title: Individualized Treatment for Tobacco Dependence in Addictions Treatment Settings: The Role of Current Depressive Symptoms on Outcomes at 3 and 6 Months.
abstract: BACKGROUND
  Individuals with concurrent tobacco dependence and other addictions often report symptoms of low mood and depression and as such may have more difficulty quitting smoking. We hypothesized that current symptoms of depression would be a significant predictor of quit success among a group of smokers receiving individualized treatment for tobacco dependence within addiction treatment settings.
  
  
  METHODS
  Individuals in treatment for other addictions were enrolled in a smoking cessation program involving brief behavioral counseling and individualized dosing of nicotine replacement therapy. The baseline assessment included the Patient Health Questionnaire (PHQ9) for depression. Smoking cessation outcomes were measured at 3 and 6 months post-enrollment. Bivariate associations between cessation outcomes and PHQ9 score were analyzed.
  
  
  RESULTS
  Of the 1,196 subjects enrolled to date, 1,171 (98%) completed the PHQ9. Moderate to severe depression (score >9) was reported by 28% of the sample, and another 29% reported mild depression (score between 5 and 9). Contrary to the extant literature and other findings by our own group, there was no association between current depression and cessation outcome at either 3 months (n = 1,171) (17.0% in those with PHQ9 > 9 vs. 19.8% in those with PHQ9 < 5, p = .32) or 6 months (n = 834) (17.8% vs. 18.9%, p = .74).
  
  
  CONCLUSIONS
  Contrary to our hypothesis, depression severity as measured by the PHQ9 did not predict cessation outcome in this clinical population. A possible explanation may be the individualized treatment and supportive environment of an addictions treatment setting. These data indicate that patients in an addictions treatment setting can successfully quit smoking regardless of current depressive symptoms.
authors.affiliation: Nicotine Dependence Service, Centre for Addiction and Mental Health, Toronto, ON, Canada; Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada; laurie.zawertailo@camh.ca.
authors.forename: Laurie A
authors.initials: LA
authors.lastname: Zawertailo
authors.affiliation: Nicotine Dependence Service, Centre for Addiction and Mental Health, Toronto, ON, Canada;
authors.forename: Dolly
authors.initials: D
authors.lastname: Baliunas
authors.affiliation: Nicotine Dependence Service, Centre for Addiction and Mental Health, Toronto, ON, Canada;
authors.forename: Anna
authors.initials: A
authors.lastname: Ivanova
authors.affiliation: Nicotine Dependence Service, Centre for Addiction and Mental Health, Toronto, ON, Canada; Department Family and Community Medicine, University of Toronto, Toronto, ON, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
authors.forename: Peter L
authors.initials: PL
authors.lastname: Selby
mesh_terms: D000328:Adult; D016739:Behavior, Addictive / Q000453:epidemiology / Q000523:psychology / Q000628:therapy*; D003863:Depression / Q000453:epidemiology / Q000523:psychology / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009864:Ontario / Q000453:epidemiology; D057285:Precision Medicine / Q000379:methods* / Q000523:psychology; D012907:Smoking / Q000453:epidemiology / Q000523:psychology / Q000628:therapy*; D016540:Smoking Cessation / Q000379:methods* / Q000523:psychology; D013997:Time Factors; D014029:Tobacco Use Disorder / Q000453:epidemiology / Q000523:psychology / Q000628:therapy*; D016896:Treatment Outcome