Depression's Role in Smoking Cessation Focus of New Study

Adults with clinical depression are twice as likely to smoke, and those who do experience more severe symptoms than people who do not smoke. These patterns begin early, as young people with depression are more likely to take up cigarettes and e-cigarettes. Surprisingly, despite these well-documented connections between depression and tobacco use, little research has studied how depression affects smoking cessation treatments. 

Sarah Tonkin, assistant professor of psychological sciences at the U of A, received a nearly $700,000 grant from the National Institutes of Health to determine how depression affects treatments designed to help people quit smoking. 

"This research is critical, because most of the treatments we have are not developed with the people who need them most in mind," Tonkin said. 

Past studies on smoking cessation excluded people with depression to simplify the results. But common symptoms of depression can also overlap with nicotine withdrawal symptoms, which may make it harder to quit smoking even with effective smoking cessation treatments. 

"It does give you cleaner outcomes to look at just people who smoke cigarettes with no psychopathology, but in the real world those people don't really exist," Tonkin said. "It's not helping if you're simplifying but not actually being able to address half the people who need it." 

Smoking remains the leading preventable cause of disease, disability and death in the United States. Nearly one in five U.S. deaths are caused by smoking or secondhand smoke. 

To address that gap, Tonkin's study will compare how people who smoke with and without depression respond to a just-in-time adaptive intervention. This evidence-based approach uses a mobile app to monitor cravings and stress, two factors that can lead to relapse. 

"We're trying to increase accessibility for people who have depression and maybe aren't motivated or don't have the resources to get another type of treatment," Tonkin said. 

The app gives users tailored advice to deal with environmental triggers that produce cravings. The approach has been shown to be an effective treatment for other types of substance use, including illicit drugs and alcohol. 

Tonkin's research aims to answer how well these just-in-time interventions for smoking cessation work for people with depression. 

"If they're just as effective, wonderful. We can push them out as is. If they're not, where are we going wrong? Where are we falling off in these treatments?"