Patten Scott B, Williams Jeanne V A, Lavorato Dina H, Wang Jian Li, Sajobi Tolulope T, Bulloch Andrew G M
Department of Community Health Sciences and Department of Psychiatry, University of Calgary, Canada; Mathison Centre for Mental Health Research & Education, Hotchkiss Brain Institute, Canada; Senior Health Scholar, Alberta Innovates, Health Solutions, Canada; Department of Community Health Sciences, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, Canada T2N 4Z6.
Department of Community Health Sciences, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, Canada T2N 4Z6.
J Affect Disord. 2017 Aug 15;218:182-187. doi: 10.1016/j.jad.2017.04.056. Epub 2017 Apr 24.
Outcome data from smoking cessation trials indicate that improvement in mental health occurs after smoking cessation. This suggests that smoking cessation should be a priority for mental health services. However, participants in such trials may not be representative of the general population. This study investigates changes in mental health following smoking cessation in a set of general population samples.
Data from a library of cross-sectional surveys conducted by Statistics Canada between 2001 and 2013 were included in this analysis. Survey estimates were pooled in order to increase precision. Associations between smoking (and smoking cessation), major depressive episodes (MDE) and non-specific distress (assessed using the K-6 scale) were evaluated using meta-analysis and meta-regression techniques.
The annual prevalence of major depression was higher in daily (11.0%) than in never smokers (4.4%). The prevalence in former daily smokers was 5.1%. The prevalence of MDE and distress was elevated in those recently quitting but returned to baseline levels within one year.
After smoking cessation, indicators of mental health improve over time, especially in the first year. The findings support the idea that smoking cessation should be a part of the management of common mood and anxiety disorders. However, due to its observational nature this study in itself cannot confirm causality, sustained abstinence may be an effect of improved mental health rather than its cause.
The cross-sectional nature of the constituent surveys does not allow causal inference. No biological measures (e.g. cotinine) were available.
戒烟试验的结果数据表明，戒烟后心理健康状况会有所改善。这表明戒烟应成为心理健康服务的优先事项。然而，此类试验的参与者可能不具有一般人群的代表性。本研究调查了一组一般人群样本戒烟后的心理健康变化。
本分析纳入了加拿大统计局在2001年至2013年期间进行的一系列横断面调查的数据。为提高精度，对调查估计值进行了汇总。使用荟萃分析和荟萃回归技术评估吸烟（和戒烟）、重度抑郁发作（MDE）与非特异性困扰（使用K-6量表评估）之间的关联。
每日吸烟者的重度抑郁症年患病率（11.0%）高于从不吸烟者（4.4%）。既往每日吸烟者的患病率为5.1%。MDE和困扰的患病率在近期戒烟者中有所升高，但在一年内恢复到基线水平。
戒烟后，心理健康指标会随时间改善，尤其是在第一年。这些发现支持了戒烟应成为常见情绪和焦虑障碍管理一部分的观点。然而，由于本研究的观察性质，其本身无法证实因果关系，持续戒烟可能是心理健康改善的结果而非原因。
构成调查的横断面性质不允许进行因果推断。没有可用的生物学指标（如可替宁）。
