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Smoking is linked to depression

More than 40 percent of U.S. adults who have depression are also smokers, according to a recent U.S. government survey. Patients with depression are more likely to be heavy smokers, and the worse the depression, the more likely they are to smoke.

Those who want to quit can do it, but they need help with both the depression and the smoking and it’s not easy, according to Laura Pratt and Debra Brody of the National Center for Health Statistics, who conducted the study.

Intensive treatment such as cognitive-behavioral therapy or antidepressant medications, which are used for depression, can help them quit and stay quit, say the authors.

Does smoking lead to depression or does depression lead to smoking?

The brain chemical imbalance present in people with mental illnes may lead many of them to seek relief from their symptoms by smoking.

“All major psychiatric disorders have a disproportionate increased number of smokers,” says William Shryer DCSW, LCSW, Clinical Director of the Diablo Behavioral Healthcare in the San Francisco Bay Area.

Nicotine enhances dopamine, which targets the pleasure centers of the brain, he says, and dopamine is deficient in those with depression, schizophrenia and other mental disorders.

But a New Zealand study suggests that smoking increases the risk of depression.

It found that those who were dependent on nicotine were more than twice as likely to have depressive symptoms as those who were not dependent.

“It’s possible that nicotine causes changes to neurotransmitter activity in the brain, leading to an increased risk of depression,” said lead researcher David M. Fergusson, PhD, professor and director of the Christchurch Health and Development Study at the University of Otago, Dunedin, New Zealand.
Even exposure to secondhand smoke appears to be associated with psychological distress and the risk of future psychiatric hospitalization among healthy adults, according to a recent report published in the Archives of General Psychiatry.

“On average, smokers die 13 to 14 years earlier than nonsmokers,” according to the U.S. Centers for Disease Control and Prevention. “Cigarette smoking is responsible for about one in five deaths annually, or about 443,000 deaths per year.”

Robert Wood Johnson Medical School researchers have determined that carbamazepine (Equetro, Tegretol, Carbatrol and Epitol) and oxycarbamazepine (Trileptal), medications commonly used to treat neurologic and psychiatric conditions, increase nicotine metabolism in smokers. As nicotine metabolism increases, cravings for nicotine return more quickly which could lead to more frequent cigarette consumption among individuals who also take these medications.

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