New government data suggests that depression and smoking may be more intertwined than previously known. The new survey data suggests that people with depression are more likely to be smokers than those without.
According to government data from the National Health and Nutrition Examination Survey (NHANES) taken from 2005 to 2008, 43 percent of adult smokers age 20 and older have depression.
Among men ages 40 to 54, a majority — 55 percent — of those who smoke have depression. Among women ages 20 to 39 who smoke, about 50 percent have depression.
The same survey data showed that about 7 percent of adults aged 20 and over had depression.
The proportion of adults who were current smokers tended to increase with an increase in depression severity. Even persons with mild depressive symptoms below the threshold for the diagnosis of depression were more likely to be smokers than people with no depressive symptoms.
Adults with depression were more likely to smoke over a pack a day and smoke their first cigarette within 5 minutes of waking up — indicators of heavy smoking. Heavy smoking is highly correlated with inability to quit.
Those with depression had a higher rate of smoking initiation (ever smoking) as well as a lower quit rate. They were also heavier smokers than persons without depression. Individuals with other mental illnesses have similar smoking patterns. Studies have shown that persons with depression and other mental illnesses smoke a disproportionate share of all the cigarettes consumed in the United States.
The few studies that have examined ability to quit smoking in persons with depression have shown that with intensive treatment, persons with depression can quit smoking and remain abstinent. These intensive cessation services often use treatments that are also used for depression, including cognitive-behavioral therapy or antidepressant medications. Adults with depression and other mental illnesses are an important subgroup to target for tobacco cessation programs.
Among the survey’s other findings:
- Adults aged 20 and over with depression were more likely to be cigarette smokers than those without depression.
- Women with depression had smoking rates similar to men with depression, while women without depression smoked less than men.
- The percentage of adults who were smokers increased as depression severity increased.
- Among adult smokers, those with depression smoked more heavily than those without depression. They were more likely to smoke their first cigarette within 5 minutes of awakening and to smoke more than one pack of cigarettes per day.
- Adults with depression were less likely to quit smoking than those without depression.
Depression is a mental disorder that often results in limitations in work, family, and social life. People with depression have higher rates of cardiovascular disease and diabetes and more risk behaviors for these diseases, such as smoking, poor diet, or lack of exercise.
Since 1964, when the Surgeon General’s first Report on Smoking and Health was released, cigarette smoking among adults in the United States has been reduced by one-half. However, 21 percent of the adult population still smokes. Better understanding the characteristics of adults who continue to smoke and the relationship between smoking and depression may lead to improved tobacco cessation interventions.
Source: National Center for Health Statistics