Does smoking track with depression in US adults?
In NHANES 2005–2018, daily smokers had ~2.4× the odds of PHQ-9 depression vs never smokers; longer cessation tracked lower odds.
Source
A cross-sectional study of smoking and depression among US adults: NHANES (2005-2018)
Study at a glance
- Design
- Cross-sectional — NHANES 2005–2018 smoking status/volume/cessation vs PHQ-9 depression
- N
- N=30524 · Adults ≥20 in final smoking-status analysis after exclusions
- Population
- US adults in NHANES with smoking and depression measures
- Outcome
- Clinically relevant depressive symptoms (PHQ-9 ≥10) by smoking patterns
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Inspect source passages
Does smoking track with depression in US adults?
These passages occur verbatim in the stored paper text. They support the points listed below; they do not verify every statement in the explanation.
Daily smokers OR 2.37 for depression vs never smokers.
Daily smokers had the highest risk of depression (OR = 2.37, 95% CI: 2.05–2.75).
Previous OR 1.25; occasional OR 1.84 vs never smokers.
Previous smokers [odds ratio (OR) = 1.25, 95% confidence interval (CI): 1.05–1.48] and occasional smokers (OR = 1.84, 95% CI: 1.39–2.45) were associated with a higher risk of depression compared with never smokers.
What they did
Analyzed adults ≥20 from NHANES 2005–2018, classifying smoking status, daily volume, and cessation duration against PHQ-9 ≥10 using multivariable logistic regression.
What they found
Previous (OR 1.25), occasional (OR 1.84), and daily smokers (OR 2.37) had higher depression odds than never smokers. Higher daily volume associated with higher odds (OR 1.65 trend); longer cessation associated with lower odds (OR 0.55 trend).
The limits
What it doesn't show
Cross-sectional data cannot establish whether smoking causes depression or depressed people smoke more; residual confounding remains.
Key terms
- PHQ-9
- Nine-item depression screen; ≥10 marks clinically relevant symptoms here.
- NHANES
- US National Health and Nutrition Examination Survey.
- Daily smoker
- Participant reporting smoking every day.
- Smoking cessation
- Time since quitting among former smokers.
- Odds ratio
- Relative odds of depression vs a reference group.
- Dose–response
- Higher smoking volume linked to higher depression odds.
Flashcards
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Quiz yourself
Daily smoker depression OR vs never smokers?
Common questions
Depression definition?
PHQ-9 score ≥10.
Highest-risk smoking status?
Daily smokers (OR 2.37).
Does quitting matter?
Longer cessation linked to lower depression odds (OR 0.55).
Can this prove causation?
No—cross-sectional associations only.
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