Relationship of mood disturbance to cigarette smoking status among 252 patients with a current mood disorder

Background: The relationship between cigarette smoking and mood has receive d increasing attention. This retrospective study evaluated the relationship between mood disturbance and cigarette smoking status among patients with a current mood disorder. The association between level of nicotine dependen ce and severity of mood disturbance was also evaluated among current smoker s. Method: Retrospective data for 252 patients (63.5% male, 85.0% white) admit ted for treatment of a mood disorder at the San Diego Veteran Affairs Menta l Health Clinical Research Center between November 1988 and June 1997 were studied. Ail current cigarette smokers at admission (N = 126) were matched with nonsmokers (N = 126) on the primary DSM-IV Axis I mood disorder diagno sis, admission status (inpatient or outpatient), gender age (+/- 5 years). and ethnicity. The Hamilton Rating Scale for Depression (HAM-D), the Beck D epression Inventory, and the Profile of Mood States (POMS) were administere d to patients on admission. Conditional logistic regression analysis for ma tched sets with a backward elimination was used to identify factors indepen dently predictive of current smoking status. Results: A greater number of cups of coffee consumed per day (p = .002), a history of alcohol ism (P = .004), and higher POMS fatigue subscale scores (p = .007) were predictive of current smoking status. Among current smokers , the HAM-D terminal insomnia item was positively associated with mean numb er of cigarettes smoked per day (p = .012). Conclusion: Cigarette smoking should be addressed in the treatment of patie nts with a current mood disorder. Smokers experience greater levels of fati gue than nonsmokers. In addition, higher cigarette consumption levels are a ssociated with mild-to-severe symptoms of terminal insomnia.