Hostname: page-component-586b7cd67f-r5fsc Total loading time: 0 Render date: 2024-11-27T21:14:48.503Z Has data issue: false hasContentIssue false

Smoking cessation is associated with lower rates of mood/anxiety and alcohol use disorders

Published online by Cambridge University Press:  12 February 2014

P. A. Cavazos-Rehg*
Affiliation:
Department of Psychiatry, Washington University School of Medicine, St Louis, MO, USA
N. Breslau
Affiliation:
Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing, MI, USA
D. Hatsukami
Affiliation:
Department of Psychiatry, University of Minnesota, Minneapolis, MN, USA
M. J. Krauss
Affiliation:
Department of Psychiatry, Washington University School of Medicine, St Louis, MO, USA
E. L. Spitznagel
Affiliation:
Department of Mathematics, Washington University in St Louis, St Louis, MO, USA
R. A. Grucza
Affiliation:
Department of Psychiatry, Washington University School of Medicine, St Louis, MO, USA
P. Salyer
Affiliation:
Department of Psychiatry, Washington University School of Medicine, St Louis, MO, USA
S. M. Hartz
Affiliation:
Department of Psychiatry, Washington University School of Medicine, St Louis, MO, USA
L. J. Bierut
Affiliation:
Department of Psychiatry, Washington University School of Medicine, St Louis, MO, USA
*
* Address for correspondence: P. A. Cavazos-Rehg, Ph.D., Campus Box 8134, Department of Psychiatry, 660 South Euclid, St Louis, MO 63110, USA. (Email: [email protected])

Abstract

Background

The psychological outcomes that accompany smoking cessation are not yet conclusive but positive outcomes could help to persuade quitting.

Method

We used data from the longitudinal National Epidemiological Study of Alcohol and Related Conditions. Logistic regression was used to examine associations between cigarette smoking reduction and Wave 2 status of addiction/mental health disorder among daily smokers at Wave 1, stratified by status of the diagnosis of interest at Wave 1. We adjusted for differences in baseline covariates between smokers with different levels of smoking reduction between Wave 1 and Wave 2 using propensity score regression adjustment.

Results

After adjusting for propensity scores and other mental health/addiction co-morbidities at Wave 2, among daily smokers who had current or lifetime history diagnosis of the outcome of interest at Wave 1, quitting by Wave 2 predicted a decreased risk of mood/anxiety disorder [adjusted odds ratio (aOR) 0.6, 95% confidence interval (CI) 0.4–0.9] and alcohol disorder (aOR 0.7, 95% CI 0.5–0.99) at Wave 2. Among daily smokers with no lifetime history diagnosis of the outcome of interest at Wave 1, quitting smoking by Wave 2 predicted a decreased risk of drug use disorder at Wave 2 (aOR 0.3, 95% CI 0.1–0.9).

