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Smoking in relation to anxiety and depression: Evidence from a large population survey: The HUNT study

Published online by Cambridge University Press:  16 April 2020

Arnstein Mykletun ,
Simon Overland ,
Leif Edvard Aarø ,
Hanne-Marthe Liabø  and
Robert Stewart
Arnstein Mykletun*
Affiliation:
University of Bergen, Faculty of Psychology, Research Centre for Health Promotion, Christiesgt 13, N-5015Bergen, Norway King's College London (Institute of Psychiatry), Health Service and Population Health Department, London, UK Norwegian Institute of Public Health, Division of Mental Health, Oslo, Norway
Simon Overland
Affiliation:
University of Bergen, Faculty of Psychology, Research Centre for Health Promotion, Christiesgt 13, N-5015Bergen, Norway
Leif Edvard Aarø
Affiliation:
University of Bergen, Faculty of Psychology, Research Centre for Health Promotion, Christiesgt 13, N-5015Bergen, Norway
Hanne-Marthe Liabø
Affiliation:
University of Bergen, Faculty of Psychology, Research Centre for Health Promotion, Christiesgt 13, N-5015Bergen, Norway
Robert Stewart
Affiliation:
King's College London (Institute of Psychiatry), Health Service and Population Health Department, London, UK
*
*Corresponding author. Research Centre for Health Promotion, Faculty of Psychology, University of Bergen, Christiesgt 13, N-5015 Bergen, Norway. Tel.: +47 91689600; fax: +47 90402307. E-mail address: [email protected] (A. Mykletun).
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Abstract

Smoking is reported to be associated with depression and anxiety. The present study (a) examines these associations taking comorbidity into account, (b) investigates possible confounders, (c) examines how former smokers compared to current and never-smokers in terms of anxiety and depression, and if anxiety and depression decline by time since cessation. Participants (66%) aged 20–89 years in a population-based health survey (N = 60,814) were screened employing the HADS. (a) The association with smoking was strongest in comorbid anxiety depression, followed by anxiety, and only marginal in depression. Associations were stronger in females and younger participants. (b) Variables partly accounting for the association comprised somatic symptoms, socio-demographics, alcohol problems, and low physical activity. (c) Anxiety and depression were most common in current smokers, followed by quitters, and then never-smokers. No decline in anxiety or depression was found with time since cessation. Previous studies of associations between depression and smoking might have overestimated the association when ignoring comorbid anxiety.

Keywords

SmokingAnxietyDepressionEpidemiologyComorbidity
Type
Original articles
Information
European Psychiatry , Volume 23 , Issue 2 , March 2008 , pp. 77 - 84
Copyright
Copyright © Elsevier Masson SAS 2008

