Researchers have determined why quitting smoking is especially difficult for those with depression and are testing a new treatment that combines medication with behavioral activation therapy.
The paper, an extensive review of current research, offers a much deeper understanding of why nicotine withdrawal symptoms for people with depression make it much more difficult to quit smoking. The paper was published in the international journal Addiction.
“We’ve used this new theory of withdrawal in depressed smokers to develop the first targeted approach for smoking cessation in this underserved population,” said senior author Brian Hitsman, associate professor of preventive medicine and of psychiatry and behavioral sciences at Northwestern University Feinberg School of Medicine.
Depressed smokers experience adverse withdrawal states that contribute to resumption of smoking, including low mood, difficulty engaging in rewarding activities and impaired thinking/memory, the paper reports. These symptoms are more severe for people with depression than for those without depression. In addition, depressed smokers tend to have fewer ways to cope with the symptoms and the nicotine in cigarettes helps to mitigate these problems, which is why depressed people tend to relapse at higher rates.
“Many smokers learn, ‘If I smoke in this situation, my mood gets better.’ But while smoking improves mood in the short term, it produces a long-term decline in mood,” said lead author Amanda Mathew, research assistant professor in preventive medicine at Feinberg and a licensed clinical psychologist. “On the other hand, successfully quitting smoking is associated with improvements in mental health.”