Department of Psychiatry and Behavioral Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CAUSA.
Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CAUSA.
Nicotine Tob Res. 2023 Jul 14;25(8):1496-1504. doi: 10.1093/ntr/ntad064.
Cigarette smoking and depression are associated with morbidity and mortality. Among veterans, approximately 22% are current smokers and 11%-15% have been diagnosed with depression. Although prior research suggests a strong association between smoking and depression among veterans, little research has examined trajectories of smoking and depressive symptoms and their correlates over time in this population.
Using parallel process growth curve modeling, we examined the longitudinal relationship between smoking and depression and tested whether posttraumatic stress disorder (PTSD) symptoms predict smoking and depression trajectories over 18 months (February 2020-August 2021). Veterans were recruited for an online, longitudinal study and responded to surveys across five-time points (baseline N = 1230; retention = 79.3%-83.3% across waves).
Associations indicated that more frequent smoking at baseline was associated with steeper increases in depression symptom severity, and greater depression severity at baseline was associated with a less steep decrease in smoking frequency over time. PTSD was associated with less smoking at time 1 but more frequent smoking at times 3-5 as well as greater depression across all time points.
Findings provide support that the growth trajectories of smoking and depression are linked, and PTSD symptoms are associated with these trajectories among veterans. Addressing these factors simultaneously in veteran treatment centers or through tobacco cessation efforts may be beneficial.
This study offers strong evidence that the growth trajectories of smoking and depression are linked, and PTSD symptoms affect these trajectories among veterans, who represent a largely understudied population despite high rates of substance use and mental health problems. Results of this study strengthen the case for a more integrated treatment approach in which both smoking and mental health concerns are simultaneously addressed, which may yield more beneficial physical health and clinical outcomes for post-9/11 veterans.
吸烟和抑郁与发病率和死亡率有关。在退伍军人中，约有 22%的人是当前吸烟者，11%-15%的人被诊断患有抑郁症。尽管先前的研究表明吸烟和抑郁之间存在很强的关联，但在这一人群中，很少有研究调查吸烟和抑郁症状的轨迹及其随时间的相关性。
我们使用平行过程增长曲线模型，研究了吸烟和抑郁之间的纵向关系，并检验了创伤后应激障碍（PTSD）症状是否能预测退伍军人在 18 个月（2020 年 2 月至 2021 年 8 月）内的吸烟和抑郁轨迹。退伍军人被招募参加一项在线纵向研究，并在五个时间点（基线 N=1230；各波次的保留率为 79.3%-83.3%）完成调查。
关联表明，基线时吸烟越频繁，抑郁症状严重程度的上升越陡峭，而基线时抑郁症状越严重，随着时间的推移，吸烟频率的下降越不陡峭。PTSD 与第 1 时间点的吸烟量较少有关，但与第 3-5 时间点的吸烟量较多以及所有时间点的抑郁程度较高有关。
研究结果提供了支持，即吸烟和抑郁的增长轨迹是相互关联的，而 PTSD 症状与退伍军人的这些轨迹有关。在退伍军人治疗中心或通过戒烟努力同时解决这些因素可能是有益的。
这项研究有力地证明了吸烟和抑郁的增长轨迹是相互关联的，PTSD 症状会影响退伍军人的这些轨迹，尽管他们存在很高的物质使用和心理健康问题，但退伍军人仍然是一个研究不足的人群。本研究结果为更综合的治疗方法提供了依据，即同时解决吸烟和心理健康问题，这可能会为 9/11 后退伍军人带来更有益的身体健康和临床结果。