Conclusions

There is no support in our data for the concern that smoking cessation would result in smokers' increased risk of some mental disorders. To the contrary, our data suggest that smoking cessation is associated with risk reduction for mood/anxiety or alcohol use disorder, even among smokers who have had a pre-existing disorder.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2014 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Adhikari, B, Kahende, J, Malarcher, A, Pechacek, T, Tong, V (2008). Smoking-attributable mortality, years of potential life lost, and productivity losses – United States, 2000–2004. Morbidity and Mortality Weekly Report 57, 12261228.Google Scholar
Anthony, JC, Echeagaray-Wagner, F (2000). Epidemiologic analysis of alcohol and tobacco use – patterns of co-occurring consumption and dependence in the United States. Alcohol Research and Health 24, 201208.Google Scholar
Asher, MK, Martin, RA, Rohsenow, DJ, MacKinnon, SV, Traficante, R, Monti, PM (2003). Perceived barriers to quitting smoking among alcohol dependent patients in treatment. Journal of Substance Abuse Treatment 24, 169174.Google Scholar
Baca, CT, Yahne, CE (2009). Smoking cessation during substance abuse treatment: what you need to know. Journal of Substance Abuse Treatment 36, 205219.Google Scholar
Becoña, E, Vázquez, FL, del Carmen Mı́guez, M (2002). Smoking cessation and anxiety in a clinical sample. Personality and Individual Differences 32, 489494.Google Scholar
Bock, BC, Goldstein, MG, Marcus, BH (1996). Depression following smoking cessation in women. Journal of Substance Abuse 8, 137144.Google Scholar
Bonard, L, Janin-Jacquat, B, Michaud, PA (2001). Who are the adolescents who stop smoking? European Journal of Pediatrics 160, 430435.Google Scholar
Borrelli, B, Niaura, R, Keuthen, NJ, Goldstein, MJ, DePue, JD, Murphy, C, Abrams, DB (1996). Development of major depressive disorder during smoking-cessation treatment. Journal of Clinical Psychiatry 57, 534538.Google Scholar
Breslau, N, Peterson, E, Schultz, L, Andreski, P, Chilcoat, H (1996). Are smokers with alcohol disorders less likely to quit? American Journal of Public Health 86, 985990.Google Scholar
Brookhart, MA, Schneeweiss, S, Rothman, KJ, Glynn, RJ, Avorn, J, Stürmer, T (2006). Variable selection for propensity score models. American Journal of Epidemiology 163, 11491156.Google Scholar
Brown, RA, Lewinsohn, PM, Seeley, JR, Wagner, EF (1996). Cigarette smoking, major depression, and other psychiatric disorders among adolescents. Journal of the American Academy of Child and Adolescent Psychiatry 35, 16021610.Google Scholar
Burgess, ES, Brown, RA, Kahler, CW, Niaura, R, Abrams, DB, Goldstein, MG, Miller, IW (2002). Patterns of change in depressive symptoms during smoking cessation: who's at risk for relapse? Journal of Consulting and Clinical Psychology 70, 356361.Google Scholar
Centers for Disease Control and Prevention (2012). Trends in current cigarette smoking among high school students and adults, United States, 1965–2011 (http://www.cdc.gov/tobacco/data_statistics/tables/trends/cig_smoking/). Accessed 7 December 2012.Google Scholar
Chen, CM, Yi, H, Dawson, DA, Stinson, FS, Grant, BF (2010). Alcohol use and alcohol use disorders in the United States, a 3-year follow-up: main findings from the 2004–2005 Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). In Alcohol Epidemiologic Data Reference Manual vol. 8, no. 2, NIH Publications no. 10–7677. National Institute on Alcohol Abuse and Alcoholism: Bethesda, MD (http://pubs.niaaa.nih.gov/publications/NESARC_DRM2/NESARC2DRM.htm). Accessed December 2013.Google Scholar
Chen, CM, Yi, H, Falk, DE, Stinson, FS, Dawson, DA, Grant, BF (2006). Alcohol use and alcohol use disorders in the United States: main findings from the 2001–2002 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). In Alcohol Epidemiologic Data Reference Manual vol. 8, no. 1, NIH Publications no. 05–5737. National Institute on Alcohol Abuse and Alcoholism: Bethesda, MD (http://pubs.niaaa.nih.gov/publications/NESARC_DRM/NESARCDRM.htm). Accessed December 2013.Google Scholar
Chiolero, A, Wietlisbach, V, Ruffieux, C, Paccaud, F, Cornuz, J (2006). Clustering of risk behaviors with cigarette consumption: a population-based survey. Preventive Medicine 42, 348353.Google Scholar
