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Factors associated with smoking and smoking cessation among primary care patients with depression: a naturalistic cohort study

Gail Gilchrist (Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK)
Sandra Davidson (Primary Care Research Unit, University of Melbourne, Melbourne, Australia)
Aves Middleton (Primary Care Research Unit, University of Melbourne, Melbourne, Australia)
Helen Herrman (Orygen Youth Health Research Centre and the Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia)
Kelsey Hegarty (Primary Care Research Unit, University of Melbourne, Melbourne, Australia)
Jane Gunn (Primary Care Research Unit, University of Melbourne, Melbourne, Australia)

Advances in Dual Diagnosis

ISSN: 1757-0972

Article publication date: 16 February 2015

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Abstract

Purpose

People with a history of depression are more likely to smoke and less likely to achieve abstinence from smoking long term. The purpose of this paper is to understand the factors associated with smoking and smoking cessation among patients with depression.

Design/methodology/approach

This paper reports on smoking prevalence and cessation in a cohort of 789 primary care attendees with depressive symptoms (Centre for Epidemiologic Studies Depression Scale score of=16) recruited from 30 randomly selected Primary Care Practices in Victoria, Australia in 2005.

Findings

At baseline, 32 per cent of participants smoked. Smokers were more likely to be male, unmarried, receive government benefits, have difficulty managing on available income, have emphysema, a chronic illness, poor self-rated health, to have more severe depressive and anxiety symptoms, to be taking anti-depressants, to be hazardous drinkers, to report suicidal ideation and to have experienced childhood physical or sexual abuse. At 12 months, 20 participants reported quitting. Females and people with good or better self-rated health were significantly more likely to have quit, while people with a chronic illness or suicidal ideation were less likely to quit. Smoking cessation was not associated with increases in depression or anxiety symptoms. Only six participants remained quit over four years.

Practical implications

Rates of smoking were high, and long-term cessation was low among primary care patients with depressive symptoms. Primary care physicians should provide additional monitoring and support to assist smokers with depression quit and remain quit.

Originality/value

This is the first naturalistic study of smoking patterns among primary care attendees with depressive symptoms.

Keywords

Citation

Gilchrist, G., Davidson, S., Middleton, A., Herrman, H., Hegarty, K. and Gunn, J. (2015), "Factors associated with smoking and smoking cessation among primary care patients with depression: a naturalistic cohort study", Advances in Dual Diagnosis, Vol. 8 No. 1, pp. 18-28. https://doi.org/10.1108/ADD-10-2014-0036

Publisher

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Emerald Group Publishing Limited

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