Salive M E, Blazer D G
Epidemiology, Demography and Biometry Program, National Institute on Aging, National Institutes of Health, Bethesda, MD 20892.
J Am Geriatr Soc. 1993 Dec;41(12):1313-6. doi: 10.1111/j.1532-5415.1993.tb06481.x.
To explore the relationship of smoking cessation and depression.
Cohort study with 3 years of follow-up.
North Carolina community of the Established Populations for the Epidemiologic Studies of the Elderly.
Stratified cluster sample of adults age 65 years and older, with an oversampling of African Americans.
Depressive symptoms using a modified Center for Epidemiologic Studies Depression (CES-D) scale; smoking cessation using change in self-reported smoking.
Current smokers had the highest prevalence of clinically significant CES-D scores (11.2%), followed by never smokers (9.6%) and former smokers (7.1%). After 3 years, 128 (25%) of 511 baseline current smokers had quit. Among women with a clinically significant CES-D score, 55% quit smoking, compared with only 25% among those with a normal score (P < 0.05). Depressive symptoms were significantly associated with nearly fourfold increased odds of smoking cessation among women (relative odds [RO] 3.7, 95% confidence interval [CI] 1.2, 11.0; P < 0.05), but not among men (RO 0.6, 95% CI 0.2, 2.0, not significant), after adjusting for potential confounding.
Depressive symptoms may directly increase the likelihood of smoking cessation among older women. When predicting smoking cessation, depression and gender should be considered in combination since to consider them separately may be misleading. This challenges prior reports that depressed smokers are less likely to quit smoking than nondepressed smokers.
探讨戒烟与抑郁之间的关系。
为期3年随访的队列研究。
北卡罗来纳州老年流行病学研究既定人群社区。
65岁及以上成年人的分层整群样本，非裔美国人进行了过度抽样。
使用改良的流行病学研究中心抑郁量表（CES-D）评估抑郁症状；通过自我报告的吸烟变化评估戒烟情况。
当前吸烟者中具有临床显著意义的CES-D评分患病率最高（11.2%），其次是从不吸烟者（9.6%）和曾经吸烟者（7.1%）。3年后，511名基线当前吸烟者中有128人（25%）戒烟。在CES-D评分具有临床显著意义的女性中，55%戒烟，而评分正常的女性中只有25%戒烟（P<0.05）。在调整潜在混杂因素后，抑郁症状与女性戒烟几率增加近四倍显著相关（相对比值[RO]3.7，95%置信区间[CI]1.2，11.0；P<0.05），但在男性中无显著相关性（RO 0.6，95%CI 0.2，2.0，无显著性）。
抑郁症状可能直接增加老年女性戒烟的可能性。在预测戒烟时，应综合考虑抑郁和性别因素，因为单独考虑可能会产生误导。这对先前关于抑郁吸烟者比非抑郁吸烟者戒烟可能性更小的报道提出了挑战。
