Smoking and depression: is smoking cessation effective?

Abstract

Patients with depression tend to have a higher rate of smoking and an increased severity of nicotine dependence. It seems that common genetic and environmental factors may influence the bimodal relationship between smoking and depression. Nicotine has some positive reinforcing/rewarding effects that may affect people with mood disorders and smoking is also used as a 'relief medication' in order to ameliorate symptoms of depression, as it is already known that nicotine, which is the major psychoactive ingredient in tobacco, may act as an antidepressant. To date, the data regarding the difficulty in smoking cessation in depressed smokers are conflicting. Low confidence and self-esteem among this group of smokers are significant predictors of failure during smoking cessation attempt. In the most recently published guidelines for smokers with psychiatric comorbidities the suggestion is for combination treatment (counseling and pharmaceutical treatment) and prolongation of a therapeutic approach.

Cognitive Dysfunction, Affective States, and Vulnerability to Nicotine Addiction: A Multifactorial Perspective

“…In conclusion, despite the fact that some of these studies failed to identify a reciprocal relationship between tobacco addiction and depression ( 30 , 37 , 108 ), the relationship seems to be bidirectional ( 113 ). As described earlier, tobacco dependence predicts the development of depressive symptoms and MD, while a history of MD predicts the onset of daily smoking and progression to tobacco dependence.…”

Smoking cessation and depressive symptoms at 1-, 3-, 6-, and 12-months follow-up

“…This decrease produced during treatment in all the groups might be due to the fact that the treatment includes psychological strategies that may also be useful for mood management (e.g., problem solving, stress management), but after completing the treatment or if there is a relapse, these positive effects on mood disappear. Ischaki and Gratziou (2009) and Brodbeck et al (2014) point to self-efficacy and self-esteem as mediating variables between depression and smoking cessation. Compared with relapsers or with those who never stopped smoking, those who remain abstinentdespite not differing in depression scores at the beginning of treatment-probably use the strategies to maintain abstinence that they learned throughout the treatment, thereby increasing their self-efficacy and the likelihood of not relapsing (Marlatt and Donovan, 2005).…”

Nicotine Addiction and Psychiatric Disorders

“…Similar to the link between anxiety disorders and smoking, depression and nicotine dependence have also a reciprocal relationship (Ischaki & Gratziou, 2009; John, Meyer, Rumpf, & Hapke, 2004). Previous studies have shown that depression symptoms are important determinants of smoking initiation, maintenance, and cessation, whereas nicotine dependence is associated with vulnerability for depression (Breslau, Kilbey, & Andreski, 1991; Fergusson, Goodwin, & Horwood, 2003; Glassman et al, 1990; Hall, Muñoz, Reus, & Sees, 1993; Morrell & Cohen, 2006; Paperwalla, Levin, Weiner, & Saravay, 2004).…”