title: Depression among current, former, and never smokers from 2005 to 2013: The hidden role of disparities in depression in the ongoing tobacco epidemic.
abstract: After declining sharply for many years, the prevalence of smoking has remained fairly stable over the past decade. One possible explanation is that there has been an increase in the prevalence of barriers to cessation, like depression, among remaining smokers.
  
  
  
  To estimate changes in the prevalence of depression among current, former and never smokers in the United States (U.S.) population from 2005 to 2013 overall and by age, gender, and income.
  
  
  
  Data were drawn from the National Household Survey on Drug Use (NSDUH), an annual cross-sectional study of persons ages 12 and over (N=496,805). The prevalence of past 12-month depression was examined annually among current (past 12-month), former (not past 12-month), and lifetime non-smokers from 2005 to 2013. Data were re-analyzed stratified by age, gender, and household income, and adjusted for demographics.
  
  
  
  Depression appears to have significantly increased in the United States from 2005 to 2013 among current, former, and never smokers. Depression prevalence increased among current smokers overall, but the increase among former and never smokers was even more prominent. Striking temporal changes emerged by age, gender and income. Specifically, (1) depression increased significantly among current smokers aged 12-17 (from 16% to 22%, p-value=0.0002) and the prevalence was consistently more than twice as high as that of never smokers; (2) depression increased among male smokers (6.19%-7.82%, p-value=0.0099); (3) depression increased significantly among smokers in the highest income group (6.36% to 8.91%, p-value=0.0400). Throughout this period, the prevalence of depression among current smokers was consistently twice as high as among former and never smokers.
  
  
  
  Public health efforts aimed at decreasing the prevalence of smoking should take depression into account, a common and modifiable barrier whose treatment may help to increase successful smoking cessation. Future work is needed to disentangle the role of smoking and other factors that lead to increases in depression in the US population.
authors.affiliation: Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA; Department of Psychology, Queens College and The Graduate Center, City University of New York (CUNY), Queens, NY, USA. Electronic address: renee.goodwin@qc.cuny.edu.
authors.forename: Renee D
authors.initials: RD
authors.lastname: Goodwin
authors.affiliation: Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY, USA; New York State Psychiatric Institute, New York, NY, USA; Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY, USA.
authors.forename: Melanie M
authors.initials: MM
authors.lastname: Wall
authors.affiliation: Department of Psychology, University of Houston,126 Heyne Building, Houston, TX, USA.
authors.forename: Lorra
authors.initials: L
authors.lastname: Garey
authors.affiliation: Department of Psychology, University of Houston,126 Heyne Building, Houston, TX, USA; Department of Behavioral Sciences, University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Zvolensky
authors.affiliation: Department of Psychology, Wesleyan University, Middletown, CT, USA.
authors.forename: Lisa
authors.initials: L
authors.lastname: Dierker
authors.affiliation: Department of Epidemiology, School of Public Health, Boston University, Boston, MA, USA.
authors.forename: Sandro
authors.initials: S
authors.lastname: Galea
authors.affiliation: Department of Psychology, Queens College and The Graduate Center, City University of New York (CUNY), Queens, NY, USA.
authors.forename: Misato
authors.initials: M
authors.lastname: Gbedemah
authors.affiliation: Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, USA; Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY, USA.
authors.forename: Andrea H
authors.initials: AH
authors.lastname: Weinberger
authors.affiliation: Department of Psychiatry, Rutgers University-Robert Wood Johnson Medical School, New Brunswick, NJ, USA.
authors.forename: Jill M
authors.initials: JM
authors.lastname: Williams
authors.affiliation: New York State Psychiatric Institute, New York, NY, USA.
authors.forename: Mei-Chen
authors.initials: MC
authors.lastname: Hu
authors.affiliation: Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA; Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY, USA; New York State Psychiatric Institute, New York, NY, USA.
authors.forename: Deborah S
authors.initials: DS
authors.lastname: Hasin
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D058872:Epidemics / Q000706:statistics & numerical data*; D005260:Female; D006306:Health Surveys; D054625:Healthcare Disparities / Q000706:statistics & numerical data*; D006801:Humans; D007182:Income; D008297:Male; D008875:Middle Aged; D012907:Smoking / Q000453:epidemiology* / Q000523:psychology; D016540:Smoking Cessation / Q000523:psychology* / Q000706:statistics & numerical data*; D014481:United States; D055815:Young Adult
keywords: Cigarette smoking; Depression; Epidemiology; Temporal trends; Tobacco use