title: Predictors of health functioning in two high-risk groups of smokers.
abstract: The relative and combined health effects of cigarette smoking, heroin use, and depression were examined in 322 clinically depressed smokers and 117 opioid-dependent smokers participating in two studies of the San Francisco Treatment Research Center. Opioid-dependent smokers averaged 16 years (S.D.=9) of heroin use; 3% of depressed smokers used opiates in the past 6 months. Cigarettes per day (M=15, S.D.=10) and Beck Depression (BDI-II) scores (M=21, S.D.=11) were comparable between the two groups. Health functioning was assessed using the Medical Outcomes Study Short Form (SF-36). Adjusting for demographic differences, depressed smokers reported better physical but poorer emotional health relative to opioid-dependent smokers. Both groups scored significantly lower than published norms (p<.05). Within groups, severity of depressive symptoms, tobacco use, and opiate use were independent predictors of lower health functioning (p<.05). Examining risk-related subgroups based on depression scores (BDI-II> or =20), cigarettes per day (> or =1 pack), and opiate use, number of risk factors was monotonically related to health functioning in both samples. Individuals with two or more risk factors scored the lowest (p<.05). Severity of depressive symptoms, tobacco use, and opiate use contributed individually and collectively to lower health functioning. Blended treatments that target multiple risk factors are needed to improve health outcomes.
authors.affiliation: Department of Psychiatry, University of California, San Francisco, CA 94143-0984, USA. jodijpr@itsa.ucsf.edu
authors.forename: Judith J
authors.initials: JJ
authors.lastname: Prochaska
authors.forename: James L
authors.initials: JL
authors.lastname: Sorensen
authors.forename: Sharon M
authors.initials: SM
authors.lastname: Hall
authors.forename: Joseph S
authors.initials: JS
authors.lastname: Rossi
authors.forename: Colleen A
authors.initials: CA
authors.lastname: Redding
authors.forename: Amy B
authors.initials: AB
authors.lastname: Rosen
authors.forename: Stuart J
authors.initials: SJ
authors.lastname: Eisendrath
authors.forename: Marc R
authors.initials: MR
authors.lastname: Meisner
mesh_terms: D000328:Adult; D015897:Comorbidity; D003866:Depressive Disorder / Q000453:epidemiology*; D005260:Female; D006304:Health Status; D006305:Health Status Indicators; D003932:Heroin; D006801:Humans; D008297:Male; D009293:Opioid-Related Disorders / Q000453:epidemiology*; D012307:Risk Factors; D012495:San Francisco / Q000453:epidemiology; D012907:Smoking / Q000453:epidemiology*; D014029:Tobacco Use Disorder / Q000453:epidemiology*; D014026:Nicotiana
chemical_list: D003932:Heroin