Cooper Jae, Borland Ron, Yong Hua-Hie, Fotuhi Omid
Cancer Council Victoria, Victoria, Australia.
Department of Psychology, University of Waterloo, Ontario, Canada.
Addiction. 2016 Aug;111(8):1448-56. doi: 10.1111/add.13367. Epub 2016 Apr 15.
To determine whether abstinence or relapse on a quit attempt in the previous year is associated with current depressive symptoms.
Prospective cohort with approximately annual waves. Mixed-effect logistic regressions tested whether time 2 (T2) quitting status was associated with reporting symptoms at T2, and whether time 1 (T1) symptoms moderated this relationship.
Waves 5-8 of the Four-Country International Tobacco Control Study: a quasi-experimental cohort study of smokers from Canada, the United States, the United Kingdom and Australia.
A total of 6978 smokers who participated in telephone surveys.
T1 and T2 depressive symptoms in the last 4 weeks were assessed with two screening items from the PRIME-MD questionnaire. Quitting status at T2: (1) no attempt since T1; (2) attempted and relapsed; and (3) attempted and abstinent at T2.
Compared with no attempt, relapse was associated with reporting T2 symptoms [odds ratio (OR) = 1.46, 95% confidence interval (CI) = 1.33, 1.59]). Associations between T2 quitting status and T2 symptoms were moderated by T1 symptoms. Relapse was associated positively with T2 symptoms for those without T1 symptoms (OR = 1.71, 95% CI = 1.45, 2.03) and those with T1 symptoms (OR = 1.45, 95% CI = 1.23, 1.70). Abstinence was associated positively for those without T1 symptoms (OR = 1.37, 95% CI = 1.10, 1.71) and negatively for those with T1 symptoms (OR = 0.74, 95% CI = 0.59, 0.94). Age moderated these associations significantly. Relapse did not predict T2 symptoms for those aged 18-39 irrespective of T1 symptoms. The negative effect of abstinence on T2 symptoms for those with T1 symptoms was significant only for those aged 18-39 (OR = 0.61, 95% CI = 0.40, 0.94) and 40-55 (OR = 0.58, 95% CI = 0.40, 0.84). The positive effect of abstinence on T2 symptoms for those without T1 symptoms was significant only for those aged more than 55 (OR =1.97, 95% CI = 1.35, 2.87).
Most people who stop smoking appear to be at no greater risk of developing symptoms of depression than if they had continued smoking. However, people aged more than 55 who stop smoking may be at greater risk of developing symptoms of depression than if they had continued smoking.
确定上一年戒烟尝试中的戒烟或复吸是否与当前的抑郁症状相关。
前瞻性队列研究，大致每年进行一次随访。混合效应逻辑回归分析用于检验时间2（T2）的戒烟状态是否与T2时报告的症状相关，以及时间1（T1）的症状是否调节了这种关系。
四国国际烟草控制研究的第5 - 8波：一项对来自加拿大、美国、英国和澳大利亚吸烟者的准实验性队列研究。
共有6978名参与电话调查的吸烟者。
使用PRIME - MD问卷中的两个筛查项目评估过去4周内T1和T2时的抑郁症状。T2时的戒烟状态：（1）自T1以来未尝试戒烟；（2）尝试戒烟但复吸；（3）尝试戒烟且在T2时已戒烟。
与未尝试戒烟相比，复吸与报告T2时的症状相关[比值比（OR）= 1.46，95%置信区间（CI）= 1.33，1.59]。T2时的戒烟状态与T2时症状之间的关联受T1时症状的调节。对于没有T1时症状的人，复吸与T2时症状呈正相关（OR = 1.71，95% CI = 1.45，2.03），对于有T1时症状的人也是如此（OR = 1.45，95% CI = 1.23，1.70）。对于没有T1时症状的人，戒烟与症状呈正相关（OR = 1.37，95% CI = 1.10，1.71），而对于有T1时症状的人则呈负相关（OR = 0.74，95% CI = 0.59，0.94）。年龄对这些关联有显著调节作用。无论T1时症状如何，18 - 39岁的人复吸并不能预测T2时的症状。对于有T1时症状的人，戒烟对T2时症状的负面影响仅在18 - 39岁（OR = 0.61，95% CI = 0.40，0.94）和40 - 55岁（OR = 0.58，95% CI = 0.40，0.84）的人群中显著。对于没有T1时症状的人，戒烟对T2时症状的积极影响仅在55岁以上的人群中显著（OR = 1.97，95% CI = 1.35，2.87）。
大多数戒烟者出现抑郁症状的风险似乎并不比继续吸烟者更高。然而，55岁以上的戒烟者出现抑郁症状的风险可能比继续吸烟者更高。
