Depressed people are more likely to smoke and more likely to smoke heavily than people without depression, says a new US government report that concludes special cessation programs are needed to help people with depression quit smoking.

These are the findings of a report published on 14 April that is based on the US Centers for Disease Control and Prevention’s (CDC’s) National Health and Nutrition Examination Surveys 2005-2008.

The report, published by the CDC’s National Center for Health Statistics (NCHS), does not prove that smoking causes depression or vice versa, but it shows there is a strong link between smoking and depression among adults aged 20 and over in the US.

Based on the survey data, about 7 per cent of adults in the US in 2005 to 2008 had depression.

Here are some of the report’s key findings:

  • 43 per cent of adults with depression were current smokers compared to 22 per cent without depression.
  • Adults with depression were less likely to quit smoking than those without depression.
  • Even adults with mild symptoms of depression were more likely to smoke than adults with no symptoms.
  • Smoking rates among women with depression were similar to men with depression, while women without depression smoked less than men.
  • For women, the sharpest contrast was among 20 to 39 year olds, where 50 per cent of women with depression were smokers compared to 21 per cent of women with no depression.
  • Among men, the sharpest contrast was in the 40 to 54 year old group, where 55 per cent of men with depression were smokers compared to 26 per cent of men with no depression.
  • The percentage of smokers went up as depression severity increased.
  • Men and women with depression smoked more heavily than those with no depression.
  • 28 per cent of those with depression smoked more than one pack a day, compared to 15 per cent of those without depression.
  • 51 per cent of people with depression smoked their first cigarette within the first 5 minutes of the day compared to 30 per cent of those with no depression; and people with depression were also more likely to smoke more than one pack a day.

The authors cite studies, of which there are not many, that have looked at the ability to quit smoking in people with depression. These have shown that with intensive treatment, people with depression can quit and stay off cigarettes.

These intensive smoking cessation treatments are similar to those used to treat depression itself, such as cognitive-behavioral therapy and antidepressant medication, said the authors, who concluded that:

“Adults with depression and other mental illnesses are an important subgroup to target for tobacco cessation programs.”

“Depression and Smoking in the U.S. Household Population Age 209 and Over, 2005-2008.”
LA Pratt and DJ Brody.
NCHS Data Brief No 34, published online 14 April 2010 (PDF). National Center for Health Statistics, Hyattsville, MD.

Source: CDC.

Written by: Catharine Paddock, PhD