Murphy Jane M, Horton Nicholas J, Monson Richard R, Laird Nan M, Sobol Arthur M, Leighton Alexander H
Department of Psychiatry, Room 10028, Massachusetts General Hospital, Harvard Medical School, 149 13th Street, Charlestown, MA 02129-2000, USA.
Am J Psychiatry. 2003 Sep;160(9):1663-9. doi: 10.1176/appi.ajp.160.9.1663.
Building on findings about the prevalence and incidence of depression over a 40-year period, the authors provide data on trends in cigarette smoking and associations with depression.
Data come from interviews with adult population samples (1952, 1970, and 1992) and followed cohorts (1952-1970 and 1970-1992). Logistic regression models and survival regressions were used to analyze the data.
The associations between smoking and depression were small and nonsignificant in 1952 and 1970. In 1992, however, the odds that a smoker would be depressed were three times the odds that a nonsmoker would be depressed. The interaction between smoking and study year was significant, indicating that the association was limited to the most recent sample. In the cohort analysis, smoking at baseline did not predict the onset of depression, but subjects who became depressed were more likely to start or continue smoking and less likely to quit than those who never had a depression.
In terms of population trends, the association between depression and cigarette smoking became prominent as the use of tobacco declined because of awareness of the risks involved. The findings about individuals followed over time suggest that those who became depressed were more involved with nicotine than those who never had a depression. The authors discuss hypotheses involving "self-medication," risk-taking, and changes in the social climate but conclude that the relationships between smoking and depression are probably multiple and complex.
基于40年间抑郁症患病率和发病率的研究结果，作者提供了吸烟趋势及与抑郁症关联的数据。
数据来自对成年人口样本（1952年、1970年和1992年）的访谈以及追踪队列（1952 - 1970年和1970 - 1992年）。采用逻辑回归模型和生存回归分析数据。
1952年和1970年，吸烟与抑郁症之间的关联较小且无统计学意义。然而，在1992年，吸烟者患抑郁症的几率是非吸烟者的三倍。吸烟与研究年份之间的交互作用显著，表明这种关联仅限于最近的样本。在队列分析中，基线时吸烟并不能预测抑郁症的发作，但与从未患过抑郁症的人相比，患抑郁症的受试者更有可能开始或继续吸烟，且戒烟的可能性更小。
就总体趋势而言，随着因意识到吸烟风险而导致烟草使用量下降，抑郁症与吸烟之间的关联变得显著。对个体随时间的追踪研究结果表明，与从未患过抑郁症的人相比，患抑郁症的人对尼古丁的依赖更强。作者讨论了涉及“自我治疗”、冒险行为和社会环境变化的假设，但得出结论认为，吸烟与抑郁症之间的关系可能是多重且复杂的。
