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Cigarette smoking and depression: tests of causal linkages using a longitudinal birth cohort

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Boden, Joseph M., Fergusson, David M., Horwood, L. John·2010·British Journal of Psychiatry
DOI 10.1192/bjp.bp.109.065912
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Abstract

Background: Research on the comorbidity between cigarette smoking and major depression has not elucidated the pathways by which smoking is associated with depression. Aims: To examine the causal relationships between smoking and depression via fixed-effects regression and structural equation modelling. Method: Data were gathered on nicotine-dependence symptoms and depressive symptoms in early adulthood using a birth cohort of over 1000 individuals. Results: Adjustment for confounding factors revealed persistent significant (P<0.05) associations between nicotine-dependence symptoms and depressive symptoms. Structural equation modelling suggested that the best-fitting causal model was one in which nicotine dependence led to increased risk of depression. The findings suggest that the comorbidity between smoking and depression arises from two routes; the first involving common or correlated risk factors and the second a direct path in which smoking increases the risk of depression. Conclusions: This evidence is consistent with the conclusion that there is a cause and effect relationship between smoking and depression in which cigarette smoking increases the risk of symptoms of depression.

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  • ANE is associated with increased mood and anxiety disorder risk.

    “ANE is associated with increased mood and anxiety disorder risk [171–174]”

    From Consequences of adolescent drug use (2023) · cites this paper as [171]

    The Results and the section on associations at ages 17–25 link nicotine dependence with increased depressive symptoms and suggest an increased risk of depression. The paper does not establish increased anxiety-disorder risk; its time-dynamic covariate section describes anxiety disorder as a measured covariate. It also does not identify the exposure as “ANE.” (LLM, conf=0.86)

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  • Nicotine has a myriad of harmful effects on adolescent development, mood, and behavior.

    “nicotine has a myriad of harmful effects on adolescent development, mood, and behavior.”

    From Consequences of adolescent drug use (2023) · cites this paper as [171]

    The Results report that nicotine-dependence symptoms remained associated with depressive symptoms and that the best-fitting model suggested smoking increased depression risk. This supports a narrower point about mood, but the paper does not establish that nicotine itself has a myriad of harmful effects on adolescent development and behavior; its measurements span ages 17–25. (LLM, conf=0.86)

    Experimental — accuracy not yet measured

  • Nicotine affects dopamine release, providing temporary pleasure and reinforcing the perception that smoking alleviates mental health symptoms, despite actually worsening these symptoms in the long-term.

    “Nicotine affects dopamine release, providing temporary pleasure and reinforcing the perception that smoking alleviates mental health symptoms, despite actually worsening these symptoms in the long-term [12, 13, 14, 15].”

    From Can an Acceptance and Commitment Therapy-Based Smartphone App Help Individuals with Mental Health Disorders Quit Smoking? (2024) · cites this paper as [12]

    The Results report a best-fitting model in which nicotine dependence increased the risk of depression, supporting the claim's worsening-symptoms component for depression. The paper does not establish that nicotine releases dopamine, produces temporary pleasure, or reinforces a perception that smoking relieves symptoms; it only mentions self-medication as an explanation proposed by other studies. Its findings also do not extend to mental health symptoms generally. (LLM, conf=0.86)

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Authors
Boden, J. M., Fergusson, D. M., & Horwood, L. J.
Affiliations
University of Otago (NZ)
Corresponding author
  • Boden, Joseph M.
  • Fergusson, David M.
ORCID
Venue
British Journal of Psychiatry
Publisher
Royal College of Psychiatrists
Published
2010-06
Volume
196
Issue
6
Pages
440-446
ISSN
  • 0007-1250 (ISSN-L)
  • 1472-1465
DOI
10.1192/bjp.bp.109.065912
OpenAlex
W2146149065
Cited by
477
References
50
Citations by year
2026: 23 · 2025: 15 · 2024: 32 · 2023: 31 · 2022: 30 · 2021: 41 · 2020: 25 · 2019: 19 · 2018: 23 · 2017: 38 · 2016: 37 · 2015: 33 · 2014: 38 · 2013: 38 · 2012: 25
FWCI
19.71
Type
journal article
Language
en
Open access
Licence
www.cambridge.org/core/terms (unspecified, 2772 d)
Locations
  • The British Journal of Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • Canterbury Medical Research Foundation
  • Lotto New Zealand
  • Health Research Council of New Zealand
Topics
  • Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
  • Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
  • Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
Keywords
cigarette smoking, depression, nicotine dependence, comorbidities, causal pathways, depressive symptoms, early adulthood, birth cohort, confounding
MeSH terms
Adolescent, Age Factors, Child, Child, Preschool, Major Depressive Disorder, Epidemiologic Methods, Female, Humans, Infant, Infant, Newborn, Male, New Zealand, Smoking, Tobacco Use Disorder

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