To determine the prevalence of major depressive disorder (MDD) by smoking status, and the temporal relationship between smoking and MDD, and explore other smoking-related variables that may be associated with MDD.
Design.
Cross-sectional study.
Setting.
Public primary care clinics.
Subjects.
Researchers studied 338 women (76% African-Americans) who were randomly selected while attending appointments in two public primary care clinics.
Measures.
Data pertaining to smoking-related variables and MDD diagnosis were obtained using the Diagnostic Interview Schedule for the Diagnostic Statistical Manual of Mental Disorders IV (DSM-IV).
Results.
The prevalence of a lifetime history of MDD was significantly higher for current smokers (56.6%) than among former smokers (37.5%) or never-smokers (30.3%; p < .001). Most ever-smokers (81.3%) began smoking and were nicotine-dependent (63.6%) prior to their first episode of MDD. Using logistic regression, after controlling for demographic and smoking-related variables, age of smoking onset was the strongest variable associated with MDD among ever-smokers. Specifically, the odds of having an MDD decreased by 8.2% for each year delay in smoking initiation.
Conclusion.
These results suggest that smoking initiation precedes MDD and that smoking is associated with a high prevalence of MDD among low-income women attending primary care clinics. Further, the younger women start smoking the more likely they are to have MDD.
GlassmanAH. Cigarette smoking: Implications for psychiatric illness. Am J Psych.1993;150:546–553.
2.
HughesJRHatsukamiDKMitchellJEDahlgrenLA. Prevalence of smoking among psychiatric outpatients. Am J Psych.1986;143:993–997.
3.
BreslauNKilbeyMMAndreskiP. Nicotine dependence, major depression, and anxiety in young adults. Arch Gen Psych.1991;48:1069–1074.
4.
KendlerKSNealeMCMacLeanCJ. Smoking and depression: A causal analysis. Arch Gen Psych.1993;50:36–43.
5.
PattonGCCarlinJBCoffeyC. Depression, anxiety, and smoking initiation: A prospective study over 3 years. Am J Public Health. 1998;88:1518–1522.
6.
GoodmanECapitmanJ. Depressive symptoms and cigarette smoking among teens. Pediatrics. 2000;106:748–755.
7.
ChoiWSPattenCAGillinJCPierceJP. Cigarette smoking predicts development of depressive symptoms among US adolescents. Ann Behav Med.1997;19:42–50.
8.
BreslauNKilbeyMMAndreskiP. Nicotine dependence and major depression: New evidence from a prospective investigation. Arch Gen Psych.1993;50:31–35.
9.
BreslauNPetersonELSchultzLRChilcoatHDAndreskiP. Major depression and stages of smoking: A longitudinal investigation. Arch Gen Psych.1998;55:161–166.
10.
GlassmanAHHelzerJECoveyLS. Smoking, smoking cessation, and major depression. JAMA. 1990;264:1546–1549.
11.
PamukEMakueCHeckK. Socioeconomic Status and Health Chartbook: Health, United States, 1998. Hyattsville, MD: National Center for Health Statistics; 1998.
12.
Centers for Disease Control and Prevention. Smoking cessation during previous year among adults—United States, 1990 and 1991. Morbid Mortal Weekly Rep.1993;42:504–507.
13.
HughesJR. The future of smoking cessation therapy in the United States. Addiction. 1996;91:1797–1802.
Centers for Disease Control and Prevention. Behavioral Risk Factor Surveillance System: Online prevalence data; 2000. Available at: http://www2.cdc.gov/nccdphp/brfss/index.asp. Accessed December, 2000.
16.
O'LoughlinJParadisGRenaudL. The “Yes, I Quit” smoking cessation course: Does it help women in a low income community quit?J Comm Health. 1997; 22:451–468.
17.
GilpinEPierceJPGoodmanJ. Reasons smokers give for stopping smoking: Do they relate to success in stopping. Tobacco Control. 1992;1(4):256–263.
18.
HalpernMTWarnerKE. Motivations for smoking cessation: A comparison of successful quitters and failures. J Subst Abuse. 1993;5(3):247–256.
19.
American Psychiatric AssociationDiagnostic and Statistical Manual of Mental Disorders. 4th ed.Washington, DC: American Psychiatric Association; 1994.
20.
BlazerDGKesslerRCMcGonagleKASwartzMS. The prevalence and distribution of major depression in a national community sample: The National Comorbidity Survey. Am J Psych.1994;151:979–986.
21.
KesslerRCMcGonagleKAZhaoS. Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States. Arch Gen Psych.1994;51:8–19.
22.
HarlowBLCohenLSOttoMW. Prevalence and predictors of depressive symptoms in older premenopausal women. Arch Gen Psych.1999;56:418–424.
23.
CoryellWEndicottJKellerM. Depression in a nonclinical sample: Demographic and clinical risk factors for first onset. Arch Gen Psych.1992;49:117–125.
24.
HusainiBACastorRSLinnG. Social support and depression among the black and white elderly. J Comm Psychol. 1990;18:12–18.
25.
ScarinciICThomasJJonesGBrantleyPJ. Smoking and major depressive disorder (MDD) among low-income females attending primary care clinics. Ann Behav Med.2000;22(Suppl):S214.
26.
CochranDLBrownDRMcGregorKC. Racial differences in the multiple social roles of older women: Implications for depressive symptoms. Gerontologist. 1999;39:465–472.
27.
