Major Depression Among Quitline Callers and Smokers at Large

Studies show smokers have higher rates of depression than nonsmokers and depressed smokers are less likely to quit than nondepressed smokers. Yet smokers who seek treatment to quit are generally not assessed for depression. This study formally assessed current major depression among smokers calling a state tobacco quitline and compared prevalence of depression among treatment seekers to smokers in the general population. It also tested whether depression predicted quitting among treatment seekers. Smokers (N=844) who called the California Smokers' Helpline were screened for depression using the Patient Health Questionnaire (PHQ-9) and for functioning using the Social Functioning Questionnaire. Follow-up evaluations at 2 months assessed successful quitting, defined as abstinence for 30 days or more at evaluation. Among quitline callers, 24% met criteria for current major depression compared to 11-12% of smokers reported from national surveys. Almost 75% of smokers with current major depression who called for help had significant social and occupational functioning deficits. At 2 months, those with major depression at baseline were less likely to have quit than those without depression at intake (18.5% vs. 28.4%, p<0.05). The rate of current major depression for quitline callers was more than twice the rate found among smokers at large. Smokers in other treatment programs likely also have high rates of major depression. This study showed that depressed smokers who sought treatment had impaired social functioning and more difficulty quitting, which suggest that there is a need to develop appropriate screening and intervention protocols to help depressed smokers succeed in quitting.