Time-Varying Smoking Abstinence Predicts Lower Depressive Symptoms Following Smoking Cessation Treatment

Abstract

Introduction: The question of whether abstinence during the months following a planned quit attempt exacerbates or improves depressive symptoms is an important clinical issue. Extant research has primarily modeled between-person covariation between postquit abstinence and depressive symptom trajectories. However, this approach cannot account for potential third variables between participants that may affect both smoking and depression. Accordingly, the current study examined within-person covariation between time-varying abstinence and depressive symptom in a multilevel model (MLM), which allowed for transitions between smoking statuses within a participant.Methods: Participants were 236 heavy drinking smokers in a randomized clinical trial testing the efficacy of incorporating brief alcohol intervention into smoking cessation treatment. Depressive symptoms and biochemically verified abstinence were assessed 1 week prior to and 2, 8, 16, and 26 weeks after quit date.Results: MLMs indicated a slight increase in depressive symptoms over time in the sample as a whole. However, there was an inverse relation between time-varying abstinence (vs. smoking) and concurrent level of depressive symptoms, indicating that transitions from smoking to abstinence within individuals were associated with reductions in depressive symptoms. Conclusions:During the first 6 months following a planned quit attempt, being abstinent in a particular week appears to be associated with lower levels of concurrent depressive symptoms. These results are not concordant with the view that intentional smoking abstinence exacerbates depressive symptoms. Efforts to promote smoking cessation should highlight that individuals are likely to feel more rather than less psychologically healthy when they successfully quit smoking.

Cigarette smoking among intimate partner violence perpetrators and victims: Findings from the National Epidemiologic Survey on Alcohol and Related Conditions

“…36 Given the significant, robust effects observed between IPV and smoking and evidence for improvements in affect after smoking cessation, it may be beneficial for both batterer intervention programs and domestic violence advocates to provide clients with psychoeducational materials on the risks of smoking, optional smoking cessation recommendations for treatment, and alternative coping skills. 37 The Clinical Practice Guidelines for Treating Tobacco Use and Dependence recommends the use of the 5 A’s to those who work with high risk populations. 25 The 5 A’s include asking about smoking, advising smokers to quit, assessing motivation to quit, assisting with quitting, and arranging contacts.…”

Whistle While You Work

“…A large body of evidence supports the relationship between positive mood state and diet (Benton & Donohoe, 1999, Neck & Cooper, 2000, exercise (Fox, 1999;Neck & Cooper, 2000, Yeung, 1996, smoking cessation (e.g., Kahler, Spillane, Busch, & Leventhal, 2011), massage (e.g., Edge, 2003;Stevensen, 1994), music (e.g., Campbell, 2001;Manz, 2003), deep relaxed breathing (Manz, 2003), laughter (e.g., Christie & Moore, 2005), and nontraditional physical fitness including activities practiced in the far East such as yoga, Qigong, and Tai Chi (e.g., Caldwell, Harrison, Adams, & Triplett, 2009). Some research suggests that eating foods high in carbohydrates, low in fat, low in sugar, and high in iron and thiamine can promote enhanced mood states (Benton & Donohoe, 1999;Somer, 1995).…”

Anxiety, depression, and cigarette smoking: A transdiagnostic vulnerability framework to understanding emotion–smoking comorbidity.

“…The link between smoking and emotional psychopathology: (1) generalizes across several emotional conditions, including major depression (Leventhal, Japuntich, et al, 2012), dysthymic disorder (Weinberger, Pilver, Desai, Mazure, & McKee, 2012), minor depression (Weinberger et al, 2012), panic disorder (Piper et al, 2011), social anxiety disorder (Piper et al, 2011), posttraumatic stress disorder (PTSD; Zvolensky, Gibson, et al, 2008), and generalized anxiety disorder (GAD; Piper et al, 2011); (2) extends to multiple stages of the smoking trajectory, including initiation (Leventhal, Ray, Rhee, & Unger, 2011; Patton et al, 1998), progression to regular smoking (Audrain-McGovern, Rodriguez, Rodgers, & Cuevas, 2011), development and maintenance of nicotine dependence (McKenzie, Olsson, Jorm, Romaniuk, & Patton, 2010), and risk of smoking cessation failure (Hall, Munoz, & Reus, 1994; Hitsman, Papandonatos, McChargue, Demott, Herrera, Spring et al, 2013). The smoking-emotion relation is bi-directional, as increases in tobacco use heightens risk of emotional disorder symptoms (Breslau, Novak, Kessler, 2004; Khaled, Bulloch, Williams, Hill, Lavorato, & Patten, 2012; Wu & Anthony, 1999; Breslau & Klein, 1999; Johnson, Cohen, Pine, Klein, Kasen, & Brook, 2000) and sustained abstinence decreases emotional symptoms (Kahler, Spillane, Busch, & Leventhal, 2011). …”