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Meta-Analysis
. 2021 Mar 9;3(3):CD013522.
doi: 10.1002/14651858.CD013522.pub2.

Smoking cessation for improving mental health

Gemma Mj Taylor  1 , Nicola Lindson  2 , Amanda Farley  3 , Andrea Leinberger-Jabari  4 , Katherine Sawyer  1 , Rebecca Te Water Naudé  5 , Annika Theodoulou  2 , Naomi King  1 , Chloe Burke  1 , Paul Aveyard  2
Affiliations
Meta-Analysis

Smoking cessation for improving mental health

Gemma Mj Taylor et al. Cochrane Database Syst Rev. .

Abstract

Background: There is a common perception that smoking generally helps people to manage stress, and may be a form of 'self-medication' in people with mental health conditions. However, there are biologically plausible reasons why smoking may worsen mental health through neuroadaptations arising from chronic smoking, leading to frequent nicotine withdrawal symptoms (e.g. anxiety, depression, irritability), in which case smoking cessation may help to improve rather than worsen mental health.

Objectives: To examine the association between tobacco smoking cessation and change in mental health.

Search methods: We searched the Cochrane Tobacco Addiction Group's Specialised Register, Cochrane Central Register of Controlled Trials, MEDLINE, Embase, PsycINFO, and the trial registries clinicaltrials.gov and the International Clinical Trials Registry Platform, from 14 April 2012 to 07 January 2020. These were updated searches of a previously-conducted non-Cochrane review where searches were conducted from database inception to 13 April 2012. SELECTION CRITERIA: We included controlled before-after studies, including randomised controlled trials (RCTs) analysed by smoking status at follow-up, and longitudinal cohort studies. In order to be eligible for inclusion studies had to recruit adults who smoked tobacco, and assess whether they quit or continued smoking during the study. They also had to measure a mental health outcome at baseline and at least six weeks later.

Data collection and analysis: We followed standard Cochrane methods for screening and data extraction. Our primary outcomes were change in depression symptoms, anxiety symptoms or mixed anxiety and depression symptoms between baseline and follow-up. Secondary outcomes included change in symptoms of stress, psychological quality of life, positive affect, and social impact or social quality of life, as well as new incidence of depression, anxiety, or mixed anxiety and depression disorders. We assessed the risk of bias for the primary outcomes using a modified ROBINS-I tool. For change in mental health outcomes, we calculated the pooled standardised mean difference (SMD) and 95% confidence interval (95% CI) for the difference in change in mental health from baseline to follow-up between those who had quit smoking and those who had continued to smoke. For the incidence of psychological disorders, we calculated odds ratios (ORs) and 95% CIs. For all meta-analyses we used a generic inverse variance random-effects model and quantified statistical heterogeneity using I2. We conducted subgroup analyses to investigate any differences in associations between sub-populations, i.e. unselected people with mental illness, people with physical chronic diseases. We assessed the certainty of evidence for our primary outcomes (depression, anxiety, and mixed depression and anxiety) and our secondary social impact outcome using the eight GRADE considerations relevant to non-randomised studies (risk of bias, inconsistency, imprecision, indirectness, publication bias, magnitude of the effect, the influence of all plausible residual confounding, the presence of a dose-response gradient).

