The impact of quitting smoking on depressive symptoms: findings from the International Tobacco Control Four‐Country Survey

Abstract

Aims To determine whether abstinence or relapse on a quit attempt in the previous year is associated with current depressive symptoms. Design Prospective cohort with approximately annual waves. Mixed effect logistic regressions tested whether Time 2 (T2) quitting status was associated with reporting symptoms at T2, and whether Time 1 (T1) symptoms moderated this relationship. Setting Waves 5 to 8 of the Four Country International Tobacco Control Study: a quasi-experimental cohort study of smokers from Canada, USA, UK and Australia. Participants 6978 smokers who participated in telephone surveys. Measurements T1 and T2 depressive symptoms in the last 4 weeks assessed with two screening items from the PRIME-MD questionnaire. Quitting status at T2: 1) No attempt since T1; 2) Attempted and relapsed; 3) Attempted and abstinent at T2. Findings Compared with no attempt, relapse was associated with reporting T2 symptoms (OR=1.46, 95% CI:1.33,1.59). Associations between T2 quitting status and T2 symptoms were moderated by T1 symptoms. Relapse was positively associated with T2 symptoms for those without T1 symptoms (OR=1.71, 95% CI:1.45,2.03) and those with T1 symptoms (OR=1.45, 95% CI:1.23,1.70). Abstinence was positively associated for those without T1 symptoms (OR=1.37, 95% CI:1.10,1.71) and negatively associated for those with T1 symptoms (OR=0.74, 95% CI:0.59,0.94). Age significantly moderated these associations. Relapse did not predict T2 symptoms for those aged 18 to 39 irrespective of T1 symptoms. The negative effect of abstinence on T2 symptoms for those with T1 symptoms was significant only for those aged 18 to 39 (OR = 0.61, 95% CI = 0.40, 0.94) and 40 to 55 (OR = 0.58, 95% CI = 0.40, 0.84). The positive effect of abstinence on T2 symptoms for those without T1 symptoms was significant only for those aged over 55 (OR = 1.97, 95% CI = 1.35, 2.87). Conclusions Most people who stop smoking appear to be at no greater risk of developing symptoms of depression than if they had continued smoking. However, people over age 55 who stop smoking may be at greater risk of developing symptoms of depression than if they had continued smoking.

Effects of behavioural activation on substance use and depression: a systematic review

“…Similarly, research has shown that people with SUDs is more likely to have a major depressive disorder, compare to those without SUDs, even after controlling for sociodemographic characteristics and additional psychiatric comorbidity (adjusted OR = 1.2 and 1.3, respectively) [ 8 ]. Moreover, depression has also been found consistently higher in smokers compared to never smokers (OR = 1.50) and former smokers (OR = 1.76) [ 9 ].…”

Depression and Smoking Cessation: Evidence from a Smoking Cessation Clinic with 1-Year Follow-Up

“…Previous data from small cessation trials [34,35] and recent data from population surveys suggested that relapse in a quit attempt may predict an increase in depressive symptoms [36]. The steep gradient of success rates linked to the number of visits is notable.…”

Predicting vaping uptake, vaping frequency and ongoing vaping among daily smokers using longitudinal data from the International Tobacco Control (ITC) Four Country Surveys

“…Having symptoms of depression was significantly associated with vaping uptake and vaping frequency in the partially adjusted models, and remained significant in predicting vaping frequency in the final adjusted model. Past research has demonstrated a bidirectional effect between depression and smoking , suggesting that depressed individuals may smoke as a form of self‐medication and that smoking may lead to increased depressive symptoms. In our study, we showed that depressive symptoms predicted higher vaping frequency, and this effect was independent of smoking.…”