Association of tobacco use with depressive symptoms in adults: Considerations of symptom severity, symptom clusters, and sex.

<h4>Objective</h4>We aim to assess the association between depressive symptoms, depressive symptom severity and symptom clusters with tobacco use. We will also evaluate sex differences in these associations.<h4>Method</h4>This cross-sectional study used data from the National...

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Bibliographic Details
Main Authors: Shakila Meshkat, Qiaowei Lin, Vanessa K Tassone, Reinhard Janssen-Aguilar, Hilary Pang, Wendy Lou, Venkat Bhat
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2025-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0319070
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Summary:<h4>Objective</h4>We aim to assess the association between depressive symptoms, depressive symptom severity and symptom clusters with tobacco use. We will also evaluate sex differences in these associations.<h4>Method</h4>This cross-sectional study used data from the National Health and Nutrition Examination Survey (2005-2018). Depressive symptoms were assessed using the Patient Health Questionnaire-9. Tobacco use was categorized into four groups: cigarette use, smoked tobacco products (pipes and cigars), smokeless tobacco products (chewing tobacco and snuff), and non-tobacco use (reference group).<h4>Results</h4>This study included 33,509 participants. Cigarette use was associated with a 0.83-unit increase in total PHQ-9 scores (95% CI =  [0.63, 1.04]), and 1.73 times higher odds of reporting depressive symptoms (95% CI =  [1.48, 2.02]) compared to non-tobacco use. However, the use of smoked and smokeless tobacco was not associated with depressive symptoms. In females, cigarette use showed a stronger association with total PHQ-9 scores (aCoef =  1.23, 95% CI =  [0.92, 1.55]) than in males (aCoef =  0.45, 95% CI =  [0.21, 0.69]). Additionally, female smoked tobacco users showed positive associations with both PHQ-9 scores and the presence of depressive symptoms, but this relationship was not observed in males. Furthermore, subgroup analysis revealed associations between cigarette use and cognitive-affective and somatic symptom clusters, as well as a relationship between the logarithm of total cigarette consumption and depressive symptoms.<h4>Conclusion</h4>Cigarette use was associated with higher odds of depressive symptoms with females having a stronger association. Further studies are needed to replicate these findings and examine the underlying mechanisms.
ISSN:1932-6203