title: Depression, smoking and smoking cessation: a qualitative study.
abstract: BACKGROUND
  A high proportion of smokers suffer from mental health problems including depression. Despite many of them wanting to stop smoking, low mood adversely affects their ability to quit.
  
  
  OBJECTIVE
  To explore the experiences of smokers with self-reported depression, the relationship of smoking with mental health problems and the experiences of smokers while trying to quit. The study also explored what help within the primary care setting could assist in quitting.
  
  
  METHODS
  Participants were recruited from a large general-practice-based smoking cessation trial. Participants who had indicated they were suffering from depression on a self-reported baseline survey were invited to participate. Semi-structured interviews were conducted over the telephone and digitally recorded. The interviews were transcribed and analysed using a phenomenological qualitative approach.
  
  
  RESULTS
  Sixteen interviews were conducted (11 females, 5 males). Mood disturbances were frequently reported as triggers for smoking and low mood was seen as a barrier to quitting. Perceived benefits of smoking when depressed were limited and for many, it was a learned response. A sense of hopelessness, lack of control over one's life and a lack of meaningful activities all emerged as important factors contributing to continued smoking. Participants felt that their quit attempts would be aided by better mood management, increased self-confidence and motivation and additional professional support.
  
  
  CONCLUSIONS
  Smoking and depression were found to be strongly interconnected. Depressed smokers interested in quitting may benefit from increased psychological help to enhance self-confidence, motivation and mood management, as well as a supportive general practice environment.
authors.affiliation: School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia.
authors.forename: Nicole
authors.initials: N
authors.lastname: Clancy
authors.forename: Nicholas
authors.initials: N
authors.lastname: Zwar
authors.forename: Robyn
authors.initials: R
authors.lastname: Richmond
mesh_terms: D000328:Adult; D000339:Affect; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000150:complications; D001294:Attitude to Health; D001714:Bipolar Disorder / Q000150:complications; D003863:Depression / Q000150:complications / Q000523:psychology*; D005260:Female; D058006:General Practice; D065026:Hope; D006801:Humans; D007389:Internal-External Control; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009042:Motivation; D011320:Primary Health Care; D011618:Psychotic Disorders / Q000150:complications; D036301:Qualitative Research; D020377:Self Efficacy; D012907:Smoking / Q000523:psychology*; D016540:Smoking Cessation / Q000523:psychology*; D000074606:Smoking Prevention; D055815:Young Adult
keywords: Depression; nurse practitioners; primary care; qualitative research; smoking/tobacco use.