Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, New York; Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, New York.
Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
Am J Prev Med. 2020 May;58(5):691-698. doi: 10.1016/j.amepre.2019.12.023. Epub 2020 Mar 7.
Cigarette smoking remains more common among individuals with depression. This study investigates whether cigarette quit ratios and cigarette use prevalence have changed differentially by depression status during the past decade.
National Survey on Drug Use and Health data (2005-2017) were analyzed in 2019. Respondents aged ≥12 years were included in analyses of smoking prevalence (n=728,691) and respondents aged ≥26 years were included in analyses of quit ratio (n=131,412). Time trends in smoking prevalence (current, daily, and nondaily) and quit ratio (former/lifetime smokers) were estimated, stratified by past-year depression. Adjusted analyses controlled for demographics.
Smoking prevalence was consistently higher among those with depression than those without depression. From 2005 to 2017, nondaily smoking did not significantly change among individuals with depression (9.25% to 9.40%; AOR=0.995, 95% CI=0.986, 1.005), whereas it decreased from 7.02% to 5.85% among those without depression (AOR=0.986, 95% CI=0.981, 0.990). By contrast, daily smoking declined among individuals with (25.21% to 15.11%; AOR=0.953, 95% CI=0.945, 0.962) and without depression (14.94% to 9.76%; AOR=0.970, 95% CI=0.967, 0.973). The quit ratio increased among individuals with (28.61% to 39.75%; AOR=1.036, 95% CI=1.021, 1.052) and without depression (47.65% to 53.09%; AOR=1.013, 95% CI=1.009, 1.017), yet quit ratios were consistently lower for those with depression than those without depression.
Quit ratios are increasing and smoking prevalence is decreasing overall, yet disparities by depression status remain significant. Disparities in quit ratio may be one contributing factor to the elevated prevalence of smoking among those with depression. Innovative tobacco control approaches for people with depression appear long overdue.
吸烟在患有抑郁症的人群中更为普遍。本研究旨在探讨在过去十年中,是否存在因抑郁状态不同而导致戒烟比例和吸烟流行率发生差异的情况。
2019 年对 2005 年至 2017 年期间的全国毒品使用和健康调查数据进行了分析。将年龄≥12 岁的受访者纳入吸烟流行率分析(n=728691),将年龄≥26 岁的受访者纳入戒烟比例分析(n=131412)。根据过去一年的抑郁状况,对吸烟流行率(当前、每日和非每日)和戒烟比例(前吸烟者/终身吸烟者)的时间趋势进行了估计。调整分析控制了人口统计学因素。
患有抑郁症的人群吸烟率始终高于无抑郁症人群。从 2005 年到 2017 年,患有抑郁症的人群中非每日吸烟的比例没有明显变化(9.25%至 9.40%;AOR=0.995,95%CI=0.986,1.005),而无抑郁症的人群中非每日吸烟的比例从 7.02%下降到 5.85%(AOR=0.986,95%CI=0.981,0.990)。相比之下,患有抑郁症的人群每日吸烟的比例从 25.21%下降到 15.11%(AOR=0.953,95%CI=0.945,0.962),而无抑郁症的人群每日吸烟的比例从 14.94%下降到 9.76%(AOR=0.970,95%CI=0.967,0.973)。患有抑郁症的人群戒烟比例从 28.61%增加到 39.75%(AOR=1.036,95%CI=1.021,1.052),而无抑郁症的人群戒烟比例从 47.65%增加到 53.09%(AOR=1.013,95%CI=1.009,1.017),但患有抑郁症的人群戒烟比例始终低于无抑郁症的人群。
总体而言,戒烟比例在上升,吸烟流行率在下降,但抑郁状态的差异仍然显著。抑郁状态对戒烟比例的差异可能是导致抑郁症患者吸烟率升高的一个因素。针对抑郁症患者的创新性烟草控制方法似乎早已迫在眉睫。