Research paperMajor depression and non-specific distress following smoking cessation in the Canadian general population
Section snippets
Background
Smoking is a well-established risk factor for cardiovascular disease, lung disease and cancer, and for these reasons smoking cessation has been a target of primary prevention for decades (Office on Smoking and Health National Centre for Chronic Disease Prevention and Health Promotion, 2015). People with mental disorders often smoke (Lawrence et al., 2009), yet it is suspected that the problem is “largely ignored” in mental health treatment settings (Williams and Ziedonis, 2004). It is suspected
Methods
The study was based on a series of national surveys conducted by the Canadian national statistical agency, Statistics Canada under its Canadian Community Health Survey (CCHS) program (Statistics Canada, 2011). This program began in 2001 with a survey called the CCHS 1.1, followed by the CCHS 2.1 (conducted in 2003), CCHS 3.1 (conducted in 2005), CCHS 4.1 (conducted in 2007/08), the CCHS 2009/10 (based on data collected in those two years), the CCHS 2011/12, CCHS-MH (conducted in 2012) and the
Results
Table 1 shows the sample size of each of the surveys, and the number of observations for past-year MDE and K-6 ratings. There were n=391,362 respondents administered the CIDI and n=239,408 administered the K-6 scale. The frequency of daily smoking in 2001 was 22.4%, declining to 14.9% in 2013 (meta-regression-derived slope term: beta=−0.005, t=−6.61, d.f.=6, p=0.001). The frequency of never smoking increased from 34.9% to 41.2% (meta-regression-derived slope term: beta =0.005, t=9.49, d.f. =6,
Discussion
Among members of the general population, smoking was associated both with MDE and distress. Former smokers were only slightly more likely to have MDE or have high distress ratings than never smokers, whereas substantially increase prevalence of both of these outcomes was observed in current daily and current occasional smokers. This replicates previous reports of an association between smoking and negative mental health. Among prior studies, the most comparable one is the MIDUS study (Bakhshaie
Limitations
The most important limitation of this study is its cross-sectional nature and the resulting inability to fully clarify temporality of the underlying causal effects. This is particularly true for estimates of MDE prevalence in respondents who had quit smoking in the year preceding their interview. Here, the temporal sequencing between past year MDE, past month distress and past year smoking cessation could not be clarified. It is possible that respondents succeeded at long-term cessation because
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