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Past major depression and smoking cessation outcome: a systematic review and meta-analysis update

Brian Hitsman1, George D Papandonatos, Dennis E McChargue

  • 1Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA. b-hitsman@northwestern.edu

Addiction (Abingdon, England)
|October 18, 2012
PubMed
Abstract

Insights

Individuals with a history of major depression (MD+) experience a modest decrease in smoking cessation success rates. Effective treatments are needed to address this disparity in smoking cessation outcomes for MD+ smokers.

Area of Science:

  • Psychiatry
  • Addiction Medicine
  • Behavioral Science

Background:

  • Past major depression (MD+) has been previously suggested to be unrelated to smoking cessation outcomes.
  • However, updated analyses are necessary to confirm or refute this association.

Purpose of the Study:

  • To update a prior meta-analysis on the relationship between past major depression and smoking cessation.
  • To investigate potential moderators influencing this association.

Main Methods:

  • An updated systematic review identified 28 eligible trials in addition to 14 from a previous review.
  • Analyses focused on placebo/lowest intensity control arms to minimize the influence of experimental treatments.
  • Study-specific odds ratios (ORs) for abstinence were estimated and combined using random effects models.

Main Results:

  • Smokers with a history of major depression (MD+) showed 17% lower odds of short-term abstinence and 19% lower odds of long-term abstinence compared to those without (MD-).
  • These associations were influenced by methodological factors (e.g., recent major depressive episode exclusion) and treatment characteristics (e.g., cognitive behavioral treatment modality).

Conclusions:

  • Past major depression exerts a modest adverse effect on smoking cessation abstinence.
  • There is a need for enhanced identification of effective treatments or adaptations to eliminate disparities in smoking cessation for individuals with a history of major depression.

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