Main results: We included 102 studies representing over 169,500 participants. Sixty-two of these were identified in the updated search for this review and 40 were included in the original version of the review. Sixty-three studies provided data on change in mental health, 10 were included in meta-analyses of incidence of mental health disorders, and 31 were synthesised narratively. For all primary outcomes, smoking cessation was associated with an improvement in mental health symptoms compared with continuing to smoke: anxiety symptoms (SMD -0.28, 95% CI -0.43 to -0.13; 15 studies, 3141 participants; I2 = 69%; low-certainty evidence); depression symptoms: (SMD -0.30, 95% CI -0.39 to -0.21; 34 studies, 7156 participants; I2 = 69%' very low-certainty evidence); mixed anxiety and depression symptoms (SMD -0.31, 95% CI -0.40 to -0.22; 8 studies, 2829 participants; I2 = 0%; moderate certainty evidence). These findings were robust to preplanned sensitivity analyses, and subgroup analysis generally did not produce evidence of differences in the effect size among subpopulations or based on methodological characteristics. All studies were deemed to be at serious risk of bias due to possible time-varying confounding, and three studies measuring depression symptoms were judged to be at critical risk of bias overall. There was also some evidence of funnel plot asymmetry. For these reasons, we rated our certainty in the estimates for anxiety as low, for depression as very low, and for mixed anxiety and depression as moderate. For the secondary outcomes, smoking cessation was associated with an improvement in symptoms of stress (SMD -0.19, 95% CI -0.34 to -0.04; 4 studies, 1792 participants; I2 = 50%), positive affect (SMD 0.22, 95% CI 0.11 to 0.33; 13 studies, 4880 participants; I2 = 75%), and psychological quality of life (SMD 0.11, 95% CI 0.06 to 0.16; 19 studies, 18,034 participants; I2 = 42%). There was also evidence that smoking cessation was not associated with a reduction in social quality of life, with the confidence interval incorporating the possibility of a small improvement (SMD 0.03, 95% CI 0.00 to 0.06; 9 studies, 14,673 participants; I2 = 0%). The incidence of new mixed anxiety and depression was lower in people who stopped smoking compared with those who continued (OR 0.76, 95% CI 0.66 to 0.86; 3 studies, 8685 participants; I2 = 57%), as was the incidence of anxiety disorder (OR 0.61, 95% CI 0.34 to 1.12; 2 studies, 2293 participants; I2 = 46%). We deemed it inappropriate to present a pooled estimate for the incidence of new cases of clinical depression, as there was high statistical heterogeneity (I2 = 87%).

Authors' conclusions: Taken together, these data provide evidence that mental health does not worsen as a result of quitting smoking, and very low- to moderate-certainty evidence that smoking cessation is associated with small to moderate improvements in mental health. These improvements are seen in both unselected samples and in subpopulations, including people diagnosed with mental health conditions. Additional studies that use more advanced methods to overcome time-varying confounding would strengthen the evidence in this area.

Trial registration: ClinicalTrials.gov NCT00689611 NCT02845687.

PubMed Disclaimer

Conflict of interest statement

GT's salary and research activity is paid for by a Cancer Research UK Postdoctoral Fellowship (C56067/A21330) that has been paid to University of Bath.

NL is employed by the University of Oxford to work as Managing Editor for the Cochrane Tobacco Addiction Group (TAG). TAG's infrastructure is funded by the NIHR. Nicola has received payment for lectures on systematic review methodology, and has been an applicant on project funding to carry out priority setting and systematic reviews in the area of tobacco control (NIHR funded). None of this is deemed a conflict of interest.

AF is employed by the University of Birmingham, has been awarded grant funding from the CRUK, NIHR and Ethicon (Johnson and Johnson) researcher‐led funding.

AL‐J: none known

KS: none known

RtWN: none known

AT: none known

NK: none known

CB: none known

PA: none known.

