Internal and Emergency Medicine

, Volume 2, Issue 3, pp 196–201 | Cite as

Association between depressive mood and cigarette smoking in a large Italian sample of smokers intending to quit: implications for treatment

  • F. Lugoboni
  • G. Quaglio
  • B. Pajusco
  • P. Mezzelani
  • A. Lechi
Original

Abstract

Objective

The aim of the study is to assess the prevalence and degree of depression at baseline of a large cohort of smokers intending to quit.

Methods

A cross-sectional investigation was carried out on a population of 757 smokers attending the Medical Service for Addictive Disorders, at Verona University Hospital. The degree of nicotine addiction was measured by the Fagerstrom Test of Nicotine Dependence (FTND) and current mood tested by the Self-rating Depression Scale (SDS), a commonly used and well validated instrument to assess depressive mood.

Results

Two hundred and twenty-two subjects (30.3%) were depressed at baseline (SDS test score≥50). Bivariate analysis, using the SDs score dichotomised at the cut-off of 50 as dependent variable, shows that female gender (p=0.01) and widowhood (p<0.001) were correlated to depression. Logistic regression analysis confirms the correlation between depression and female gender (OR=2.03, IC 95%=1.42–2.88, p<0.001) and between depression and widowhood, with the greatest risk of depression among widows and widowers (OR=3.22, IC 95%=1.01–10.27, p<0.048).

Conclusions

The study showed a high degree of pre-treatment depression in smokers intending to quit. Although the association between depression and nicotine dependence has been consistently reported many times, and it is well known that depressed subjects find it more difficult to quit, most guidelines seem not to consider this connection. These findings suggest the need for baseline assessment of depression by screening all smokers seeking assistance in quitting, a priority health objective because smoking is the number one avoidable killer in developed countries.

