Psychosocial Treatments Can Help Depressed Smokers Quit

People affected by major depression and other depressive illnesses are known to smoke on a greater number of days than their non-depressed peers, and also go through more cigarettes on any given day. In addition, depressed people commonly have an unusually hard time when trying to stop smoking.

In a large-scale study review published in September 2013 in The Cochrane Library, a Dutch research team examined the usefulness of a non-medication-based approach called psychosocial treatment as an aid for helping depressed people break nicotine addictions. The members of this team found that psychosocial treatments can significantly improve depressed smokers’ chances for smoking cessation success. 

Depression and Smoking

Although the link between depression and smoking is clearly established, doctors and other mental health professionals don’t know for sure why depressed people smoke so often and so much. However, a number of explanations may potentially account for the connection, including a common genetic predisposition for both depression and nicotine use, exposure to environmental factors that simultaneously increase a person’s chances for smoking involvement and depression, and a tendency among some depression sufferers to knowingly or unwittingly rely on the antidepressant properties of nicotine to ease their negative mental states.

When depressed people try to stop smoking, they commonly experience amplified versions of the short-term downturns in mood typically associated with all cases of nicotine withdrawal. In addition, nicotine cravings in depressed people going through withdrawal frequently reach higher levels of intensity than the cravings found in non-depressed people withdrawing from nicotine. In combination, these factors can seriously increase the chances that a depressed individual trying to stop smoking will give up before completing the cessation process and continue using nicotine. As a result, people affected by depression typically have lower smoking cessation success rates than their peers unaffected by depression.

Psychosocial Treatment Basics

Psychosocial treatments are a group of techniques designed to help people with mental disorders understand those disorders, cope with the challenges of mental health recovery and get the help they need to make recovery a realistic possibility. Some mental health professionals also refer to these techniques as psychosocial interventions. Specific forms of psychosocial treatment include individualized psychotherapy, group or family psychotherapy, participation in mental health-oriented mutual aid or self-help organizations and psychoeducation, an approach that gives patients and families detailed information on the effects of specific illnesses, as well as on the treatments used to combat those illnesses. Some psychosocial programs also involve participation in some form of exercise.

Current Findings

In the study review published in The Cochrane Library, researchers from three Dutch institutions used an analysis of 49 previous studies to examine the potential usefulness of psychosocial treatment as an aid for smoking cessation efforts in people diagnosed with some form of depression. Most of the studies under review looked at smoking cessation programs using psychosocial mood management as part of their curriculum. The rest of the studies under review did not include psychosocial treatment; instead they relied on the use of buproprion, an anti-smoking medication known for its antidepressant properties.

After completing their analysis, the authors of the review concluded that depressed smokers enrolled in smoking cessation programs with a psychosocial component successfully quit smoking for longer periods of time than depressed smokers enrolled in programs that don’t use psychosocial treatments. These findings hold true for smokers currently affected by depression and smokers with past histories of depression. While the use of buproprion can also help smokers with a history of depression complete smoking cessation, the authors found that use of this medication does not help currently depressed individuals quit smoking.

Significance and Considerations

The authors of the study in The Cochrane Library believe that incorporation of psychosocial treatments into smoking cessation programs can help depressed people overcome the special challenges  they face during nicotine withdrawal, and thereby improve the chances that depressed smokers will remain nicotine-free over extended periods of time. This is especially important, since smokers dealing with depression commonly incur more smoking-related body damage than smokers unaffected by depression, and also die from smoking-related health problems with greater frequency. In addition, when depressed people successfully quit smoking, they often see a considerable improvement in their depression-related symptoms and experience greater levels of general mental well-being. While buproprion use produces some benefit, it has a positive effect on a much smaller group of depression-affected individuals than psychosocial treatment.