Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
Nicotine Tob Res. 2022 Jan 1;24(1):37-43. doi: 10.1093/ntr/ntab147.
Smoking among adults with major depressive disorder (MDD) is at least double that of the general US population. More effective smoking cessation interventions for depressed smokers may be facilitated through a better understanding of the smoking and depression-related characteristics of this population.
We used baseline data from 300 participants enrolled in randomized clinical trial for smokers with current or past MDD. We described history of smoking cessation behaviors (ie, quit attempts, quit motivation, and cessation treatment utilization) and used multivariate regression to identify demographic and depression-related correlates of these behaviors.
Sixty-eight percent of participants reported at least one quit attempt in the past year, nearly 51% reported motivation to quit in the subsequent 30 days, and 83% reported prior use of a nicotine replacement therapy. A greater readiness to quit smoking was associated with increased age (p = .04) and lower cigarettes per day (p = .01). Greater use of smoking cessation medication was associated with greater education and nicotine dependence, minority race, and greater use of complementary reinforcers (eg, activities associated with increased reinforcing value of smoking; p's < .05).
These data indicate that smokers with current or past MDD are highly motivated to quit smoking and have a history of engaging in efforts to quit. Interventions to promote smoking cessation behaviors should address younger and lighter smokers, who may perceive less risk from tobacco use, and efforts to promote smoking cessation medications and counseling should address minority smokers who are engaging in complementary reinforcers.
These data are inconsistent with the assumption that smokers with serious mental illness are not willing to quit smoking and suggest the need for studies that test behavioral interventions that address complementary reinforcers to treat tobacco use in this community.
患有重度抑郁症（MDD）的成年人吸烟率至少是美国普通人群的两倍。通过更好地了解该人群的吸烟和抑郁相关特征，可能会促进针对抑郁吸烟者的更有效的戒烟干预。
我们使用了参加当前或过去有 MDD 的吸烟者的随机临床试验的 300 名参与者的基线数据。我们描述了戒烟行为的历史（即戒烟尝试、戒烟动机和戒烟治疗的使用），并使用多元回归分析确定了这些行为的人口统计学和与抑郁相关的相关因素。
68%的参与者报告在过去一年中至少有一次戒烟尝试，近 51%的参与者报告在接下来的 30 天内有戒烟动机，83%的参与者报告曾使用尼古丁替代疗法。戒烟的准备程度与年龄的增加（p =.04）和每天吸烟量的减少（p =.01）有关。更频繁地使用戒烟药物与更高的教育程度和尼古丁依赖、少数族裔、以及更频繁地使用补充增强剂（例如，与增加吸烟强化价值相关的活动；p 值<.05）有关。
这些数据表明，目前或过去有 MDD 的吸烟者非常有意愿戒烟，并且有过戒烟的努力。促进戒烟行为的干预措施应针对年轻和吸烟量较少的人群，他们可能认为吸烟的风险较小，而促进戒烟药物和咨询的努力应针对使用补充增强剂的少数族裔吸烟者。
这些数据与严重精神疾病患者不愿意戒烟的假设不一致，并表明需要进行研究，以测试针对该人群烟草使用的行为干预措施，这些干预措施可以解决补充增强剂的问题。
