title: Depression and Smoking Cessation: Evidence from a Smoking Cessation Clinic with 1-Year Follow-Up.
abstract: BACKGROUND
  Smoking is more prevalent among people with depression. Depression may make cessation more difficult and cessation may affect depression symptoms.
  
  
  OBJECTIVE
  The aims of this study were to assess the associations between (1) baseline depression and 1-year smoking abstinence and (2) abstinence and change in depression.
  
  
  METHODS
  Observational study using data collected routinely in a smoking cessation clinic in the Czech Republic from 2008 to 2014. Aim 1: N = 3775 patients; 14.3% reported mild and 15.4% moderate/severe baseline depression levels measured using Beck's Depression Inventory (BDI-II). Logistic regressions assessed if depression level predicted 1-year biochemically verified abstinence while adjusting for patient and treatment characteristics. Aim 2: N = 835 patients abstinent at 1 year; change in depression was analysed using Chi-square statistics, t test and mixed method analyses of variance.
  
  
  RESULTS
  Rate of abstinence was lower for patients with mild (32.5%, OR = 0.68; 95% CI: 0.54 to 0.87, p = 0.002) and moderate/severe depression (25.8%; OR = 0.57, 95% CI: 0.45 to 0.74, p < 0.001) compared with patients without depression (40.5%). Across abstinent patients, the majority with baseline depression reported lower depression levels at follow-up. Overall mean (SD) BDI-II scores improved from 9.2 (8.6) to 5.3 (6.1); t(834) = 14.6, p < 0.001. There were significant main effects of time (F(1832) = 880.8, p < 0.001, partial η2= 0.51) and baseline depression level (F(2832) = 666.4, p < 0.001, partial η2= 0.62) on follow-up depression and a significant depression * time interaction (F(2832) = 296.5, p < 0.001, partial η2= 0.42).
  
  
  CONCLUSIONS
  In this effective smoking cessation clinic, depression at the start of treatment predicted reduced smoking abstinence 1 year later. Patients abstinent from smoking experienced considerable improvement in depression.
authors.affiliation: Center for Tobacco-Dependent of the 3rd Medical Department-Department of Endocrinology and Metabolism, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Karlovo namesti 32, 128 00, Praha 2, Czech Republic. lenka.stepankova@lf1.cuni.cz.
authors.forename: Lenka
authors.initials: L
authors.lastname: Stepankova
authors.affiliation: Center for Tobacco-Dependent of the 3rd Medical Department-Department of Endocrinology and Metabolism, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Karlovo namesti 32, 128 00, Praha 2, Czech Republic.|Institute of Hygiene and Epidemiology, First Faculty of Medicine, Charles University and General University Hospital Prague, Studničkova 7, 128 00, Praha 2, Czech Republic.
authors.forename: Eva
authors.initials: E
authors.lastname: Kralikova
authors.affiliation: Center for Tobacco-Dependent of the 3rd Medical Department-Department of Endocrinology and Metabolism, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Karlovo namesti 32, 128 00, Praha 2, Czech Republic.
authors.forename: Kamila
authors.initials: K
authors.lastname: Zvolska
authors.affiliation: Center for Tobacco-Dependent of the 3rd Medical Department-Department of Endocrinology and Metabolism, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Karlovo namesti 32, 128 00, Praha 2, Czech Republic.|Institute of Hygiene and Epidemiology, First Faculty of Medicine, Charles University and General University Hospital Prague, Studničkova 7, 128 00, Praha 2, Czech Republic.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Pankova
authors.affiliation: Institute of Biostatistics and Analyses at the Faculty of Medicine and the Faculty of Science, Masaryk University, Kamenice 126/3, 625 00 Brno, Czech Republic.
authors.forename: Petra
authors.initials: P
authors.lastname: Ovesna
authors.affiliation: Institute of Biostatistics and Analyses at the Faculty of Medicine and the Faculty of Science, Masaryk University, Kamenice 126/3, 625 00 Brno, Czech Republic.
authors.forename: Milan
authors.initials: M
authors.lastname: Blaha
authors.affiliation: Psychology and Neuroscience, King's College London, UK and UK Centre for Tobacco and Alcohol Studies, Institute of Psychiatry, Addictions Sciences Building, 4 Windsor Walk, Denmark Hill, SE5 8BB, London, UK.
authors.forename: Leonie S
authors.initials: LS
authors.lastname: Brose
mesh_terms: D000328:Adult; D015331:Cohort Studies; D003376:Counseling; D003863:Depression / Q000523:psychology*; D055317:Evidence-Based Practice; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012907:Smoking / Q000523:psychology* / Q000628:therapy*; D016540:Smoking Cessation / Q000523:psychology*; D016896:Treatment Outcome
keywords: Cohort study; Depression; Effectiveness; Evidence-based practice; Preventive health services; Smoking cessation