title: Prevalence and correlates of smoking status among veterans affairs primary care patients with probable major depressive disorder.
abstract: In an attempt to guide planning and optimize outcomes for population-specific smoking cessation efforts, the present study examined smoking prevalence and the demographic, clinical and psychosocial characteristics associated with smoking among a sample of Veterans Affairs primary care patients with probable major depression. Survey data were collected between 2003 and 2004 from 761 patients with probable major depression who attended one of 10 geographically dispersed VA primary care clinics. Current smoking prevalence was 39.8%. Relative to nonsmokers with probable major depression, bivariate comparisons revealed that current smokers had higher depression severity, drank more heavily, and were more likely to have comorbid PTSD. Smokers with probable major depression were also more likely than nonsmokers with probable major depression to have missed a health care appointment and to have missed medication doses in the previous 5months. Smokers were more amenable than non-smokers to depression treatment and diagnosis, and they reported more frequent visits to a mental health specialist and less social support. Alcohol abuse and low levels of social support were significant concurrent predictors of smoking status in controlled multivariable logistic regression. In conclusion, smoking prevalence was high among primary care patients with probable major depression, and these smokers reported a range of psychiatric and psychosocial characteristics with potential to complicate systems-level smoking cessation interventions.
authors.affiliation: Department of Psychology, The University of Montana, 32 Campus Drive, Missoula, MT 59812, United States. Electronic address: anayansilombardero@gmail.com.
authors.forename: Anayansi
authors.initials: A
authors.lastname: Lombardero
authors.affiliation: Department of Psychology, The University of Montana, 32 Campus Drive, Missoula, MT 59812, United States.
authors.forename: Duncan G
authors.initials: DG
authors.lastname: Campbell
authors.affiliation: School of Public and Community Health Sciences, The University of Montana, 32 Campus Drive, Missoula, MT 59812, United States.
authors.forename: Kari J
authors.initials: KJ
authors.lastname: Harris
authors.affiliation: VA Puget Sound Healthcare System, 1660 S Columbian Way, Seattle, WA 98108, United States; University of Washington School of Medicine, Warren G. Magnuson Health Sciences Center, Box 356340, 1925 N.E. Pacific Street Seattle, WA 98195-6340, United States.
authors.forename: Edmund F
authors.initials: EF
authors.lastname: Chaney
authors.affiliation: VA Greater Los Angeles Healthcare System, 11301 Wilshire Blvd #6005, Los Angeles, CA 90073, United States.
authors.forename: Andrew B
authors.initials: AB
authors.lastname: Lanto
authors.affiliation: VA Greater Los Angeles Healthcare System, 11301 Wilshire Blvd #6005, Los Angeles, CA 90073, United States; RAND Health Program, 1776 Main Street, P.O. Box 2138, Santa Monica, CA 90407, United States.
authors.forename: Lisa V
authors.initials: LV
authors.lastname: Rubenstein
mesh_terms: D000368:Aged; D000428:Alcohol Drinking / Q000453:epidemiology; D003865:Major Depressive Disorder / Q000453:epidemiology*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D055118:Medication Adherence; D008605:Mental Health Services / Q000706:statistics & numerical data; D008875:Middle Aged; D015995:Prevalence; D011320:Primary Health Care; D012720:Severity of Illness Index; D012907:Smoking / Q000453:epidemiology*; D012944:Social Support; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology; D014481:United States / Q000453:epidemiology; D014493:United States Department of Veterans Affairs; D014728:Veterans / Q000523:psychology / Q000706:statistics & numerical data*
keywords: Alcohol misuse; Depression; PTSD; Primary care; Smoking; Veterans