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References

Aertgeerts, B.The value of the CAGE in screening for alcohol abuse and alcohol dependance in general clinical populations: a diagnostic meta-analysis. Journal of Clinical Epidemiology 2004;57(1):30–39.CrossRefGoogle Scholar
Albers, A.B., Biener, L.The role of smoking and rebelliousness in the development of depressive symptoms among a cohort of Massachusetts adolescents. Preventive Medicine 2002 Jun;34(6):625–631.CrossRefGoogle ScholarPubMed
Bjelland, I., Dahl, A.A., Haug, T.T., Neckelmann, D.The validity of the hospital anxiety and depression scale. An updated literature review. Journal of Psychosomatics Research 2002 Feb;52(2):69–77.CrossRefGoogle ScholarPubMed
Black, D.W., Zimmerman, M., Coryell, W.H.Cigarette smoking and psychiatric disorder in a community sample. Annals of Clinical Psychiatry 1999;11(3):129–136.CrossRefGoogle Scholar
Breslau, N., Klein, D.F.Smoking and panic attacks: an epidemiologic investigation. Archives of General Psychiatry 1999;56(12):1141–1147.CrossRefGoogle ScholarPubMed
Breslau, N., Novak, S.P., Kessler, R.C.Daily smoking and the subsequent onset of psychiatric disorders. Psychological Medicine 2004;34(2):323–333.CrossRefGoogle ScholarPubMed
Breslau, N., Novak, S.P., Kessler, R.C.Psychiatric disorders and stages of smoking. Biological Psychiatry 2004;55(1):69–76.CrossRefGoogle ScholarPubMed
Breslau, N., Peterson, E.L., Schultz, L.R., Chilcoat, H.D., Andreski, P.Major depression and stages of smoking: a longitudinal investigation. Archives of General Psychiatry 1998 Feb;55(2):161–166.CrossRefGoogle ScholarPubMed
Chassin, L., Presson, C.C., Sherman, S.J., Kim, K.Long-term psychological sequelae of smoking cessation and relapse. Health Psychology 2002 Sep;21(5):438–443.CrossRefGoogle ScholarPubMed
Covey, L., Glassman, A., Stetner, F.Major depression following smoking cessation. Am J Psychiatry Feb 1997;154(2):263–265.Google ScholarPubMed
Covey, L.S., Glassman, A.H., Stetner, F.Cigarette smoking and major depression. Journal of Addictive Diseases 1998;17(1):35–46.CrossRefGoogle ScholarPubMed
Dierker, L.C., Albano, A.M., Clarke, G.N., Heimberg, R.G., Kendall, P.C., Merikangas, K.R.et al.Screening for anxiety and depression in early adolescence. Journal of the American Academy of Child and Adolescent Psychiatry Aug 2001;40(8):929–936.CrossRefGoogle ScholarPubMed
Doll, R., Peto, R., Boreham, J., Sutherland, I.Mortality in relation to smoking: 50 years' observations on male British doctors. British Medical Journal 2004;328(7455):1519–1528.CrossRefGoogle ScholarPubMed
Dursun, S.M., Kutcher, S.Smoking, nicotine and psychiatric disorders: evidence for therapeutic role, controversies and implications for future research. Medical Hypotheses Feb 1999;52(2):101–109.CrossRefGoogle ScholarPubMed
Eaton, W.W., Holzer, C.E., VonKorff, M., Anthony, J.C., Helzer, J.E., George, L.et al.The design of the epidemiologic catchment-area surveys – the control and measurement of error. Archives of General Psychiatry 1984;41(10):942–948.CrossRefGoogle ScholarPubMed
Feldner, M.T., Babson, K.A., Zvolensky, M.J.Smoking, traumatic event exposure, and post-traumatic stress: a critical review of the empirical literature. Clinical Psychology Review Jan 2007;27(1):14–45.CrossRefGoogle ScholarPubMed
Fergusson, D.M., Goodwin, R.D., Horwood, L.J.Major depression and cigarette smoking: results of a 21-year longitudinal study. Psychological Medicine 2003 Nov;33(8):1357–1367.CrossRefGoogle ScholarPubMed
Glassman, A.Cigarette smoking: implications for psychiatric illness. The American Journal of Psychiatry 1993;150(4):546–553.Google ScholarPubMed
Glassman, A.H., Covey, L.S., Stetner, F., Rivelli, S.Smoking cessation and the course of major depression: a follow-up study. The Lancet 2001 Jun;357(9272):1929–1932.CrossRefGoogle ScholarPubMed
Glassman, A.H., Helzer, J.E., Covey, L.S., Cottler, L.B., Stetner, F., Tipp, J.E.et al.Smoking, Smoking cessation, and major depression. Jama 1990 Sep;264(12):1546–1549.CrossRefGoogle ScholarPubMed
Goodwin, R., Hamilton, S.P.Cigarette smoking and panic: the role of neuroticism. American Journal of Psychiatry 2002 Jul;159(7):1208–1213.CrossRefGoogle ScholarPubMed
Grant, B.F., Hasin, D.S., Chou, S.P., Stinson, F.S., Dawson, D.A.Nicotine dependence and psychiatric disorders in the United States – results from the national epidemiologic survey on alcohol and related conditions. Archives of General Psychiatry 2004 Nov;61(11):1107–1115.CrossRefGoogle ScholarPubMed
Haustein, K., Roland, A review of the pharmacological and psychopharmacological aspects of smoking and smoking cessation in psychiatric patients. International Journal of Clinical Pharmacology and Therapeutics 2002;40(9):404–418.CrossRefGoogle ScholarPubMed
Hitsman, B.J.History of depression and smoking cessation outcome: a meta-analysis. Journal of Consulting and Clinical Psychology 2003;71(4):657–663.CrossRefGoogle ScholarPubMed
