The Impact of Depression on Smoking Cessation in Women

Abstract

Cigarette smoking poses unique, but preventable health risks to women. Identification of barriers to womens' quitting is essential to tailor interventions accordingly. Major depression, whether historical, current, or subsyndromal, may present unique challenges to women quitting smoking. Although several reviews discuss women and smoking in general, this review focuses exclusively on the role of depression in womens' smoking. The goals of this review are to (1) discuss and synthesize the current findings on the association between smoking and depression in women in general, and in particular subgroups of women (underserved, premenstrual, postpartum, menopausal), (2) discuss physician-assisted, pharmacologic, behavioral interventions for mood management, and (3) propose future avenues for intervention, research, and policy. IMPACT OF DEPRESSION: Major depression may influence smoking cessation in women because (1) depression is twice as common among women as men, (2) history of depression and negative affect have been associated with smoking treatment failure, (3) quitting smoking is especially difficult during certain phases of the reproductive cycle, phases that have also been associated with greater levels of dysphoria, and (4) subgroups of women who have a high risk of continuing to smoke (underserved, less educated, low SES) also have a high risk of developing depression. Since many women who are depressed (or who have developed depression during prior quit attempts) may be less likely to seek formal cessation treatment, practitioners have a unique opportunity to persuade their patients to quit. We discuss patient-treatment matching.