Cooney, JL, Cooney, NL, Pilkey, DT, Kranzler, HR, Oncken, CA (2003). Effects of nicotine deprivation on urges to drink and smoke in alcoholic smokers. Addiction 98, 913921.Google Scholar
Covey, LS, Glassman, AH, Stetner, F (1990). Depression and depressive symptoms in smoking cessation. Comprehensive Psychiatry 31, 350354.Google Scholar
Covey, LS, Glassman, AH, Stetner, F (1997). Major depression following smoking cessation. American Journal of Psychiatry 154, 263265.Google Scholar
Crum, RM, La Flair, L, Storr, CL, Green, KM, Stuart, EA, Alvanzo, AA, Lazareck, S, Bolton, JM, Robinson, J, Sareen, J, Mojtabai, R (2013). Reports of drinking to self-medicate anxiety symptoms: longitudinal assessment for subgroups of individuals with alcohol dependence. Depression and Anxiety 30, 174183.Google Scholar
Dawson, DA (2000). Drinking as a risk factor for sustained smoking. Drug and Alcohol Dependence 59, 235249.Google Scholar
Degenhardt, L, Hall, W (2001). The relationship between tobacco use, substance-use disorders and mental health: results from the national survey of mental health and well-being. Nicotine and Tobacco Research 3, 225234.Google Scholar
Dierker, LC, Avenevoli, S, Stolar, M, Merikangas, KR (2002). Smoking and depression: an examination of mechanisms of comorbidity. American Journal of Psychiatry 159, 947953.Google Scholar
Donald, S, Chartrand, H, Bolton, JM (2013). The relationship between nicotine cessation and mental disorders in a nationally representative sample. Journal of Psychiatric Research 47, 16731679.Google Scholar
Ferguson, D, Goodwin, RD, Horwood, LJ (2003). Major depression and cigarette smoking: results of a 21-year longitudinal study. Psychological Medicine 33, 13571367.Google Scholar
Flach, SD, Diener, A (2004). Eliciting patients' preferences for cigarette and alcohol cessation: an application of conjoint analysis. Addictive Behaviors 29, 791799.Google Scholar
Glassman, AH, Covey, LS, Stetner, F, Rivelli, S (2001). Smoking cessation and the course of major depression: a follow-up study. Lancet 357, 19291932.Google Scholar
Grant, BF, Moore, TC, Shepard, J, Kaplan, K (2003). Source and accuracy statement: Wave 1 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). National Institute on Alcohol Abuse and Alcoholism: Bethesda, MD.Google Scholar
Grant, BF, Stinson, FS, Dawson, DA, Chou, SP, Ruan, WJ, Pickering, RP (2004). Co-occurrence of 12-month alcohol and drug use disorders and personality disorders in the United States: results from the National Epidemiologic Survey on Alcohol and Related Conditions. Archives of General Psychiatry 61, 361368.Google Scholar
Guydish, J, Passalacqua, E, Tajima, B, Chan, M, Chun, J, Bostrom, A (2011). Smoking prevalence in addiction treatment: a review. Nicotine and Tobacco Research 13, 401411.Google Scholar
Hajek, P, Taylor, T, McRobbie, H (2010). The effect of stopping smoking on perceived stress levels. Addiction 105, 14661471.Google Scholar
Hall, SM, Muñoz, RF, Reus, VI, Sees, KL (1993). Nicotine, negative affect, and depression. Journal of Consulting and Clinical Psychology 61, 761767.Google Scholar
Hall, SM, Tsoh, JY, Prochaska, JJ, Eisendrath, S, Rossi, JS, Redding, CA, Rosen, AB, Meisner, M, Humfleet, GL, Gorecki, JA (2006). Treatment for cigarette smoking among depressed mental health outpatients: a randomized clinical trial. American Journal of Public Health 96, 18081814.Google Scholar
Hemmingsson, T, Kriebel, D, Tynelius, P, Rasmussen, F, Lundberg, I (2008). Adolescent mental health predicts quitting smoking in adulthood: a longitudinal analysis. European Journal of Public Health 18, 6670.Google Scholar
Hughes, JR (2007). Depression during tobacco abstinence. Nicotine and Tobacco Research 9, 443446.Google Scholar
Hughes, JR (2008). Smoking and suicide: a brief overview. Drug and Alcohol Dependence 98, 169178.Google Scholar
Imbens, GW (2000). The role of the propensity score in estimating dose–response functions. Biometrika 87, 706710.Google Scholar
Kalman, D, Morissette, SB, George, TP (2005). Co-morbidity of smoking in patients with psychiatric and substance use disorders. American Journal of Addictions 14, 106123.Google Scholar
Killen, JD, Fortmann, SP, Schatzberg, A, Hayward, C, Varady, A (2003). Onset of major depression during treatment for nicotine dependence. Addictive Behaviors 28, 461470.Google Scholar