Holmen, J., Midthjell, K., Krüger, O., Langhammer, A., Holmen, T., Bratberg, G.et al.The Nord-Trøndelag Health Study 1995–97 (HUNT 2): objectives, contents, method and participation. Norsk Epidemiologi 2003;13(1):19–32.Google Scholar
Hughes, J.R., Hatsukami, D.K., Mitchell, J.E., Dahlgren, L.A.Prevalence of smoking among psychiatric outpatients. The American Journal of Psychiatry 1986;143(8):993–997.Google ScholarPubMed
John, U., Meyer, C., Rumpf, H.-J., Hapke, U.Smoking, nicotine dependence and psychiatric comorbidity – a population-based study including smoking cessation after three years. Drug and Alcohol Dependence 2004 Dec;76(3):287–295.CrossRefGoogle ScholarPubMed
Johnson, J.G., Cohen, P., Pine, D.S., Klein, D.F., Kasen, S., Brook, J.S.Association between cigarette smoking and anxiety disorders during adolescence and early adulthood. Jama 2000 Nov;284(18):2348–2351.CrossRefGoogle ScholarPubMed
Klungsoyr, O., Nygard, J.F., Sorensen, T., Sandanger, I.Cigarette smoking and incidence of first depressive episode: an 11-year, population-based follow-up study. American Journal of Epidemiology 2006 Mar;163(5):421–432.CrossRefGoogle ScholarPubMed
Koenen, K.C., Hitsman, B., Lyons, M.J., Niaura, R., McCaffery, J., Goldberg, J.et al.A twin registry study of the relationship between posttraumatic stress disorder and nicotine dependence in men. Archives of General Psychiatry 2005 Nov;62(11):1258–1265.CrossRefGoogle ScholarPubMed
Korhonen, T., Broms, U., Varjonen, J., Romanov, K., Koskenvuo, M., Kinnunen, T.et al.Smoking behaviour as a predictor of depression among Finnish men and women: a prospective cohort study of adult twins. Psychological Medicine 2007 May;37(5):705–715.CrossRefGoogle ScholarPubMed
Krokstad, S., Westin, S.Health inequalities by socioeconomic status among men in the Nord-Trondelag health study, Norway. Scandinavian Journal of Public Health 2002;30(2):113–124.Google ScholarPubMed
Lasser, K., Boyd, J.W., Woolhandler, S., Himmelstein, D.U., McCormick, D., Bor, D.H.Smoking and mental illness: a population-based prevalence study. Jama 2000 Nov;284(20):2606–2610.CrossRefGoogle ScholarPubMed
McCabe, R.E., Chudzik, S.M., Antony, M.M., Young, L., Swinson, R.P., Zolvensky, M.J.Smoking behaviors across anxiety disorders. Journal of Anxiety Disorders 2004;18(1):7–18.CrossRefGoogle ScholarPubMed
Morissette, S.B., Tull, M.T., Gulliver, S.B., Kamholz, B.W., Zimering, R.T.Anxiety, anxiety disorders, tobacco use, and nicotine: a critical review of interrelationships. Psychological Bulletin 2007;133(2):245–272.CrossRefGoogle ScholarPubMed
Mykletun, A., Bjerkeset, O., Dewey, M., Prince, M., Overland, S., Stewart, R.Anxiety, depression and cause specific mortality. The HUNT study. Psychosomatic Medicine 2007;69:323–331.CrossRefGoogle ScholarPubMed
Mykletun, A., Overland, S., Dahl, A.A., Krokstad, S., Bjerkeset, O., Glozier, N.et al.A population-based cohort study of the effect of common mental disorders on disability pension awards. American Journal of Psychiatry 2006 Aug;163(8):1412–1418.CrossRefGoogle ScholarPubMed
Mykletun, A., Stordal, E., Dahl, A.A.Hospital anxiety and depression (HAD) scale: factor structure, item analyses and internal consistency in a large population. British Journal of Psychiatry 2001;179:540–544.CrossRefGoogle ScholarPubMed
Parrott, A.C.Cigarette smoking does cause stress. American Psychologist 2000 Oct;55(10):1159–1160.CrossRefGoogle ScholarPubMed
Parrott, A.C.Cigarette-derived nicotine is not a medicine. World Journal of Biological Psychiatry 2003 Apr;4(2):49–55.CrossRefGoogle Scholar
Parslow, R.A., Jorm, A.F.Tobacco use after experiencing a major natural disaster: analysis of a longitudinal study of 2063 young adults. Addiction 2006 Jul;101(7):1044–1050.CrossRefGoogle Scholar
Pomerleau, O.F., Pomerleau, C.S., Mehringer, A.M., Snedecor, S.M., Ninowski, R., Sen, A.Nicotine dependence, depression, and gender: characterizing phenotypes based on withdrawal discomfort, response to smoking, and ability to abstain. Nicotine & Tobacco Research 2005 Feb;7(1):91–102.CrossRefGoogle ScholarPubMed
Roness, A., Mykletun, A., Dahl, A.A.Help-seeking behaviour in patients with anxiety disorder and depression. Acta Psychiatrica Scandinavica 2005;111(1):51–58.CrossRefGoogle ScholarPubMed
WHO. The European health report 2002. World Health Organization; 2002.Google Scholar
Ziedonis, D.M., George, T.P.Schizophrenia and nicotine use: report of a pilot smoking cessation program and review of neurobiological and clinical issues. Schizophrenia Bulletin 1997;23(2):247–254.CrossRefGoogle ScholarPubMed
Zvolensky, M.J., Feldner, M.T., Leen-Feldner, E.W., McLeish, A.C.Smoking and panic attacks, panic disorder, and agoraphobia: a review of the empirical literature. Clinical Psychology Review 2005 Sep;25(6):761–789.CrossRefGoogle ScholarPubMed
Zvolensky, M.J., Schmidt, N.B., McCreary, B.T.The impact of smoking on panic disorder: an initial investigation of a pathoplastic relationship. Journal of Anxiety Disorders 2003;17(4):447–460.CrossRefGoogle ScholarPubMed
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