High smoking dependence linked to depression
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An international study provides new information on the connection between symptoms of depression and smoking dependence. The results support the importance of understanding the reasons behind smoking dependence to be able to help depressed smokers to quit, and thus possibly relieve depression symptoms.

The study published by Addiction was aimed to investigate how strongly smoking dependence and smoking dependence motives are associated with depressive symptoms among daily smokers and if these associations are independent of measured confounders and shared familial factors.

918 daily smokers including 38 twin pairs discordant for depression were enrolled. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression scale with a cut-off value ≥ 20 for depression. Smoking dependence was assessed using the Fagerström Test for Cigarette Dependence (FTCD) and smoking dependence motives with three subscales from the multi-dimensional Brief Wisconsin Inventory of Smoking Dependence Motives (WISDM): primary dependence motives (PDM), affective enhancement (AE), and Taste.

--The prevalence of depression was 18%. Higher smoking dependence measured by the FTCD and dependence motives measured by the PDM and the AE were associated with higher odds of depression.

--The associations remained after adjusting for individual confounders, except for neuroticism, which attenuated all associations.

--FTCD, PDM, and AE showed associations with depression within depression-discordant monozygotic pairs, suggesting an association independent of familial factors.

In conclusion, depression appears to be associated with smoking dependence and smoking dependence motives related to heavy, automatic use and use to regulate affective states. The associations appear to be confounded or mediated by neuroticism but are independent of shared familial influences.

Source: https://doi.org/10.1111/add.15390