Institute for Molecular Medicine Finland (FIMM), University of Helsinki, PO. Box 20, 00014 University of Helsinki, Helsinki, Finland.
Department of Public Health, University of Helsinki, Po. Box 20, 20014 University of Helsinki, Helsinki, Finland.
Addiction. 2021 Aug;116(8):2162-2174. doi: 10.1111/add.15390. Epub 2021 Feb 24.
To investigate how strongly smoking dependence and smoking dependence motives are associated with depressive symptoms among daily smokers and if these associations are independent of measured confounders and shared familial factors.
Cross-sectional individual-based and within-pair analyses.
Fourth wave of the population-based Finnish Twin Cohort conducted in 2011.
918 daily smokers born 1945-1957 (48% men), mean age 59.5 years including 38 twin pairs discordant for depression.
Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression scale with a cut off value ≥20 for depression. Smoking dependence was assessed using the Fagerström Test for Cigarette Dependence (FTCD) and smoking dependence motives with three subscales from the multi-dimensional Brief Wisconsin Inventory of Smoking Dependence Motives (WISDM): primary dependence motives (PDM), affective enhancement (AE), and Taste. Logistic regressions, using standardized scores of independent variables and adjusted for multiple confounders with correction for sampling as twin pairs, were used in the individual-based analyses. Conditional logistic regression was used to control for shared familial factors in discordant twin pairs.
Prevalence of depression was 18% (n = 163: 61 [14%] in men, n = 102 [22%] in women). Higher smoking dependence measured by the FTCD (OR 1.45; 95% CI 1.20, 1.75), and dependence motives measured by the PDM (1.56; 1.30, 1.87) and the AE (1.54; 1.28, 1.85) were associated with higher odds of depression. The associations remained after adjusting for individual confounders, except for neuroticism, which attenuated all associations. FTCD, PDM, and AE showed associations with depression within depression-discordant monozygotic pairs, suggesting an association independent of familial factors.
Depression appears to be associated with smoking dependence and smoking dependence motives related to heavy, automatic use and use to regulate affective states. The associations appear to be confounded or mediated by neuroticism but are independent of shared familial influences.
探究吸烟依赖程度和吸烟依赖动机与每日吸烟者抑郁症状的关联强度，并分析这些关联是否独立于测量的混杂因素和共同的家族因素。
基于个体的横断面和个体内对双胞胎的分析。
2011 年进行的基于人群的芬兰双胞胎队列的第四波研究。
918 名 1945-1957 年出生的每日吸烟者（48%为男性），平均年龄 59.5 岁，包括 38 对抑郁状态不一致的双胞胎。
使用中心流行病学研究抑郁量表评估抑郁症状，以得分≥20 作为抑郁的截断值。使用 Fagerström 吸烟依赖测试（FTCD）评估吸烟依赖程度，使用多维简短威斯康星吸烟依赖动机量表（WISDM）的三个分量表评估吸烟依赖动机：主要依赖动机（PDM）、情感增强（AE）和口味。使用标准化的自变量得分进行逻辑回归，并使用作为双胞胎的抽样校正调整多个混杂因素进行个体内分析。在不一致的双胞胎中，使用条件逻辑回归控制共同的家族因素。
抑郁的患病率为 18%（n=163：61[14%]为男性，n=102[22%]为女性）。较高的吸烟依赖程度（FTCD）（OR 1.45；95%CI 1.20，1.75）和依赖动机（PDM）（1.56；1.30，1.87）和 AE（1.54；1.28，1.85）与抑郁的可能性增加有关。在调整个体混杂因素后，除了神经质外，所有关联均减弱，这些关联仍然存在。FTCD、PDM 和 AE 与抑郁不一致的同卵双胞胎内的抑郁相关，表明这些关联独立于家族因素。
抑郁似乎与吸烟依赖和与大量、自动使用和调节情绪状态相关的吸烟依赖动机有关。这些关联似乎受到神经质的混杂或中介作用的影响，但与共同的家族影响无关。
