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Depression and smoking cessation: does the evidence support psychiatric practice?
Anna Lembke1, Kenasha Johnson, Charles DeBattista
1Department of Psychiatry, Stanford University, Stanford, CA, USA. alembke@stanford.edu
Neuropsychiatric Disease and Treatment
|March 21, 2009
Summary
Depressed smokers can successfully quit smoking and may even see improvement in their depression. Current psychiatric practices often fail to address nicotine dependence in these patients, despite evidence of resiliency.
Area of Science:
- Psychiatry
- Addiction Medicine
- Public Health
Background:
- High comorbidity between depression and nicotine dependence.
- Current psychiatric practice often neglects nicotine dependence treatment in depressed patients.
- Belief that depressed smokers are unwilling or unable to quit, fearing increased depression.
Purpose of the Study:
- To review clinical evidence on depression and smoking cessation.
- To evaluate the validity of current psychiatric practices regarding depressed smokers.
- To assess the willingness and ability of depressed smokers to quit.
Main Methods:
- Systematic review of clinical evidence.
- Analysis of studies on depression, smoking cessation, and nicotine dependence.
- Evaluation of risk factors for depression post-cessation.
Main Results:
- Limited evidence supports current psychiatric practices of not treating nicotine dependence.
- Quitting smoking may pose a risk for depression, but not significantly higher in those with prior depression.
- Depressed smokers demonstrate capability and willingness (at least 25%) to quit.
- Sustained smoking abstinence may improve depressive disorders.
Conclusions:
- Current clinical evidence contradicts the notion that depressed smokers lack the capacity or willingness to quit.
- Psychiatric care should more actively address nicotine dependence in patients with depression.
- Further research is needed, but depressed smokers exhibit greater resilience than commonly assumed.
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