Amanda Mathew, Ph.D.
Amanda Mathew, Ph.D.
Preventive Medicine
Cigarette smoking, nicotine dependence, depressive disorder, negative affect, withdrawal
Ryan Family Atrium, Robert H. Lurie Medical Research Center
Although smoking and depression commonly co-occur, the specific mechanisms underlying this association remain poorly understood. Depression may drive smoking persistence by enhancing sensitivity to internal states of negative affect and acute withdrawal, and promoting tobacco-seeking behavior in response to these states. In this human laboratory study, we examined performance on a mood-induced tobacco choice task in depressed and non-depressed smokers. Participants were 29 smokers aged 18-65 who smoked >10 cigarettes/day. Nine participants endorsed a current episode of Major Depressive Disorder (MDD), as determined by the MINI International Neuropsychiatric interview, while the remainder were non-depressed. Participants completed two sessions one week apart, with smoking as normal prior to the session 1, and at least 6 hours of nicotine deprivation prior to session 2. Abstinence was confirmed by CO of either <10 ppm or less than half baseline value. The effect of negative mood induction on tobacco-seeking was measured in both sessions using a method which has been previously validated. Baseline tobacco choice was first indexed by participants’ preference to view smoking vs. food images. Negative mood was then induced by a series of negative ruminative statements and sad music, before tobacco choice was again measured. We used ANOVA models to examine the main effect of group (MDD+ vs. MDD-) and interaction with abstinence status (non-deprived vs. deprived) as predictors of tobacco choice at baseline and following negative mood induction. In the smoking as normal session 1, MDD+ smokers showed a greater increase in tobacco choice following negative mood induction from baseline, as compared to MDD- smokers (p=.046). MDD+ smokers also showed a greater increase in baseline tobacco choice between the non-deprived and deprived study sessions, relative to MDD- smokers (p=.023). Finally, negative affect and withdrawal induced tobacco choice were highly correlated (r=.67, p<.001). In conclusion, the relationship between depression and smoking persistence may be driven by a comparable vulnerability to increases in tobacco-seeking in response to both negative affective and acute withdrawal states.