THE IMPACT OF DEPRESSION ON SMOKING CESSATION IN WOMEN

Introduction: Cigarette smoking poses unique, but preventable health r isks ro women. Identification of barriers to womens' quitting is essen tial to tailor interventions accordingly. Major depression, whether hi storical, current, or subsyndromal, may present unique challenges to w omen quitting smoking. Although several reviews discuss women and smok ing in general, this review focuses exclusively on the role. of depres sion in womens' smoking. Objectives: The goals of this review are to ( 1) discuss and synthesize the current findings on the association betw een smoking and depression in women in general, and in particular subg roups of women (underserved, premenstrual, postpartum, menopausal), (2 ) discuss physician-assisted, pharmacologic, behavioral interventions for mood management, and (3) propose future avenues for intervention, research, and policy. Impact of Depression: Major depression may influ ence smoking cessation in women because (1) depression is twice as com mon among women as men, (2) history of depression and negative affect have been associated with smoking treatment failure, (3) quitting smok ing is especially difficult during certain phases of the reproductive cycle, phases that have also been associated with greater levels of dy sphoria, and (4) subgroups of women who have a high risk of continuing to smoke (underserved, less educated, low SES) also have a high risk of developing depression. Conclusions: Since many women who are depres sed (or who have developed depression during prior quit attempts) map be less likely to seek formal cessation treatment, practitioners have a unique opportunity to persuade their patients to quit. We discuss pa tient-treatment matching.