Meshkat Shakila, Lin Qiaowei, Tassone Vanessa K, Janssen-Aguilar Reinhard, Pang Hilary, Lou Wendy, Bhat Venkat
Interventional Psychiatry Program, St. Michael's Hospital, Toronto, Ontario, Canada.
Department of Biostatistics, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
PLoS One. 2025 Apr 2;20(4):e0319070. doi: 10.1371/journal.pone.0319070. eCollection 2025.
We aim to assess the association between depressive symptoms, depressive symptom severity and symptom clusters with tobacco use. We will also evaluate sex differences in these associations.
This cross-sectional study used data from the National Health and Nutrition Examination Survey (2005-2018). Depressive symptoms were assessed using the Patient Health Questionnaire-9. Tobacco use was categorized into four groups: cigarette use, smoked tobacco products (pipes and cigars), smokeless tobacco products (chewing tobacco and snuff), and non-tobacco use (reference group).
This study included 33,509 participants. Cigarette use was associated with a 0.83-unit increase in total PHQ-9 scores (95% CI = [0.63, 1.04]), and 1.73 times higher odds of reporting depressive symptoms (95% CI = [1.48, 2.02]) compared to non-tobacco use. However, the use of smoked and smokeless tobacco was not associated with depressive symptoms. In females, cigarette use showed a stronger association with total PHQ-9 scores (aCoef = 1.23, 95% CI = [0.92, 1.55]) than in males (aCoef = 0.45, 95% CI = [0.21, 0.69]). Additionally, female smoked tobacco users showed positive associations with both PHQ-9 scores and the presence of depressive symptoms, but this relationship was not observed in males. Furthermore, subgroup analysis revealed associations between cigarette use and cognitive-affective and somatic symptom clusters, as well as a relationship between the logarithm of total cigarette consumption and depressive symptoms.
Cigarette use was associated with higher odds of depressive symptoms with females having a stronger association. Further studies are needed to replicate these findings and examine the underlying mechanisms.
我们旨在评估抑郁症状、抑郁症状严重程度及症状群与烟草使用之间的关联。我们还将评估这些关联中的性别差异。
这项横断面研究使用了国家健康与营养检查调查（2005 - 2018年）的数据。使用患者健康问卷-9评估抑郁症状。烟草使用分为四组：卷烟使用、吸食烟草制品（烟斗和雪茄）、无烟烟草制品（嚼烟和鼻烟）以及非烟草使用（参照组）。
本研究纳入了33509名参与者。与非烟草使用相比，卷烟使用与患者健康问卷-9总分增加0.83分相关（95%置信区间 = [0.63, 1.04]），报告抑郁症状的几率高出1.73倍（95%置信区间 = [1.48, 2.02]）。然而，吸食烟草制品和无烟烟草制品的使用与抑郁症状无关。在女性中，卷烟使用与患者健康问卷-9总分的关联（调整系数 = 1.23，95%置信区间 = [0.92, 1.55]）比男性更强（调整系数 = 0.45，95%置信区间 = [0.21, 0.69]）。此外，女性吸食烟草使用者与患者健康问卷-9总分及抑郁症状的存在均呈正相关，但在男性中未观察到这种关系。此外，亚组分析揭示了卷烟使用与认知情感和躯体症状群之间的关联，以及卷烟总消费量的对数与抑郁症状之间的关系。
卷烟使用与抑郁症状的较高几率相关，女性的关联更强。需要进一步研究来重复这些发现并探究潜在机制。
