Association between Smoking Abstinence and Depression and Anxiety Symptoms After Hospital Discharge: The Helping HAND 4 Trial.

IF 4.2 3区 医学 Q1 SUBSTANCE ABUSE Journal of Addiction Medicine Pub Date : 2024-08-08 DOI:10.1097/ADM.0000000000001358
Catherine S Nagawa, Nancy A Rigotti, Yuchiao Chang, Douglas E Levy, Joanna M Streck, Thomas Ylioja, Scott S Lee, Hilary A Tindle
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Abstract

Objectives: Some people who stop smoking experience improved mood, but few studies have examined this relationship after hospitalization or accounted for concomitant substance use and psychological factors. We examined associations between smoking abstinence after a hospital discharge and change in depression and anxiety symptoms.

Methods: We conducted a secondary analysis of data from the Helping HAND 4 smoking cessation trial, which enrolled people who used tobacco when admitted to three academic medical center general hospitals. Participants (n = 986) were categorized as continuously abstinent (CA) or not. We used linear and logistic regression to model continuous and binary measures of depression (Patient Health Questionnaire [PHQ-8] ≥/<10), and anxiety (Generalized Anxiety Disorder Assessment [GAD-7], ≥/<8) over 6 months, adjusting for baseline mood, psychological factors, and substance use. Binary outcomes were defined using established clinical thresholds to aid in the clinical interpretation of the results.

Results: Mean age was 52.3 years, 56.5% were female, and the baseline mean cigarettes/day was 16.2 (SD: 3.2). In the adjusted analyses, depression and anxiety scores improved more in CA than non-CA participants over 6 months (difference-in-improvement, 2.43 [95% CI: 1.50-3.36] for PHQ-8; 3.04 [95% CI: 2.16-3.93] for GAD-7). At 6 months, CA participants were more likely to have a PHQ-8 score <10 (aOR = 2.07 [95% CI: 1.36-3.16]) and a GAD-7 score <8 (aOR = 2.90 [95% CI: 1.91-4.39]).

Conclusions: Individuals who were CA, compared to those who were not, had fewer depression and anxiety symptoms at 6 months, and were twice as likely to score below the population screening thresholds for major depression and anxiety disorders. Clinicians should emphasize the association between continuous abstinence and improved mood symptoms after hospital discharge.

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出院后戒烟与抑郁和焦虑症状之间的关系:Helping HAND 4 试验
研究目的:一些戒烟者的情绪会得到改善,但很少有研究对住院后的这种关系进行研究,也很少有研究考虑到同时使用药物和心理因素。我们研究了出院后戒烟与抑郁和焦虑症状变化之间的关系:我们对 Helping HAND 4 戒烟试验的数据进行了二次分析。参与者(n = 986)被分为连续戒烟(CA)或未连续戒烟。我们使用线性回归和逻辑回归对抑郁的连续和二元测量指标(患者健康问卷 [PHQ-8] ≥/结果)进行建模:平均年龄为 52.3 岁,56.5% 为女性,基线平均吸烟量为 16.2 支/天(标清:3.2 支)。在调整分析中,6 个月内,CA 参与者的抑郁和焦虑评分改善程度高于非 CA 参与者(PHQ-8 的改善差异为 2.43 [95% CI:1.50-3.36];GAD-7 的改善差异为 3.04 [95% CI:2.16-3.93])。在 6 个月时,CA 参与者更有可能得出 PHQ-8 评分结论:与非 CA 患者相比,CA 患者在 6 个月时的抑郁和焦虑症状较少,其得分低于重度抑郁和焦虑症人群筛查阈值的可能性是非 CA 患者的两倍。临床医生应强调持续戒酒与出院后情绪症状改善之间的关联。
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来源期刊
Journal of Addiction Medicine
Journal of Addiction Medicine 医学-药物滥用
CiteScore
6.10
自引率
9.10%
发文量
260
审稿时长
>12 weeks
期刊介绍: The mission of Journal of Addiction Medicine, the official peer-reviewed journal of the American Society of Addiction Medicine, is to promote excellence in the practice of addiction medicine and in clinical research as well as to support Addiction Medicine as a mainstream medical sub-specialty. Under the guidance of an esteemed Editorial Board, peer-reviewed articles published in the Journal focus on developments in addiction medicine as well as on treatment innovations and ethical, economic, forensic, and social topics including: •addiction and substance use in pregnancy •adolescent addiction and at-risk use •the drug-exposed neonate •pharmacology •all psychoactive substances relevant to addiction, including alcohol, nicotine, caffeine, marijuana, opioids, stimulants and other prescription and illicit substances •diagnosis •neuroimaging techniques •treatment of special populations •treatment, early intervention and prevention of alcohol and drug use disorders •methodological issues in addiction research •pain and addiction, prescription drug use disorder •co-occurring addiction, medical and psychiatric disorders •pathological gambling disorder, sexual and other behavioral addictions •pathophysiology of addiction •behavioral and pharmacological treatments •issues in graduate medical education •recovery •health services delivery •ethical, legal and liability issues in addiction medicine practice •drug testing •self- and mutual-help.
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