title: The association between depressive symptoms and cigarette smoking in an urban primary care sample.
abstract: OBJECTIVE
  To examine the relationship between cigarette smoking and depressive symptoms in an urban primary care sample.
  
  
  METHODS
  Eligible participants were 526 patients aged eighteen to sixty-four presenting in the waiting rooms of two university affiliated internal medicine clinics. Participants were asked to complete a brief interview which ascertained current depressive symptoms using the Center for Epidemiologic Studies Depression Scale (CES-D), demographic information, and smoking status using a modified version of the Fagerstrom Test for Nicotine Dependence (FTND).
  
  
  RESULTS
  Smoking status differed significantly by age, gender, education, and employment status. Mean level of depressive severity also differed by smoking status. Current smokers with nicotine dependence symptoms had significantly higher CES-D scores than those who had never smoked, ex-smokers, and non-dependent smokers. Logistic regression analyses indicated that gender, employment status, age, and smoking status were significantly associated with CES-D scores > or = 16. Exploratory analyses suggested that among smokers with a symptom of nicotine dependence, significantly more women than men had clinically significant levels of depressive symptoms.
  
  
  CONCLUSIONS
  The association between smoking behavior and depressive symptoms in the present study is consistent with that reported in population-based and psychiatric samples. Symptoms of nicotine dependence were significantly associated with clinical levels of depressive symptoms. Primary care physicians may wish to inquire about depressive symptoms among smokers, because these symptoms may interfere with patients' efforts to quit.
authors.affiliation: Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pennsylvania, USA.
authors.forename: C
authors.initials: C
authors.lastname: Brown
authors.forename: P A
authors.initials: PA
authors.lastname: Madden
authors.forename: D R
authors.initials: DR
authors.lastname: Palenchar
authors.forename: L
authors.initials: L
authors.lastname: Cooper-Patrick
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D003863:Depression / Q000150:complications* / Q000453:epidemiology / Q000523:psychology; D004651:Employment; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D011320:Primary Health Care; D012680:Sensitivity and Specificity; D017678:Sex Distribution; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014029:Tobacco Use Disorder / Q000150:complications* / Q000453:epidemiology / Q000523:psychology; D014505:Urban Population / Q000706:statistics & numerical data