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Increasing Depression and Substance Use Among Former Smokers in the United States, 2002–2016

While former smoker numbers in the United States have outgrown the number of current smokers, there is not a lot known about their mental health and substance use. This study looked at trends in depression, marijuana use, and alcohol use in former smokers in the United States. The worry is that if former smokers are simply replacing cigarette smoking with other drug use, the benefit of smoking cessation is greatly decreased. The study included individuals over the age of 18 who had smoked over 100 lifetime cigarettes but had not smoked in the past year.

The data used was taken from the National Survey on Drug Use and Health from 2002-2016. They look at past-year marijuana use, alcohol dependence, binge alcohol drinking, and past-year major depressive episodes. They found that major depressive episodes increased from 2005-2016 and from 2002-2016 marijuana use and alcohol misuse also increased. Marijuana use increased the most which can be understood because marijuana use has increased across the United States due to its growing legalization. The age group of 18-49 years old had generally the greatest increase in each of these categories compared to the 50-64 years of age group and the group over 65 years of age.

This information is important for clinicians to understand so that they can better help and treat this patient group. It has been found that major depression increases the risk of relapse to smoking. Also, former smokers are more likely to substitute marijuana for cigarettes which leads to new health concerns and the possibility that they may go back to smoking cigarettes in the future. If providers understand these increased risks, they can target these factors to hopefully help reduce the risk of patients relapsing and smoking cigarettes again or simply replacing one addiction for another.

Take Away: It is important to understand connections between former smokers and their risks for depression and other substance use. This study found that former smokers had increased depression, marijuana, and alcohol misuse in the years following quitting smoking. This is important because it shows that there is a risk of these individuals replacing one substance with another or even having a higher risk of beginning to use cigarettes again. Knowing this information can help providers and clinicians target these risks when caring for patients that are former smokers.

Cheslack-Postava, K., Wall, M. M., Weinberger, A. H., & Goodwin, R. D. (2019). Increasing Depression and Substance Use Among Former Smokers in the United States, 2002–2016. American Journal of Preventive Medicine. doi: 10.1016/j.amepre.2019.05.014

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