Johnson Eric O, Breslau Naomi
Division of Health, Social and Economic Research, Research Triangle Institute International, Research Triangle Park, NC 27709-2194, USA.
Nicotine Tob Res. 2006 Apr;8(2):257-62. doi: 10.1080/14622200600576644.
Part of the hardening hypothesis to explain the persistence of smoking-despite powerful antismoking forces-links smoking with psychopathology, especially depression. It has been proposed that the association between depression and smoking has emerged in more recent cohorts as smoking rates declined, disproportionately leaving among current smokers those who found it more difficult to quit because of their psychopathology. We examined the association of regular smoking and depression in a cohort who began smoking prior to the decline in smoking rates in the United States and assessed a corollary hypothesis that smokers with depression were more likely to persist in smoking than were those without depression. Data were from the Wisconsin Longitudinal Study of a random sample of high school graduates from the class of 1957. In the 1992 follow-up, a subset of these 53-54-year-olds were assessed for lifetime and current depression and smoking (n = 4,858). A modest association between regular smoking and depression was found (OR = 1.4, 95% CI = 1.2-1.6); persistence of smoking (current smoking among ever regular smokers) was unrelated to single-episode or recurrent depression (OR = 1.1, 95% CI = 0.8-1.5). The results do not support the proposition that the association between smoking and depression emerged when smoking rates declined, or that self-medication of depression through smoking is a likely mechanism for the persistence of smoking.
尽管存在强大的反吸烟力量，但吸烟现象依然持续存在，对此有一个“强化假说”，该假说将吸烟与精神病理学，尤其是抑郁症联系起来。有人提出，随着吸烟率下降，抑郁症与吸烟之间的关联在最近几代人群中显现出来，在当前吸烟者中，因精神病理学原因而更难戒烟的人不成比例地留存了下来。我们在美国吸烟率下降之前就开始吸烟的队列中，研究了经常吸烟与抑郁症之间的关联，并评估了一个相关假说，即患有抑郁症的吸烟者比没有抑郁症的吸烟者更有可能持续吸烟。数据来自对1957届高中毕业生随机抽样的威斯康星纵向研究。在1992年的随访中，对这些53至54岁人群中的一部分进行了终生和当前抑郁症及吸烟情况的评估（n = 4858）。发现经常吸烟与抑郁症之间存在适度关联（比值比 = 1.4，95%置信区间 = 1.2 - 1.6）；吸烟的持续性（曾经经常吸烟者中的当前吸烟情况）与单次发作或复发性抑郁症无关（比值比 = 1.1，95%置信区间 = 0.8 - 1.5）。研究结果不支持以下观点：吸烟率下降时吸烟与抑郁症之间的关联才出现，或者通过吸烟自我治疗抑郁症是吸烟持续存在的一种可能机制。
