Current major depression is associated with greater sensitivity to the motivational effect of both negative mood induction and abstinence on tobacco-seeking behavior

Abstract

Background: Although depression and smoking commonly co-occur, the mechanisms underpinning this association are poorly understood. One hypothesis is that depression promotes tobacco dependence, persistence and relapse by increasing sensitivity to acute negative mood and abstinence induced tobacco-seeking behavior.

Methods: Twenty nine daily smokers of >10 cigarettes per day, nine with major depression and 20 without, completed two laboratory sessions one week apart, smoking as normal prior to session 1 (sated session), and 6h abstinent prior to session 2 (abstinent session). In both sessions, tobacco-seeking was measured at baseline by preference to view smoking versus food images. Negative mood was then induced by negative ruminative statements and sad music, before tobacco-seeking was measured again at test.

Results: In the sated session, negative mood induction produced a greater increase in tobacco choice from baseline to test in depressed (p<0.001, η_p²=0.782) compared to non-depressed smokers (p=0.045, η_p²=0.216, interaction: p=0.046, η_p²=0.150). Abstinence also produced a greater increase in baseline tobacco choice between the sated and abstinent sessions in depressed (p=0.002, η_p²=0.771) compared to non-depressed smokers (p=0.22, η_p²=0.089, interaction: p=0.023, η_p²=0.189). These mood and abstinence induced increases in tobacco choice were positively associated with depression symptoms across the sample as a whole (ps≤0.04, η_p²≥0.159), and correlated with each other (r=0.67, p<0.001).

Conclusions: Current major depression or depression symptoms may promote tobacco dependence, persistence and relapse by increasing sensitivity to both acute negative mood and abstinence induced tobacco-seeking behavior. Treatments should seek to break the association between adverse states and smoking to cope.

Keywords: Abstinence; Depression; Mood induction; Smoking; Vulnerability.

Figure 1

A. Task used to test the effect of mood induction on tobacco choice, completed in both the sated and abstinent sessions. B. Percent choice of tobacco versus food in the baseline and test blocks of the task, completed in the sated and abstinent sessions. Smokers with major depression showed a greater increase in tobacco choice between the sated-baseline and sated-test condition (mood induction effect), and between the sated-baseline and abstinent-baseline condition (abstinence effect), compared to non-depressed smokers. C. Regression slopes relating depression symptoms (BDI-II) across the sample as a whole to percent tobacco choice in the baseline and test blocks completed in the sated session (mood induction effect). The difference between slopes increased with BDI-II scores indicating greater sensitivity to negative mood induced tobacco-seeking. The F statistic reports this interaction. D. Regression slopes relating depression symptoms (BDI-II) across the sample as a whole to percent tobacco choice in the baseline blocks of the sated and abstinent session (abstinence effect). The difference between slopes increased with BDI-II scores indicating greater sensitivity to abstinence induced tobacco-seeking. The F statistic reports this interaction. E. Correlation between the mood induction effect (sated-test minus sated-baseline) and the abstinence effect (abstinent-baseline minus sated-baseline) on tobacco choice across the sample as a whole. Symbols denote depressed (+) and non-depressed (O) smokers.