Learning Objectives: Identify those tobacco withdrawarl symptoms where NRT is particularly effective among depressed vs. non-depressed smokers.
Abstract:
Problem/Objective: Depression remains a major impediment for smoking cessation. We examined how NRT moderates tobacco withdrawal symptoms during 2 weeks of post-cessation among depressed and non-depressed smokers.
Methods: We recruited 608 smokers, attempting to quit within a randomized controlled trial, and followed them for one year. Participants were provided nicotine or placebo gum and brief counseling. For this study we analyzed data among 242 (39.8%) quitters who remained abstinent for at least 2 weeks. We measured withdrawal at 1, 7 and 14 post-cessation days. We used the Center of Epidemiological Studies Depression Scale to measure depressive symptoms, and found that 32% of the participants met the criterion for depression at baseline. We measured as withdrawal symptoms anxiety, irritability, depressed mood, difficulties concentrating, fatigue, weight gain, and bradykardia. We used a mixed-design ANOVA (Depression x NRT x Time) to assess withdrawal. Tukey’s tests for unequal sample sizes were used as post hoc tests.
Results: We found significant Depression x NRT- interaction effects in anxiety, irritability, depressed mood, and difficulties concentrating. The depressed participants in placebo treatment had the highest scores at all follow-ups. Fatigue had also a significant interaction; the depressed in NRT treatment reporting significant decrease of symptoms after cessation. For weight gain and bradykardia only a Time main effect was found. All sub-groups had significant weight gain and lower heart rate at the post-cessation measurements.
Conclusions: NRT may be particularly helpful among depressed in alleviating affective and cognitive withdrawal symptoms while having minimal impact on somatic symptoms.
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