What is the association between nicotine addiction and depression?

Updated: Jul 16, 2018
  • Author: R Gregory Lande, DO, FACN; Chief Editor: Glen L Xiong, MD  more...
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The association between depression and smoking is well established. A lifetime history of major depression is more than twice as common in people who smoke than in people who do not. A history of major depressive disorder (MDD) is associated with a decreased ability to quit smoking and an increased likelihood of smoking relapse.

As shown by the National Institute on Alcohol Abuse and Alcoholism’s National Epidemiologic Survey on Alcohol and Related Conditions, current daily smokers with lifetime MDD and current MDD were more likely to report a continuation of smoking than those without a diagnosis of MDD. Former daily smokers with current MDD were also less likely to report continued abstinence. [9]

In subjects with a history of major depression, smoking may be an attempt to decrease negative affect. After an attempt to quit, such patients are likely to experience greater symptoms of nicotine withdrawal than smokers without a history of depression. Therefore, in patients who are attempting to quit smoking, inquiring about present or past symptoms of depression and anxiety is advisable, and specific therapy may be indicated.

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