Smoking cessation interventions for smokers with current or past depression

Adding a psychosocial mood management component to a standard smoking cessation intervention may increase long-term cessation rates in smokers with both current and past depression when compared with the standard intervention alone.

Comment: The quality of evidence is downgraded by study limitations (unclear allocation concealment and incomplete outcome data in half of the studies, and lack of blinding) and by imprecise results (few outcome events).

Summary

A Cochrane review included 33 studies investigatinfg smoking cessation interventions with specific mood management components for depression. In smokers with current depression, meta-analysis showed a significant positive effect for adding psychosocial mood management to a standard smoking cessation intervention when compared with standard smoking cessation intervention alone (RR 1.47, 95% CI 1.13 to 1.92; 11 trials, n=1844). In smokers with past depression there was a similar effect (RR 1.41, 95% CI 1.13 to 1.77; 13 trials, n=1496). Meta-analysis resulted in a positive effect, although not significant, for adding bupropion compared with placebo in smokers with current depression (RR 1.37, 95% CI 0.83 to 2.27; 5 trials, n=410). Bupropion (RR 2.04, 95% CI 1.31 to 3.18; 4 trials, n=404) might significantly increase long-term cessation among smokers with past depression when compared with placebo. There were not enough data to evaluate the effectiveness of fluoxetine and paroxetine for smokers with current depression or fluoxetine, nortriptyline, paroxetine, selegiline, and sertraline in smokers with past depression.

Clinical comments

Date of latest search: 1 April 2013

Ədəbiyyat

1. van der Meer RM, Willemsen MC, Smit F et al. Smoking cessation interventions for smokers with current or past depression. Cochrane Database Syst Rev 2013;(8):CD006102.