Klungsoyr, O, Nygard, JF, Sorensen, T, Sandanger, I (2006). Cigarette smoking and incidence of first depressive episode: an 11-year, population-based follow-up study. American Journal of Epidemiology 163, 421432.Google Scholar
Kohn, CS, Tsoh, JY, Weisner, CM (2003). Changes in smoking status among substance abusers: baseline characteristics and abstinence from alcohol and drugs at 12-month follow-up. Drug and Alcohol Dependence 69, 6171.Google Scholar
Launiainen, T, Broms, U, Keskitalo-Vuokko, K, Pitkäniemi, J, Pelander, A, Kaprio, J, Ojanperä, I (2011). Nicotine, alcohol, and drug findings in young adults in a population-based postmortem database. Nicotine and Tobacco Research 13, 763771.Google Scholar
Lawrence, D, Mitrou, F, Zubrick, SR (2009). Smoking and mental illness: results from population surveys in Australia and the United States. BMC Public Health 9, 285.Google Scholar
Leistikow, BN, Shipley, MJ (1999). Might stopping smoking reduce injury death risks? A meta-analysis of randomized, controlled trials. Preventive Medicine 28, 255259.Google Scholar
Lewinsohn, PM, Rohde, P, Brown, RA (1999). Level of current and past adolescent cigarette smoking as predictors of future substance use disorders in young adulthood. Addiction 94, 913921.Google Scholar
Mathew, AR, Robinson, JD, Norton, PJ, Cinciripini, PM, Brown, RA, Blalock, JA (2013). Affective trajectories before and after a quit attempt in smokers with current depressive disorders. Nicotine and Tobacco Research 15, 18071815.Google Scholar
McCabe, RE, Chudzik, SM, Antony, MM, Young, L, Swinson, RP, Zolvensky, MJ (2004). Smoking behaviors across anxiety disorders. Journal of Anxiety Disorders 18, 718.Google Scholar
McFall, M, Atkins, DC, Yoshimoto, D, Thompson, CE, Kanter, E, Malte, CA, Saxon, AJ (2006). Integrating tobacco cessation treatment into mental health care for patients with posttraumatic stress disorder. American Journal on Addictions 15, 336344.Google Scholar
Miller, M, Hemenway, D, Rimm, E (2000). Cigarettes and suicide: a prospective study of 50,000 men. American Journal of Public Health 90, 768773.Google Scholar
Morissette, SB, Gulliver, SB, Kamholz, BW, Spiegel, DA, Tiffany, ST, Barlow, DH (2012). Transdermal nicotine during cue reactivity in adult smokers with and without anxiety disorders. Psychology of Addictive Behaviors 26, 507518.Google Scholar
Mulder, I, Tijhuis, M, Smit, HA, Kromhout, D (2001). Smoking cessation and quality of life: the effect of amount of smoking and time since quitting. Preventive Medicine 33, 653660.Google Scholar
Munafò, MRB, Hitsman, B, Rende, R, Metcalfe, C, Niaura, R (2008). Effects of progression to cigarette smoking on depressed mood in adolescents: evidence from the National Longitudinal Study of Adolescent Health. Addiction 103, 162171.Google Scholar
Myers, MG, Kelly, JF (2006). Cigarette smoking among adolescents with alcohol and other drug use problems. Alcohol Research and Health 29, 221227.Google Scholar
Pirie, K, Peto, R, Reeves, GK, Green, J, Beral, V (2013). The 21st century hazards of smoking and benefits of stopping: a prospective study of one million women in the UK. Lancet 381, 133141.Google Scholar
Prochaska, JJ, Delucchi, K, Hall, SM (2004 a). A meta-analysis of smoking cessation interventions with individuals in substance abuse treatment or recovery. Journal of Consulting and Clinical Psychology 72, 11441156.Google Scholar
Prochaska, JJ, Hall, SM, Tsoh, JY, Eisendrath, S, Rossi, JS, Redding, CA, Rosen, AB, Meisner, M, Humfleet, GL, Gorecki, JA (2008). Treating tobacco dependence in clinically depressed smokers: effect of smoking cessation on mental health functioning. American Journal of Public Health 98, 446448.Google Scholar
Prochaska, JJ, Rossi, JS, Redding, CA, Rosen, AB, Tsoh, JY, Humfleet, GL, Eisendrath, SJ, Meisner, MR, Hall, SM (2004 b). Depressed smokers and stage of change: implications for treatment interventions. Drug and Alcohol Dependence 76, 143151.Google Scholar
Ramsey, SE, Brown, RA, Strong, DR, Stuart, GL, Weinstock, MC, Myers, MG (2005). Cigarette smoking and substance use among adolescents in psychiatric treatment. Journal of Child and Adolescent Substance Abuse 14, 113.Google Scholar
