Depressed Smokers Less Likely To Quit After Heart Attack

Main Category: Smoking / Quit Smoking
Also Included In: Cardiovascular / Cardiology;  Depression;  Psychology / Psychiatry
Article Date: 08 Feb 2008 - 1:00 PST

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A new study shows that smokers who have depressive symptoms during hospitalisation for a heart attack will have a harder time giving up.

Dr. Anne N. Thorndike of Harvard Medical School in Boston, the study's lead author, said, "Depression is common among heart attack patients and the findings show those issues have to be addressed before you can really make much progress with their smoking."

Thorndike added, "Quitting sharply reduces the death rate among smokers with heart disease, but at least 40 percent of smokers start again within a year of having a heart attack. Meanwhile, heart attack patients with depressive symptoms are known to have trouble following recommendations for reducing their risk of future cardiac events."

To investigate the relationship between smoking cessation success and depressive symptoms, Thorndike and her team followed 245 smokers who had been hospitalised for a heart attack or unstable angina.

All of the patients received smoking cessation counselling in the hospital and for 12 weeks afterwards, and were randomly assigned to treatment with either bupropion hydrochloride (an anti-smoking medication sold as Zyban) or an inactive placebo.

Twenty two percent of the patients had moderate to severe depressive symptoms. These individuals had worse craving and withdrawal symptoms, and also scored higher on a test of their nicotine dependence.

The researchers found that the depressed patients were 2.4 times more likely than their non-depressed peers to start smoking again.

Among the depressed patients, 19 percent on bupropion were able to quit, compared to 3 percent on placebo. For non-depressed patients, by comparison, quit rates were 27 percent for those on placebo and 27 percent for those on the drug. However, Thorndike cautioned, the difference in the effect of Zyban and placebo on the depressed patients wasn't significant from a statistical standpoint.

Based on the findings, smokers and their families should understand just how tough it can be to quit after a heart attack, and be on the lookout for depressive symptoms that could make quitting even more difficult, Thorndike said.

http://www.ash.org.uk

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