Cigarette Smoking in Relation to Depression: Historical Trends From the Stirling County Study

OBJECTIVE: Building on findings about the prevalence and incidence of depression over a 40-year period, the authors provide data on trends in cigarette smoking and associations with depression. METHOD: Data come from interviews with adult population samples (1952, 1970, and 1992) and followed cohorts (1952–1970 and 1970–1992). Logistic regression models and survival regressions were used to analyze the data. RESULTS: The associations between smoking and depression were small and nonsignificant in 1952 and 1970. In 1992, however, the odds that a smoker would be depressed were three times the odds that a nonsmoker would be depressed. The interaction between smoking and study year was significant, indicating that the association was limited to the most recent sample. In the cohort analysis, smoking at baseline did not predict the onset of depression, but subjects who became depressed were more likely to start or continue smoking and less likely to quit than those who never had a depression. CONCLUSIONS: In terms of population trends, the association between depression and cigarette smoking became prominent as the use of tobacco declined because of awareness of the risks involved. The findings about individuals followed over time suggest that those who became depressed were more involved with nicotine than those who never had a depression. The authors discuss hypotheses involving “self-medication,” risk-taking, and changes in the social climate but conclude that the relationships between smoking and depression are probably multiple and complex.