Emergence of depression during early abstinence in depressed and non-depressed women smokers

The emergence of depression early in a quit attempt and its relationship to ability to maintain abstinence were studied in 99 depressed and non-depres sed women smokers. Participants rated withdrawal symptomatology during a ba seline week and the first two weeks of a quit attempt, during which they us ed a 21-mg nicotine patch and received behavioral counseling. Depressed wom en experienced greater difficulty maintaining early abstinence than non-dep ressed women. They were significantly more likely to smoke on the first day of abstinence and smoked marginally more days during the first week. Among participants who relapsed during the first two weeks, latency to relapse w as significantly shorter for depressed women. Although craving and ail with drawal symptoms except insomnia showed significant increases over baseline, only depression showed significant group differences, with trend analyses suggesting that depression asymptotes in non-depressed women after the firs t week but continues increasing in depressed women. Larger increases in dep ression on the first day of abstinence were associated with earlier lapse. Because depression is relatively infrequent as a withdrawal symptom, it may not be a "true" withdrawal symptom except in depressed people. Identificat ion of depressed smokers and anticipation of their increased need for suppo rt during this period may help to counteract the " first-day effect " and d ifficulties during early abstinence.