Depression during treatment may make it harder for women to quit smoking

April 09, 2003

Researchers from the University of Pittsburgh found that women smokers who experienced an increase in depressive symptoms during smoking-cessation treatment may be more likely to relapse. However, a history of major depressive disorder (MDD) before treatment was not predictive of failure to quit smoking.

The researchers recruited 219 women smokers who were highly motivated to quit. Their history of depression was assessed and they were classified as being positive (MDD+) or negative (MDD-) for major depressive disorder. All the women received a standard group-based smoking cessation treatment consisting of 10 90-minute sessions over a seven-week period. At each treatment session, the women reported their symptoms of depression and the number of cigarettes they had smoked since the previous session. Their depression was also assessed one, three, six and 12 months after the treatment period.

Overall, about 85 percent of the women relapsed to smoking within one year following treatment. There were no differences in the overall relapse rate among women with or without a history of depression; however, MDD+ women were more likely to relapse prior to the end of the 7-week treatment. Of those that relapsed, about 60 percent of the MDD+ women relapsed during treatment compared to 40 percent of MDD- women. Additionally, MDD+ women were more likely to drop out of treatment before the quit date compared to MDD- women.

Women who successfully quit smoking reported significant decreases in depressive symptoms from pre- to post-treatment, while those who had relapsed reported an increase in depressive symptoms. However, this change in depressive symptoms during treatment was not predictive of continuous abstinence three, six or 12 months after quitting.

WHAT IT MEANS: Women smokers who are depressed have more difficulties getting through treatment. They may require different treatment approaches that address their depression.

Drs. Michele Levine, Kenneth Perkins, and colleagues published this study in the February 2003 issue of Nicotine and Tobacco Research. It was funded by the National Institute on Drug Abuse.
The National Institute on Drug Abuse (NIDA) is a component of the National Institutes of Health, U.S. Department of Health and Human Services. NIDA supports more than 85 percent of the world's research on the health aspects of drug abuse and addiction. The Institute carries out a large variety of programs to ensure the rapid dissemination of research information and its implementation in policy and practice. Fact sheets on the health effects of drugs of abuse and other topics are available in English and Spanish. These fact sheets and further information on NIDA research and other activities can be found on the NIDA home page at

NIH/National Institute on Drug Abuse

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