Smoking Cessation Could Improve Depression Symptoms

A recent study found that smoking cessation improved depressive symptoms in patients with mild to severe depression.

The study was conducted in a smoking cessation clinic in the Czech Republic from 2008 to 2014, and include 3775 patients. Mild depression was reported in 14.3% of patients, and moderate to severe depression was reported in 15.4% of patients.
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Patients visited the clinic several times for treatment, which included face-to-face counselling and an option of pharmacotherapy provided by a nurse and physician. Physical examinations, medical history, mental health problems were recorded, and the Beck Depression Inventory was completed during a 1-hour session at the beginning of the trial. In addition, patients discussed their psychosocial dependence on cigarettes and cessation steps during a 2-hour session, and were asked to set a quit date.

After the quit date, participants returned to the clinic for 30 minute sessions every 2 weeks for 3 months, and dropped to monthly visits for another 3 to 6 months. One year after cessation, participants completed another physical examination and Beck Depressive Inventory. Patients were not treated for depression at the cessation clinic.

Of the 3775 participants, depression was diagnosed in 835, and 13.1% were taking antidepressants at the start of the trial.

Their findings showed that patients with mild depression were less likely to remain non-smoking for 1 year than patients without depression. Likewise, patients with moderate or severe depression were considerably less likely to remain non-smoking for 1 year. Antidepressant use marginally decreased the likelihood of 1-year abstinence, and a combination of nicotine replacement therapy and varenicline, or other mixed pharmacotherapies, also reduced abstinence success in patients.

Patients on 1 pharmacotherapy were more likely to remain abstinent for 1 year.

Smoking abstinence was associated with more visits to the clinic, and number of visits were the strongest predictor for successful cessation.

Researchers did not find any association between smoking cessation and gender, age, other mental health problems, and baselines level of depression.

In participants with depression who quit smoking, the majority reported improvements in their levels of depression, which were reflected in changes in the Beck Depressive Inventory score mean, which dropped from 9.2 at baseline to 5.3.

Overall, the study demonstrated that successful smoking cessation was related to depression level in patients, but smoking abstinence at 1 year did improve symptoms.

“Future research should assess the change in depression symptoms in smokers who attempt to stop smoking but are not successful. Previous data from small cessation trials and recent data from population surveys suggested that relapse in a quit attempt may predict an increase in depressive symptoms,” the researchers concluded.

—Melissa Weiss

Reference:

Stepankova L, Kralikova E, Zvolska K, et al. Depression and smoking cessation: evidence from a smoking cessation clinic with 1-year follow-up [published online December 29, 1016]. Annals of Behavioral Medicine. doi:10.1007/s12160-016-9869-6.