Depression Associated With Higher Cigarette Use and Lower Quit Rates

cigarette ashes
cigarette ashes
From 2005 to 2017, there was a statistically significant reduction in the prevalence of current cigarette smoking from 23.58% to 17.89%.

Patients with depression are more likely to smoke cigarettes and are less likely to quit compared to individuals without depression, according to a study in the American Journal of Preventative Medicine.

This study used 2005 to 2017 data from the National Survey on Drug Use and Health public data portal. Cigarette smoking prevalence and quit ratios were assessed in respondents aged ≥12 years (n=728,691) and ≥26 years (n=131,412), respectively. Current cigarette smokers were identified if they reported smoking ≥100 lifetime cigarettes and had reported smoking cigarettes in the previous 30 days. Cigarette smokers in the quit ratio analysis were classified accordingly if they had reported smoking ≥100 lifetime cigarettes. Temporal trends in both smoking prevalence and quit ratio were estimated and stratified by past-year depression.

From 2005 to 2017, there was a statistically significant reduction in the prevalence of current cigarette smoking from 23.58% (95% CI, 23.22-24.04) to 17.89% (95% CI, 17.61-18.17) in the full sample. During this same time, there was no significant change in nondaily smoking rates in people with depression (9.25% to 9.40%; adjusted odds ratio [aOR], 0.995; 95% CI, 0.986-1.005). Comparatively, nondaily smoking decreased from 7.02% in 2005 to 5.85% in 2017 in people without depression (aOR, 0.986; 95% CI, 0.981-0.990).

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Despite these findings, the rate of daily smoking from 2005 to 2015 decreased in individuals with depression (25.21% to 15.11%; aOR, 0.953; 95% CI, 0.945-0.962) and without depression (14.94% to 9.76%; aOR, 0.970; 95% CI, 0.967-0.973). While the quit ratio increased during this period in patients with depression (28.61% to 39.75%; aOR, 1.036; 95% CI, 1.021-1.052) and those without depression (47.65% to 53.09%; aOR, 1.013; 95% CI, 1.009-1.017), these ratios were lower for patients with depression.

Limitations of the study included the focus on only noninstitutionalized or nonhospitalized patients with depression.

The investigators suggested that implementing innovative tobacco control programs and “reducing inequalities in tobacco use among people with depression, a large and vulnerable subgroup of smokers, is imperative to advance public health and tobacco control.”


Weinberger AH, Chaiton MO, Zhu J, Wall MM, Hasin DS, Goodwin RD. Trends in the prevalence of current, daily, and nondaily cigarette smoking and quit ratios by depression status in the U.S.: 2005-2017 [published online March 7, 2020]. Am J Prev Med. doi: 10.1016/j.amepre.2019.12.023.