Next Steps Toward Understanding the Relationship Between Cigarette Smoking and Depression/Anxiety Disorders: A Lifecourse Perspective

Adolescents' Depression Symptoms After Social Distancing and Restrictions: The EpiCoV French Longitudinal Population-Based Cohort

PURPOSE

The recent worldwide health pandemic and related social distancing and restrictions negatively impacted adolescents' mental health, including depression, underscoring the need for comprehensive understanding beyond immediate impacts. We aimed to identify factors assessed during the first and second lockdowns that were associated with depression symptoms 2 years after restrictions easing.

METHODS

This study included 1,946 adolescents, aged 15-18 years, involved in the French Epidémiologie et Conditions de Vie population-based cohort. Depression symptoms were assessed twice, with the nine-item Patient Health Questionnaire, at the beginning of restrictions easing and 1 year later. Logistic regressions were used to estimate associations among sociodemographic, socioeconomics, health, substance use, lockdown conditions, and pandemic-related factors, self-reported during the first and second lockdowns in France, and depression symptoms. Elastic-Net regression was used to study the joint effect of characteristics assessed during both lockdowns.

RESULTS

A total of 472 (25.25%) adolescents reported depression symptoms in the restrictions easing period, 369 (78.18%) were girls and 103 (21.82%) were boys. Factors associated with a higher risk of reporting depression symptoms included being a girl, a smoker, frequently consuming alcohol, having spent lockdowns in a place without outdoor space, poor perceived health, and pre-existing mental disorders.

DISCUSSION

Factors associated with depression symptoms after restrictions easing were well known and mostly not related to social distancing and restrictions, suggesting that already vulnerable youth were more likely to be impacted by the stressful pandemic context. Special caution is needed for these adolescents to limit pandemic's impact on long-lasting mental health. These results also underscore the importance of early identification of at-risk adolescents and the development of interventions to enhance their resilience and support in case of future crises.

Smoking-diseases correlation database: comprehensive analysis of the correlation between smoking and 422 diseases based on NHANES 2013-2018

Background

Smoking is a risk factor for a wide range of diseases. Previous research has confirmed over 30 Smoking-Associated Diseases in diverse systems. There is limited research exploring the correlation among multiple diseases, with an absence of comprehensive investigations. Few studies concentrate on diseases exhibiting a negative correlation with smoking, wherein smokers demonstrate a lower prevalence.

Objective

This study aimed to detect the correlation between smoking and other diseases using data from National Health and Nutrition Examination Surveys (NHANES) and construct a Smoking-Diseases Correlation Database (SDCD). The second aim is to obtain an extensive screening test for diseases that may be linked to smoking.

Methods

39,126 subjects' data from the NHANES 2013-2018 dataset were extracted. The baseline information, difference in blood routine and blood chemistry indicators between smokers and non-smokers, and diseases' correlation with smoking in four different models were analyzed by R. The data and statistics were aggregated into an online SDCD.

Results

Our study reported 46 Smoking-Associated Diseases (SAD), including 29 Smoking Positively Associated Diseases (SPAD) and 17 Smoking Negatively Associated Diseases (SNAD). The SDCD of 422 diseases was constructed and can be accessed at https://chatgptmodel.shinyapps.io/sdcd/.

Conclusion

Our findings revealed 46 SADs including 29 SPADs and 17 SNADs. We aggregated the statistics and developed online SDCD, advancing our understanding of the correlation between smoking and diseases.

Association of psychological distress and current cigarette smoking among Native Hawaiian and Pacific Islander adults and compared to adults from other racial/ethnic groups: Data from the National Health Interview Survey, 2014

Cigarette smoking is the leading cause of preventable deaths worldwide. Research has documented an association between psychological distress and smoking among certain racial/ethnic groups but has not examined this association among Native Hawaiian and Pacific Islander (NHPI) adults. Data from the 2014 general and the NHPI-specific National Health Interview Surveys were analyzed at the University of Arkansas for Medical Sciences Regional Campus (Fayetteville, AR) in April 2021 to determine the association between current cigarette smoking and levels of psychological distress among NHPI adults and to assess the difference in the magnitude of that association among NHPI adults compared to adults of other racial/ethnic groups in the United States. The final analytic sample (n = 34,782) included 1,916 NHPI, 20,430 White, 4,725 Black, 2,001 Asian, and 5,710 Hispanic adults. A significant association between current cigarette smoking and psychological distress levels was found among NHPI adults as well as among adults from other racial/ethnic groups. There was no significant difference in the magnitude of the detected association among NHPI adults compared to the magnitude of the same association detected among adults of other racial/ethnic groups. However, this finding indicates race/ethnicity does not moderate the association between psychological distress and current cigarette smoking. Future studies should explore factors that may further explain the variation in current cigarette smoking within and across all racial/ethnic groups.

