Role of nicotine gum and pretreatment depressive symptoms in smoking cessation: twelve-month results of a randomized placebo controlled trial.
OBJECTIVE
The aim was to investigate the role of nicotine gum and pretreatment depressive symptoms in long-term smoking cessation.


METHODS
12-month follow-up of 608 participants within a randomized, controlled trial was conducted. Participants received brief counseling plus nicotine or placebo treatment. Based on the Center for Epidemiological Studies Depression Scale pre-treatment score (> or =16), 32% of the participants were classified as depressed at baseline.


RESULTS
At the 12-month follow-up the non-depressed participants with nicotine replacement therapy (NRT) were most successful (20.1%), while the depressed ones with placebo were least successful (5.7%) (p = .004). However, the depressed participants with NRT (15.1%) were not significantly less successful than the non-depressed ones with NRT (20.1%, p = .23). Survival analysis showed significant depression (p = .01) and treatment effects (p = < .001) on the abstinence. Further, when adjusted for marital status and education, the treatment effect remained significant (p < .001), whereas the depression effect became non-significant (p = .08).


CONCLUSIONS
NRT improved cessation both among the depressed and non-depressed. To understand discrepancies in literature reporting depression and smoking cessation outcome, the pharmacological treatment modality and social-demographic variables should be examined as additional variables.
Kinnunen
Taru
T
Harvard Medical School & Harvard School of Dental Medicine, MA 02115, USA. taru_kinnunen@hms.harvard.edu
Korhonen
Tellervo
T
Garvey
Arthur J
AJ
D000328:Adult; D002638:Chewing Gum; D015897:Comorbidity; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology; D004522:Educational Status; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D017533:Marital Status; D009538:Nicotine / Q000008:administration & dosage* / Q000627:therapeutic use; D010919:Placebos; D011569:Psychiatric Status Rating Scales; D012907:Smoking / Q000453:epidemiology / Q000523:psychology; D016540:Smoking Cessation / Q000379:methods*; D000074606:Smoking Prevention; D016019:Survival Analysis; D016896:Treatment Outcome
D002638:Chewing Gum; D010919:Placebos; D009538:Nicotine