORCID
Venue
Nicotine & Tobacco Research
Publisher
Oxford University Press (OUP)
Published
2012-10-25
Volume
15
Issue
6
Pages
1014-1031
ISSN
  • 1462-2203 (ISSN-L)
  • 1469-994X
DOI
10.1093/ntr/nts213
PMC
PMC3693502
OpenAlex
W2108315730
Cited by
96
References
186
Citations by year
2026: 2 · 2024: 3 · 2023: 4 · 2022: 2 · 2021: 5 · 2020: 4 · 2019: 3 · 2018: 11 · 2017: 14 · 2016: 18 · 2015: 13 · 2014: 12 · 2013: 5
FWCI
1.05
Type
journal article
Language
en
Open access
Locations
  • Nicotine & Tobacco Research (publishedVersion)
  • Europe PMC (PubMed Central) (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • HighWire Press Open Archive (submittedVersion)
Funders
  • Yale University
  • Yale Cancer Center
  • National Institutes of Health (DA033945)
  • U.S. Public Health Service (NIH/NIGMS SDSU MARC T34-GM008303)
  • National Institute on Drug Abuse (R03DA027052, P50DA033945, DA033945)
  • National Institute of General Medical Sciences
  • Office of Research on Women's Health
Topics
  • Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
  • Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
Keywords
smoking cessation, depression, major depressive disorder, dysthymia, minor depression, gender differences, racial differences, tobacco use, treatment outcomes, nicotine dependence, women smokers, future research directions, tobacco control, health disparities
MeSH terms
Smoking Prevention, Depression, Depressive Disorder, Major, Major Depressive Disorder, Depressive Disorder, Female, Humans, Male, Sex Factors, Smoking, United States, Smoking Cessation, Treatment Outcome, Dysthymic Disorder, Racial Groups, Tobacco Products

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