Association of Environmental tobacco smoke exposure with depression among non-smoking adults

Background

Depression is a psychological dysfunction that impairs health and quality of life. However, whether environmental tobacco smoke exposure (ETSE) is associated with depression is poorly understood. This study was designed to evaluate the association of ETSE with depression among non-smoking adults in the United States.

Method

Using the 2015–2016 United States National Health and Nutrition Examination Survey (NHANES), we identified 2623 adults (females – 64.2%, males – 35.8%) who had never smoked and applied multivariable adjusted-logistic regression to determine the adjusted odds ratio (aOR) and 95% confidence interval (CI) at P < 0.05 for the association of ETSE with depression adjusting for relevant confounders.

Results

Mean age of respondents was 46.5 ± 17.9 years, 23.5% reported ETSE, and 4.7% reported depression. Also, aORs for the association of ETSE with depression were 1.992 (1.987, 1.997) among females and 0.674 (0.670, 0.677) among males. When we examined the association by age groups, the aORs were 1.792 (1.787, 1.796) among young adults (< 60 years) and 1.146 (1.140, 1.152) among older adults (≥60 years).

Conclusions

We found that ETSE was associated with higher odds of depression among females but not among males.

Contribution of Alcohol and Nicotine Dependence to the Prevalence of Depressed Mood in Different Ethnic Groups in The Netherlands: The HELIUS Study

Objective: Ethnic minorities report different levels of drinking and smoking and higher rates of depression compared to native populations. In this study we aimed to investigate in six ethnic groups whether tobacco and alcohol use were associated with depressive symptoms, which are more prevalent in ethnic minorities.Methods: Cross-sectional data from the multi-ethnic Healthy Life in an Urban Setting (HELIUS) study sample (N = 22,471) was used, comprising 4,580 native Dutch participants which were compared with participants from five ethnic minority groups (3,259 South Asian Surinamese, 4,292 African Surinamese, 2,262 Ghanaian, 3,891 Turkish, and 4,187 Moroccan).Results: Alcohol misuse was positively associated with depressed mood in all ethnic groups except for the Dutch and the Ghanaians. Nicotine dependence was positively associated with depressed mood in all ethnic groups except for the Ghanaian group.Conclusions: Alcohol misuse and nicotine dependence were significantly associated with depressed mood in most but not all ethnic groups and especially in men. However, across all groups the contribution of alcohol misuse and nicotine dependence to depressed mood was small. Prospective multi-ethnic studies should confirm whether the relations are causal and elucidate their direction.

The Role of Anxiety in Smoking Onset, Severity, and Cessation-Related Outcomes: a Review of Recent Literature

PURPOSE OF REVIEW

Anxiety is one of the most common mental health conditions globally and co-occurs with smoking at a markedly high rate. The present review offers a narrative overview of the most recent research on the role of anxiety in smoking onset, maintenance, and cessation-related outcomes. Additionally, given the rise in electronic cigarette use, we review the emerging literature on the influence of anxiety on e-cigarette use.

RECENT FINDINGS

Evidence across studies varied as to the role of anxiety or anxiety symptoms in smoking behavior. The most consistent findings suggested that those with anxiety are more likely to be a smoker, supporting a high rate of co-occurrence across these conditions. Less consistent evidence was observed for the association between anxiety and onset, indicators of severity, and cessation outcomes. Although there is robust evidence for an association between smoking and anxiety, there were considerable discrepancies for the precise role of anxiety in smoking onset, severity, and cessation outcomes. Future work utilizing more sophisticated methodologies is needed to identify causal relations as well as putative moderators and mediators of the anxiety-smoking relation.