HoughESBrumittGATemplinTN. Social support, demands of illness, and depression in chronically ill urban women. Health Care Women Int.1999;20:349–362.
28.
GazmararianJAJamesSALepkowskiJM. Depression in black and white women: The role of marriage of socioeconomic status. Ann Epidemiol. 1995;5:455–463.
29.
KahnRSWisePHKennedyBPKawachiI. State income inequality, household income, and maternal mental and physical health: Cross sectional national survey. Br Med J.2000;321:1311–1315.
30.
ScarinciICBeechBMNaumannW. Depression, socioeconomic status, age, and marital status in black women: A national study. Ethnicity Dis. In press.
31.
AndaRFWilliamsonDFEscobedoLG. Depression and the dynamics of smoking: A national perspective. JAm Med Assoc.1990; 264:1541–1545.
32.
BrownCMaddenPAFPalencharDRCooper-PatrickL. The association between depressive symptoms and cigarette smoking in an urban primary care sample. Int J Psych Med.2000;30:15–26.
33.
ParchmanML. Recognition of depression in patients who smoke. Journal Fam Pract.1991;33:255–258.
34.
Fechner-BatesSCoyneJDSchwenkTL. The relationship of self-reported distress to depressive disorders and other psychopathology. J Consult Clin Psychol. 1994;62:550–559.
35.
MyersJKWeissmanMM. Use of a self-report symptom scale to detect depression in a community sample. Am J Psych.1980;137(9):1081–1084.
36.
BoudreauxDCarmackCLScarinciICBrantleyPJ. Predicting smoking stage of change among a sample of low socioeconomic status, primary care outpatients: Replication and extension using decisional balance and self-efficacy theories. Int J Behav Med.1998;5:148–165.
37.
CrittendenKSManfrediCLaceyL. Measuring readiness and motivation to quit smoking among women in public health clinics. Addict Behav.1994;19:497–507.
38.
VonKorffMShapiroSBurkeJD. Anxiety and depression in a primary care clinic: Comparison of the Diagnostic Interview Schedule, General Health Questionnaire, and practitioner assessments. Arch Gen Psych.1987;44:152–156.
39.
RobinsLNCottlerLBBucholzKComptonW. Diagnostic Interview Schedule for DSM-IV. 1995.
40.
RobinsLNHelzerJECroughanJRatcliffKS. National Institute of Mental Health Diagnostic Interview Schedule. Arch Gen Psych.1981;38:381–391.
41.
HelzerJESpitznagelELMcEvoyL. The predictive validity of lay Diagnostic Interview Schedule diagnoses in the general population. Arch Gen Psych.1987;44:1069–1077.
42.
VandiverTSherKJ. Temporal stability of the Diagnostic Interview Schedule. Psychol Assess. 1991;3:277–281.
43.
RobinsLNHelzerJERatcliffKSSeyfriedW. Validity of the Diagnostic Interview Schedule Version II: DSM-III diagnoses. Psychol Med.1982;12:855–870.
44.
Centers for Disease Control and Prevention. Cigarette smoking among adults: United States, 1998. Morbid Mortal Weekly Rep.2000;49:881–884.
45.
Centers for Disease Control and Prevention. Smoking-attributable mortality and years of potential life lost—United States, 1984. Morbid Mortal Weekly Rep.1997;46:444–451.
46.
GeronimusATNeidertLJBoundJ. Age patterns of smoking in US black and white women of childbearing age. Am J Public Health. 1993;83:1258–1264.
47.
WatsonJMKlesgesRCScarinciICMurrayDMVander WegMWDeBonMEck-ClemensLHSlawsonDLMcClanahanB. The relationship between smoking status, ethnicity, socioeconomic status and lifestyle variables in a biracial sample of women. Ann Behav Med.2001;23(suppl):S47.
48.
RoyceJMHymowitzNCorbettK. Smoking cessation factors among African Americans and whites. Am J Public Health. 1993;83:220–226.
49.
CoyneJDSchwenkTL. The relationship of distress to mood disturbance in primary care and psychiatric population. J Consult Clin Psych.1997;65:161–168.
50.
SchulbergHCSaulMMcClellandM. Assessing depression in primary medical and psychiatric practices. Arch Gen Psych.1985;42:1164–1170.
51.
BruceMLTakeuchiDTLeafPJ. Poverty and psychiatric status. Arch Gen Psych.1991;48:470–474.
52.
RegierDAGoldbertIDTaubeCA. The de facto US mental health services system. Arch Gen Psych.1978;35:685–693.
53.
GlassmanAHStetnerFWalshT. Heavy smokers, smoking cessation, and clonidine: Results of a double-blind, randomized trial. JAMA. 1988;259:2863–2866.
54.
HayfordKEPattenCARummansTA. Effectiveness of bupropion for smoking cessation in smokers with a former history of major depression or alcoholism. Br J Psych.1999;174:173–178.
55.
LermanCCaporasoNMainD. Depression and self-medication with nicotine: The modifying influence of the dopamine D4 receptor gene. Health Psychol. 1998;17:56–62.
56.
FoleyDLNealeMCKendlerKS. Reliability of a lifetime history of major depression: Implications for heritability and co-morbidity. Psychol Med.1998;28:857–870.
57.
KendlerKSGardnerCOPrescottCA. Are there sex differences in the reliability of a lifetime history of major depression and its predictors?Psychol Med.2001; 31:617–625.