Keywords

Nicotine addiction Smoking cessation Depression Anti-depressant treatment 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Breslau N, Peterson E, Schultz L et al (1998) Major depression and stages of smoking: A longitudinal investigation. Arch Gen Psychiatry 55:161–166PubMedCrossRefGoogle Scholar
  2. 2.
    Lerman C, Audrain J, Orleans C et al (1996) Investigation of mechanisms linking depressed mood to nicotine dependence. Addict Behav 21:9–19PubMedCrossRefGoogle Scholar
  3. 3.
    Dierker L, Ramirez R, Chavez L, Canino G (2005) Association between psychiatric disorders and smoking stages among Latino adolescents. Drug Alcohol Depend 80:361–368PubMedCrossRefGoogle Scholar
  4. 4.
    Anda R, Williamson D, Escobedo L et al (1990) Depression and the dynamics of smoking. A national perspective. JAMA 264:1541–1545PubMedCrossRefGoogle Scholar
  5. 5.
    Killen J, Fortmann S, Kramer H et al (1996) Interactive effects of depression symptoms, nicotine dependence and weight change on late smoking relapse. J Consult Clin Psychol 64:1060–1067PubMedCrossRefGoogle Scholar
  6. 6.
    Pomerleau C, Marks J, Pomerleau O (2000) Who gets what symptom? Effects of psychiatric cofactors and nicotine dependence on patterns of smoking withdrawal symptomatology. Nicotine Tob Res 2:275–280PubMedCrossRefGoogle Scholar
  7. 7.
    Breslau N, Johnson E (2000) Predicting smoking cessation and major depression in nicotine-dependent smokers. Am J Public Health 90:1122–1127PubMedCrossRefGoogle Scholar
  8. 8.
    Brown C, Madden P, Palenchar D, Cooper-Patrick L (2000) The association between depressive symptoms and cigarette smoking in a urban primary care sample. Int J Psychiatry Med 30:15–26PubMedCrossRefGoogle Scholar
  9. 9.
    Patten C, Gillin J, Golshan S et al (2001) Relationship of mood disturbance to cigarette smoking status among 252 patients with a current mood disorder. J Clin Psychiatry 62:319–324PubMedCrossRefGoogle Scholar
  10. 10.
    Quattrocki E, Baird A, Yurgelun-Todd D (2000) Biological aspects of the link between smoking and depression. Harv Rev Psychiatry 8:99–110PubMedCrossRefGoogle Scholar
  11. 11.
    Klimek V, Zhu M, Dilley G et al (2001) Effects of long-term cigarette smoking on the human locus coeruleus. Arch Gen Psychiatry 58:821–827PubMedCrossRefGoogle Scholar
  12. 12.
    Balfour D (2002) The neurobiology of tobacco dependence: a commentary. Respiration 69:7–11PubMedCrossRefGoogle Scholar
  13. 13.
    Hughes J, Stead L, Lancaster T (2003) Antidepressants for smoking cessation. Cochrane Database Syst Rev CD000031Google Scholar
  14. 14.
    Haukkala A, Uutela A, Vartianinen E et al (2000) Depression and smoking cessation: the role of motivation and self efficacy. Addict Behav 25:311–316PubMedCrossRefGoogle Scholar
  15. 15.
    Glassman A, Helzer J, Covey L et al (1990) Smoking, smoking cessation and major depression. JAMA 264:1546–1549PubMedCrossRefGoogle Scholar
  16. 16.
    Holm K, Spencer C (2000) Bupropion. A review of its use in the management of smoking cessation. Drugs 59:1007–1024PubMedCrossRefGoogle Scholar
  17. 17.
    Chengappa K, Kambhampati R, Perkins K et al (2001) Bupropion sustained release as smoking cessation treatment in remitted depressed patients maintained on treatment with selective serotonin reuptake inhibitor antidepressant. J Clin Psychiatry 62:503–508PubMedCrossRefGoogle Scholar
  18. 18.
    Simon GE, VonKorff M, Piccinelli M et al (1999) An international study of the relation between somatic symptoms and depression. N Engl J Med 341:1329–1335PubMedCrossRefGoogle Scholar
  19. 19.
    Bellantuono C, Mazzi MA, Tansella M et al (2002) The identification of depression and the coverage of antidepressant drug prescriptions in Italian general practice. J Affect Disord 72:53–59PubMedCrossRefGoogle Scholar
  20. 20.
    US Public Health Service (2000) Clinical practice guideline for treating tobacco use and dependence. JAMA 283:3244–3254CrossRefGoogle Scholar
  21. 21.
    Health Development Agency. Standard for training in smoking cessation treatments. http://www.hda.nhs.uk (accessed 2003)
  22. 22.
    Nardini S, Bertoletti R, Carrozzi L, Sabato E (2000) Recommendations for activating and managing a doctor’s surgery treating tobacco addiction in the pneumological field. Rassegna di Patologia dell’Apparato Respiratorio 15:1–31Google Scholar
  23. 23.
    Lugoboni F, Quaglio G, Sarti M et al (2003) Curing smoking: a priority health objective. Ann It Int Med 10:394–400Google Scholar
  24. 24.
    Sakamoto S, Kijima N, Tomoda A, Kambara M (1998) Factor structures of the Zung Self-Rating Depression Scale (SDS) for undergraduates. J Clin Psychol 54:477–487PubMedCrossRefGoogle Scholar
  25. 25.
    Berardi D, Leggieri G, Ceroni G et al (2002) Depression in primary care. A nationwide epidemiological survey. Fam Pract 19:397–400PubMedCrossRefGoogle Scholar
  26. 26.
    Bandura A (1977) Self efficacy: toward a unifying theory of behavioural change. Psychol Rev 84:191–215PubMedCrossRefGoogle Scholar
  27. 27.
    Prochaska J, Rossi J, Redding C et al (2004) Depressed smokers and stage of change: implications for treatment interventions. Drug Alcohol Depend 76:143–151PubMedCrossRefGoogle Scholar
  28. 28.
    Lugoboni F, Quaglio G, Mezzelani P et al (2004) Improving compliance in Internal Medicine: the motivational discussion. Ann It Int Med 19:155–162Google Scholar
  29. 29.
    Shiffman S, West RJ, Gilbert DG (2004) Recommendation for the assessment of tobacco craving and withdrawal in smoking cessation trials. Nicotine Tab Res 6:599–614CrossRefGoogle Scholar

Copyright information

© Springer-Verlag Italia Srl 2007

Authors and Affiliations

  • F. Lugoboni
    • 1
  • G. Quaglio
    • 1
  • B. Pajusco
    • 1
  • P. Mezzelani
    • 1
  • A. Lechi
    • 2
  1. 1.Medical Service for Addictive Disorders Department of Internal Medicine Policlinico GB RossiUniversity of VeronaVeronaItaly
  2. 2.Department of Internal MedicineUniversity of VeronaVeronaItaly

Personalised recommendations