Gender differences in the comorbidity of smoking behavior and major depression.

Objective: The present investigation sought to determine whether smoking behavior was associated with current or lifetime major depression and whether this association was greater in women.

Methods: Data were derived from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC; Wave 1, 2001-2002, n=42,565). Relationships between smoking status (daily, occasional, prior) and DSM-IV major depression (current or lifetime) by gender were assessed in terms of odds ratios using logistic regressions.

Results: Current (daily, occasional) and prior smoking significantly increased odds of having current or prior major depression. These associations varied as a function of gender. Women with prior smoking were at significantly higher risk of current and past depression than men (OR: 1.53 vs 1.36; 1.72 vs 1.36), as was true for current occasional (OR: 1.92 vs 1.39; 1.90 vs 1.30) and daily smoking (OR: 2.52 vs 1.95; 1.84 vs 1.48).

Conclusions: The association between smoking and current or past depression is not necessarily limited to smoking that meets criteria for nicotine dependence, and is more potent in women. Smoking cessation interventions for this population should consider the role that depression may play in failure to quit and smoking relapse, particularly in women.