Smoking behavior of "marriage squeezed" men and its impact on their quality of life: A survey study in China

From the 1980s, along with the wide application of the "one-child policy" and new technologies for prenatal sex determination, China's population has experienced a growing male population. China will thus face an increasingly serious male "marriage squeeze," possibly resulting in decreased psychological and sexual well-being of involuntary bachelors, which, in turn, may result in decreased quality of life (QoL). This study used data from the Social Survey on Gender Role and Family Life, which was conducted from August 2014 to January 2015 in Shaanxi Province (N = 1,144; 516 never-married and 628 married rural men). Descriptive analyses, crosstab analyses, and independent sample t-tests were used to compare the scores of three dimensions of QoL (physical and psychological health, and social relationships) and the overall QoL of rural men. Using the linear regression analysis method, this study analyzed involuntary bachelors' smoking behavior and its impact on their QoL. Results indicate that smoking not only fails to alleviate the psychological or sexual problems of involuntary bachelors, it has an independent and negative impact on the physical and psychological health of married and never-married men, which negatively affects their overall QoL. Subjective and objective exposure to marriage squeeze negatively impacts three dimensions of QoL and overall QoL of married and never-married men; however, this influence was moderated by sexual satisfaction. In addition, sexual satisfaction positively affected the three dimensions of QoL and overall QoL of married and never-married men. Since involuntary bachelors may be a high-risk group, further research is warranted.

Perceived effectiveness of objective features of pictorial warning messages

BACKGROUND

Previous research shows that pictorial warning messages (PWMs) for tobacco cigarettes increase quit attempts and smoking-related knowledge. However, few studies have investigated what specific features within PWMs are most effective. The current study sought to examine the specific features of PWMs associated with effectiveness using four outcome measures as indicators.

METHOD

A sample of n=319 PWMs was collected and underwent systematic content analysis on 48 different content features. A sample of n=1392 current smokers each rated a subset of the labels on perceived effectiveness, negative emotional engagement, intentions to enact avoidance behaviours and intentions to forego a cigarette. Multilevel random-effects models were fitted with all coded content features and each of the outcome measures.

RESULTS

Analysis across all four outcome measures shows that PWMs depicting diseased and damaged body parts and employing a testimonial format were most effective. Additional mediation analysis showed that image-level negative emotionality partially mediated the relationship between PWM features and perceived effectiveness.

CONCLUSION

The effectiveness of graphic imagery, testimonials and images that elicit negative emotions provides guidance for researchers as well as for future implementation of more effective PWMs.

Depression among current, former, and never smokers from 2005 to 2013: The hidden role of disparities in depression in the ongoing tobacco epidemic

BACKGROUND

After declining sharply for many years, the prevalence of smoking has remained fairly stable over the past decade. One possible explanation is that there has been an increase in the prevalence of barriers to cessation, like depression, among remaining smokers.

OBJECTIVES

To estimate changes in the prevalence of depression among current, former and never smokers in the United States (U.S.) population from 2005 to 2013 overall and by age, gender, and income.

METHODS

Data were drawn from the National Household Survey on Drug Use (NSDUH), an annual cross-sectional study of persons ages 12 and over (N=496,805). The prevalence of past 12-month depression was examined annually among current (past 12-month), former (not past 12-month), and lifetime non-smokers from 2005 to 2013. Data were re-analyzed stratified by age, gender, and household income, and adjusted for demographics.

RESULTS

Depression appears to have significantly increased in the United States from 2005 to 2013 among current, former, and never smokers. Depression prevalence increased among current smokers overall, but the increase among former and never smokers was even more prominent. Striking temporal changes emerged by age, gender and income. Specifically, (1) depression increased significantly among current smokers aged 12-17 (from 16% to 22%, p-value=0.0002) and the prevalence was consistently more than twice as high as that of never smokers; (2) depression increased among male smokers (6.19%-7.82%, p-value=0.0099); (3) depression increased significantly among smokers in the highest income group (6.36% to 8.91%, p-value=0.0400). Throughout this period, the prevalence of depression among current smokers was consistently twice as high as among former and never smokers.

DISCUSSION

Public health efforts aimed at decreasing the prevalence of smoking should take depression into account, a common and modifiable barrier whose treatment may help to increase successful smoking cessation. Future work is needed to disentangle the role of smoking and other factors that lead to increases in depression in the US population.