Goodwin Renee D, Wall Melanie M, Garey Lorra, Zvolensky Michael J, Dierker Lisa, Galea Sandro, Gbedemah Misato, Weinberger Andrea H, Williams Jill M, Hu Mei-Chen, Hasin Deborah S
Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA; Department of Psychology, Queens College and The Graduate Center, City University of New York (CUNY), Queens, NY, USA.
Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY, USA; New York State Psychiatric Institute, New York, NY, USA; Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY, USA.
Drug Alcohol Depend. 2017 Apr 1;173:191-199. doi: 10.1016/j.drugalcdep.2016.11.038. Epub 2017 Jan 11.
After declining sharply for many years, the prevalence of smoking has remained fairly stable over the past decade. One possible explanation is that there has been an increase in the prevalence of barriers to cessation, like depression, among remaining smokers.
To estimate changes in the prevalence of depression among current, former and never smokers in the United States (U.S.) population from 2005 to 2013 overall and by age, gender, and income.
Data were drawn from the National Household Survey on Drug Use (NSDUH), an annual cross-sectional study of persons ages 12 and over (N=496,805). The prevalence of past 12-month depression was examined annually among current (past 12-month), former (not past 12-month), and lifetime non-smokers from 2005 to 2013. Data were re-analyzed stratified by age, gender, and household income, and adjusted for demographics.
Depression appears to have significantly increased in the United States from 2005 to 2013 among current, former, and never smokers. Depression prevalence increased among current smokers overall, but the increase among former and never smokers was even more prominent. Striking temporal changes emerged by age, gender and income. Specifically, (1) depression increased significantly among current smokers aged 12-17 (from 16% to 22%, p-value=0.0002) and the prevalence was consistently more than twice as high as that of never smokers; (2) depression increased among male smokers (6.19%-7.82%, p-value=0.0099); (3) depression increased significantly among smokers in the highest income group (6.36% to 8.91%, p-value=0.0400). Throughout this period, the prevalence of depression among current smokers was consistently twice as high as among former and never smokers.
Public health efforts aimed at decreasing the prevalence of smoking should take depression into account, a common and modifiable barrier whose treatment may help to increase successful smoking cessation. Future work is needed to disentangle the role of smoking and other factors that lead to increases in depression in the US population.
在多年急剧下降之后，吸烟率在过去十年中一直保持相当稳定。一种可能的解释是，在仍在吸烟的人群中，诸如抑郁症等戒烟障碍的患病率有所上升。
估计2005年至2013年美国人群中当前吸烟者、曾经吸烟者和从不吸烟者的抑郁症患病率总体变化情况，以及按年龄、性别和收入划分的变化情况。
数据取自全国药物使用家庭调查（NSDUH），这是一项对12岁及以上人群进行的年度横断面研究（N = 496,805）。对2005年至2013年期间当前（过去12个月内）吸烟者、曾经吸烟者（过去12个月内未吸烟）和终身不吸烟者中过去12个月患抑郁症的患病率进行年度检查。数据按年龄、性别和家庭收入进行分层重新分析，并对人口统计学因素进行了调整。
2005年至2013年期间，美国当前吸烟者、曾经吸烟者和从不吸烟者的抑郁症患病率似乎都显著上升。当前吸烟者的抑郁症患病率总体上升，但曾经吸烟者和从不吸烟者的上升更为显著。按年龄、性别和收入出现了明显的时间变化。具体而言，（1）12 - 17岁的当前吸烟者中抑郁症显著增加（从16%增至22%，p值 = 0.0002），患病率一直是从不吸烟者的两倍多；（2）男性吸烟者中抑郁症增加（从6.19%至7.82%，p值 = 0.0099）；（3）最高收入组吸烟者中抑郁症显著增加（从6.36%至8.91%，p值 = 0.0400）。在此期间，当前吸烟者的抑郁症患病率一直是曾经吸烟者和从不吸烟者的两倍。
旨在降低吸烟率的公共卫生努力应考虑到抑郁症，这是一种常见且可改变的障碍，对其进行治疗可能有助于提高戒烟成功率。未来需要开展工作，以厘清吸烟以及导致美国人群抑郁症增加的其他因素所起的作用。
