Scott B Patten1, Jeanne V A Williams2, Dina H Lavorato2, Jian Li Wang3, Tolulope T Sajobi4, Andrew G M Bulloch3. 1. Department of Community Health Sciences and Department of Psychiatry, University of Calgary, Canada; Mathison Centre for Mental Health Research & Education, Hotchkiss Brain Institute, Canada; Senior Health Scholar, Alberta Innovates, Health Solutions, Canada; Department of Community Health Sciences, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, Canada T2N 4Z6. Electronic address: patten@ucalgary.ca. 2. Department of Community Health Sciences, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, Canada T2N 4Z6. 3. Department of Community Health Sciences and Department of Psychiatry, University of Calgary, Canada; Mathison Centre for Mental Health Research & Education, Hotchkiss Brain Institute, Canada. 4. Department of Community Health Sciences and Department of Clinical Neurosciences, University of Calgary and the O'Brien Institute for Public Health, Canada.
Abstract
BACKGROUND: Outcome data from smoking cessation trials indicate that improvement in mental health occurs after smoking cessation. This suggests that smoking cessation should be a priority for mental health services. However, participants in such trials may not be representative of the general population. This study investigates changes in mental health following smoking cessation in a set of general population samples. METHODS: Data from a library of cross-sectional surveys conducted by Statistics Canada between 2001 and 2013 were included in this analysis. Survey estimates were pooled in order to increase precision. Associations between smoking (and smoking cessation), major depressive episodes (MDE) and non-specific distress (assessed using the K-6 scale) were evaluated using meta-analysis and meta-regression techniques. RESULTS: The annual prevalence of major depression was higher in daily (11.0%) than in never smokers (4.4%). The prevalence in former daily smokers was 5.1%. The prevalence of MDE and distress was elevated in those recently quitting but returned to baseline levels within one year. CONCLUSIONS: After smoking cessation, indicators of mental health improve over time, especially in the first year. The findings support the idea that smoking cessation should be a part of the management of common mood and anxiety disorders. However, due to its observational nature this study in itself cannot confirm causality, sustained abstinence may be an effect of improved mental health rather than its cause. LIMITATIONS: The cross-sectional nature of the constituent surveys does not allow causal inference. No biological measures (e.g. cotinine) were available.
BACKGROUND: Outcome data from smoking cessation trials indicate that improvement in mental health occurs after smoking cessation. This suggests that smoking cessation should be a priority for mental health services. However, participants in such trials may not be representative of the general population. This study investigates changes in mental health following smoking cessation in a set of general population samples. METHODS: Data from a library of cross-sectional surveys conducted by Statistics Canada between 2001 and 2013 were included in this analysis. Survey estimates were pooled in order to increase precision. Associations between smoking (and smoking cessation), major depressive episodes (MDE) and non-specific distress (assessed using the K-6 scale) were evaluated using meta-analysis and meta-regression techniques. RESULTS: The annual prevalence of major depression was higher in daily (11.0%) than in never smokers (4.4%). The prevalence in former daily smokers was 5.1%. The prevalence of MDE and distress was elevated in those recently quitting but returned to baseline levels within one year. CONCLUSIONS: After smoking cessation, indicators of mental health improve over time, especially in the first year. The findings support the idea that smoking cessation should be a part of the management of common mood and anxiety disorders. However, due to its observational nature this study in itself cannot confirm causality, sustained abstinence may be an effect of improved mental health rather than its cause. LIMITATIONS: The cross-sectional nature of the constituent surveys does not allow causal inference. No biological measures (e.g. cotinine) were available.