Rohsenow, DJ, Colby, SM, Martin, RA, Monti, PM (2005). Nicotine and other substance interaction expectancies questionnaire: relationship of expectancies to substance use. Addictive Behaviors 30, 629641.Google Scholar
Romberger, DJ, Grant, K (2004). Alcohol consumption and smoking status: the role of smoking cessation. Biomedicine and Pharmacotherapy 58, 7783.Google Scholar
Rosenbaum, PR, Rubin, DB (1983). The central role of the propensity score in observational studies for causal effects. Biometrika, 70, 4155.Google Scholar
Ruan, WJ, Goldstein, RB, Chou, SP, Smith, SM, Saha, TD, Pickering, RP, Dawson, DA, Huang, B, Stinson, FS, Grant, BF (2008). The Alcohol Use Disorder and Associated Disabilities Interview Schedule-IV (AUDADIS-IV): reliability of new psychiatric diagnostic modules and risk factors in a general population sample. Drug and Alcohol Depenence 92, 2736.Google Scholar
Schroeder, SA, Morris, CD (2010). Confronting a neglected epidemic: tobacco cessation for persons with mental illnesses and substance abuse problems. Annual Review of Public Health 31, 297314.Google Scholar
Seidner, AL, Burling, TA, Gaither, DE, Thomas, RG (1996). Substance-dependent inpatients who accept smoking treatment. Journal of Substance Abuse 8, 3344.Google Scholar
Shah, BV, Branwell, G, Bieler, GS (2002). The SUDAAN User's Manual, release 7.5. Research Triangle Institute: Research Triangle Park, NC.Google Scholar
Shahab, L, West, R (2009). Do ex-smokers report feeling happier following cessation? Evidence from a cross-sectional survey. Nicotine and Tobacco Research 11, 553557.Google Scholar
Shahab, L, West, R (2012). Differences in happiness between smokers, ex-smokers and never smokers: cross-sectional findings from a national household survey. Drug and Alcohol Dependence 121, 3844.Google Scholar
Shiffman, S (1982). Relapse following smoking cessation: a situational analysis. Journal of Consulting and Clinical Psychology 50, 7186.Google Scholar
Sobell, LC, Sobell, MB (1996). Alcohol abuse and smoking – dual recoveries. Alcohol Health and Research World 20, 124127.Google Scholar
Spreeuwenberg, MD, Bartak, A, Croon, MA, Hagenaars, JA, Busschbach, JJ, Andrea, H, Twisk, J, Stijnen, T (2010). The multiple propensity score as control for bias in the comparison of more than two treatment arms: an introduction from a case study in mental health. Medical Care 48, 166174.Google Scholar
Stage, KB, Glassman, AH, Covey, LS (1996). Depression after smoking cessation: case reports. Journal of Clinical Psychiatry 57, 467469.Google Scholar
Stuyt, EB (1997). Recovery rates after treatment for alcohol/drug dependence: tobacco users vs. non-tobacco users. American Journal on Addictions 6, 159167.Google Scholar
Tobias, M, Templeton, R, Collings, S (2008). How much do mental disorders contribute to New Zealand's tobacco epidemic? Tobacco Control 17, 347350.Google Scholar
Torres, LD, Barrera, AZ, Delucchi, K, Penilla, C, Pérez-Stable, EJ, Muñoz, RF (2010). Quitting smoking does not increase the risk of major depressive episodes among users of Internet smoking cessation interventions. Psychological Medicine 40, 441449.Google Scholar
Tsoh, JY, Humfleet, GL, Munoz, RF, Reus, VI, Hartz, DT, Hall, SM (2000). Development of major depression after treatment for smoking cessation. American Journal of Psychiatry 157, 368374.Google Scholar
Upadhyaya, HP, Deas, D, Brady, KT, Kruesi, M (2002). Cigarette smoking and psychiatric comorbidity in children and adolescents. Journal of the American Academy of Child and Adolescent Psychiatry 41, 12941305.Google Scholar
Viswanath, K, Herbst, RS, Land, SR, Leischow, SJ, Shields, PG (2010). Tobacco and cancer: an American Association for Cancer Research policy statement. Cancer Research 70, 34193430.Google Scholar
West, R, Hajek, P (1997). What happens to anxiety levels on giving up smoking? American Journal of Psychiatry 154, 15891592.Google Scholar
Zanutto, E, Lu, B, Hornik, R (2005). Using propensity score subclassification for multiple treatment doses to evaluate a national antidrug media campaign. Journal of Educational and Behavioral Statistics 30, 5973.Google Scholar
Ziedonis, DM, Guydish, J, Williams, J, Steinberg, M, Foulds, J (2006). Barriers and solutions to addressing tobacco dependence in addiction treatment programs. Alcohol Research and Health 29, 228235.Google Scholar