Past major depression and smoking cessation outcome: a systematic review and meta-analysis update
Article first published online: 17 JAN 2013
© 2012 The Authors, Addiction © 2012 Society for the Study of Addiction
Volume 108, Issue 2, pages 294–306, February 2013
How to Cite
Hitsman, B., Papandonatos, G. D., McChargue, D. E., DeMott, A., Herrera, M. J., Spring, B., Borrelli, B. and Niaura, R. (2013), Past major depression and smoking cessation outcome: a systematic review and meta-analysis update. Addiction, 108: 294–306. doi: 10.1111/add.12009
- Issue published online: 17 JAN 2013
- Article first published online: 17 JAN 2013
- Accepted manuscript online: 16 OCT 2012 08:38AM EST
- Manuscript Accepted: 4 OCT 2012
- Manuscript Revised: 3 JUL 2012
- Manuscript Received: 7 MAY 2012
- major depression;
- smoking cessation;
- systematic review;
To update our prior meta-analysis that showed past major depression (MD+) to be unrelated to smoking cessation outcome.
Eligible trials included 14 from our original review and 28 identified through an updated systematic review (2000–2009). We coded for assessment of past MD, exclusion for recent MD episode (MDE; ≤6 months versus no exclusion), duration/modality of cognitive behavioral treatment (CBT; face-to-face versus self-help) and other factors. To minimize influence of experimental treatments that may selectively benefit MD+ smokers we analyzed placebo/lowest intensity control arms only. Study-specific ORs for the effect of past MD on short-term (≤3 months) and long-term (≥6 months) abstinence were estimated and combined using random effects. Two-way interaction models of past MD with study methodology and treatment factors were used to evaluate hypothesized moderators of the past MD-abstinence association.
MD+ smokers had 17% lower odds of short-term abstinence (n = 35, OR = 0.83, 95% CI = 0.72–0.95, P = 0.009) and 19% lower odds of long-term abstinence (n = 38, OR = 0.81, 95% CI = 0.67–0.97, P = 0.023) than MD- smokers after excluding the sole study of varenicline because of its antidepressant properties. The association between past MD and abstinence was affected by methodological (recent MDE exclusion, type of MD assessment) and treatment (CBT modality) factors.
Past major depression has a modest adverse effect on abstinence during and after smoking cessation treatment. An increased focus on the identification of effective treatments or treatment adaptations that eliminate this disparity in smoking cessation for MD+ smokers is needed.