College of Humanities Education, Inner Mongolia Medical University, Hohhot, China.
The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, China.
Front Public Health. 2022 Aug 26;10:913636. doi: 10.3389/fpubh.2022.913636. eCollection 2022.
The high co-occurrence of tobacco smoking and depression is a major public health concern during the novel coronavirus disease-2019 pandemic. However, no studies have dealt with missing values when assessing depression. Therefore, the present study aimed to examine the effect of tobacco smoking on depressive symptoms using a multiple imputation technique.
This research was a longitudinal study using data from four waves of the China Health and Retirement Longitudinal Study conducted between 2011 and 2018, and the final sample consisted of 74,381 observations across all four waves of data collection. The present study employed a multiple imputation technique to deal with missing values, and a fixed effects logistic regression model was used for the analysis.
The results of fixed effects logistic regression showed that heavy smokers had 20% higher odds of suffering from depressive symptoms than those who never smoked. Compared to those who never smoked, for short-term and moderate-term quitters, the odds of suffering from depressive symptoms increased by 30% and 22%, respectively. The magnitudes of the odds ratios for of the variables short-term quitters, moderate-term quitters, and long-term quitters decreased in absolute terms with increasing time-gaps since quitting. The sub-group analysis for men and women found that heavy male smokers, short-term and moderate-term male quitters had higher odds of suffering from depressive symptoms than those who never smoked. However, associations between smoking status and depressive symptoms were not significant for women.
The empirical findings suggested that among Chinese middle-aged and older adults, heavy smokers and short-term and moderate-term quitters have increased odds of suffering from depressive symptoms than those who never smoked. Moreover, former smokers reported that the probability of having depressive symptoms decreased with a longer duration since quitting. Nevertheless, the association between depressive symptoms and smoking among Chinese middle-aged and older adults is not straightforward and may vary according to gender. These results may have important implications that support the government in allocating more resources to smoking cessation programs to help middle-aged and older smokers, particularly in men.
新型冠状病毒病-2019 大流行期间，吸烟和抑郁的高度共存是一个主要的公共卫生关注点。然而，在评估抑郁时，没有研究涉及缺失值。因此，本研究旨在使用多重插补技术研究吸烟对抑郁症状的影响。
本研究是一项纵向研究，使用了 2011 年至 2018 年期间进行的中国健康与退休纵向研究的四个波次的数据，最终样本包括所有四个波次数据收集的 74381 个观测值。本研究采用多重插补技术处理缺失值，并使用固定效应逻辑回归模型进行分析。
固定效应逻辑回归的结果表明，重度吸烟者患抑郁症状的几率比从不吸烟者高 20%。与从不吸烟者相比，短期和中期戒烟者患抑郁症状的几率分别增加了 30%和 22%。随着戒烟时间的延长，短期戒烟者、中期戒烟者和长期戒烟者变量的优势比的绝对值减小。对男性和女性的亚组分析发现，重度男性吸烟者、短期和中期男性戒烟者患抑郁症状的几率比从不吸烟者高。然而，吸烟状况与女性抑郁症状之间的关联并不显著。
实证结果表明，在中国中年和老年人中，重度吸烟者以及短期和中期戒烟者患抑郁症状的几率高于从不吸烟者。此外，以前吸烟者报告说，随着戒烟时间的延长，出现抑郁症状的概率降低。然而，中国中年和老年人抑郁症状与吸烟之间的关联并不简单，可能因性别而异。这些结果可能具有重要意义，支持政府分配更多资源用于戒烟计划，以帮助中年和老年吸烟者，特别是男性。