Figures

1
1
Study Flow Diagram 2020 (*40 of these studies were identified through the 2012 literature searches)
2
2
Risk‐of‐bias: “traffic light” plot of the domain‐level judgements for each individual result according to the ROBINS‐I tool
3
3
Risk‐of‐bias: Weighted bar plot of the distribution of risk‐of‐bias judgements within each bias domain according to the ROBINS‐I tool
4
4
Funnel plot of comparison: 1 Main analysis: Difference in change (from baseline to longest follow‐up) between people who quit and people who continued smoking, outcome: 1.1 Primary outcome: Anxiety.
5
5
Funnel plot of comparison: 2 Change in depression, outcome: 2.1 Main continuous data analysis.
6
6
Funnel plot of comparison: 5 Change in positive affect, outcome: 5.1 Main continuous data analysis.
7
7
Funnel plot of comparison: 6 Change psychological quality of life, outcome: 6.1 Main continuous data analysis.
1.1
1.1. Analysis
Comparison 1: Change in anxiety, Outcome 1: Main continuous data analysis
1.2
1.2. Analysis
Comparison 1: Change in anxiety, Outcome 2: Sensitivity analysis: no biochemical validation
1.3
1.3. Analysis
Comparison 1: Change in anxiety, Outcome 3: Sensitivity analysis: point prevalence or no abstinence definition
1.4
1.4. Analysis
Comparison 1: Change in anxiety, Outcome 4: Sensitivity analysis: psychoactive/psychological treatment used
1.5
1.5. Analysis
Comparison 1: Change in anxiety, Outcome 5: Subgroups: comparing clinical populations
1.6
1.6. Analysis
Comparison 1: Change in anxiety, Outcome 6: Subgroups: motivation to quit
1.7
1.7. Analysis
Comparison 1: Change in anxiety, Outcome 7: Subgroups: comparing adjusted & unadjusted estimates
1.8
1.8. Analysis
Comparison 1: Change in anxiety, Outcome 8: Subgroups: comparing study designs
1.9
1.9. Analysis
Comparison 1: Change in anxiety, Outcome 9: Subgroups: length of longest follow‐up
1.10
1.10. Analysis
Comparison 1: Change in anxiety, Outcome 10: Subgroups: primary versus secondary outcome
1.11
1.11. Analysis
Comparison 1: Change in anxiety, Outcome 11: New incidence of anxiety
2.1
2.1. Analysis
Comparison 2: Change in depression, Outcome 1: Main continuous data analysis
2.2
2.2. Analysis
Comparison 2: Change in depression, Outcome 2: Sensitivity analysis: risk of bias
2.3
2.3. Analysis
Comparison 2: Change in depression, Outcome 3: Sensitivity analysis: no biochemical validation
2.4
2.4. Analysis
Comparison 2: Change in depression, Outcome 4: Sensitivity analysis: point prevalence or no abstinence definition
2.5
2.5. Analysis
Comparison 2: Change in depression, Outcome 5: Sensitivity analysis: psychoactive/psychological treatment used
2.6
2.6. Analysis
Comparison 2: Change in depression, Outcome 6: Sensitivity analysis: differing Ns analysed
2.7
2.7. Analysis
Comparison 2: Change in depression, Outcome 7: Subgroups: comparing clinical populations
2.8
2.8. Analysis
Comparison 2: Change in depression, Outcome 8: Subgroups: motivation to quit
2.9
2.9. Analysis
Comparison 2: Change in depression, Outcome 9: Subgroups: comparing adjusted & unadjusted estimates
2.10
2.10. Analysis
Comparison 2: Change in depression, Outcome 10: Subgroups: comparing study designs
2.11
2.11. Analysis
Comparison 2: Change in depression, Outcome 11: Subgroups: length of longest follow‐up
2.12
2.12. Analysis
Comparison 2: Change in depression, Outcome 12: Subgroups: primary versus secondary outcome
2.13
2.13. Analysis
Comparison 2: Change in depression, Outcome 13: New incidence of depression
3.1
3.1. Analysis
Comparison 3: Change in mixed anxiety and depression, Outcome 1: Main continuous data analysis
3.2
3.2. Analysis
Comparison 3: Change in mixed anxiety and depression, Outcome 2: Sensitivity analysis: no biochemical validation
3.3
3.3. Analysis
Comparison 3: Change in mixed anxiety and depression, Outcome 3: Sensitivity analysis: point prevalence or no abstinence definition
3.4
3.4. Analysis
Comparison 3: Change in mixed anxiety and depression, Outcome 4: Sensitivity analysis: psychoactive/psychological treatment used
3.5
3.5. Analysis
Comparison 3: Change in mixed anxiety and depression, Outcome 5: Sensitivity analysis: differing Ns analysed
3.6
3.6. Analysis
Comparison 3: Change in mixed anxiety and depression, Outcome 6: Subgroups: comparing clinical populations
3.7
3.7. Analysis
Comparison 3: Change in mixed anxiety and depression, Outcome 7: Subgroups: motivation to quit
3.8
3.8. Analysis
Comparison 3: Change in mixed anxiety and depression, Outcome 8: Subgroups: comparing study designs
3.9
3.9. Analysis
Comparison 3: Change in mixed anxiety and depression, Outcome 9: Subgroups: length of longest follow‐up
3.10
3.10. Analysis
Comparison 3: Change in mixed anxiety and depression, Outcome 10: Subgroups: primary versus secondary outcome
3.11
3.11. Analysis
Comparison 3: Change in mixed anxiety and depression, Outcome 11: New incidence of mixed anxiety and depression
4.1
4.1. Analysis
Comparison 4: Change in stress, Outcome 1: Main continuous data analysis
4.2
4.2. Analysis
Comparison 4: Change in stress, Outcome 2: Sensitivity analysis: no biochemical validation
4.3
4.3. Analysis
Comparison 4: Change in stress, Outcome 3: Sensitivity analysis: point prevalence or no abstinence definition
4.4
4.4. Analysis
Comparison 4: Change in stress, Outcome 4: Sensitivity analysis: differing Ns analysed
4.5
4.5. Analysis
Comparison 4: Change in stress, Outcome 5: Subgroups: comparing clinical populations
4.6
4.6. Analysis
Comparison 4: Change in stress, Outcome 6: Subgroups: motivation to quit
4.7
4.7. Analysis
Comparison 4: Change in stress, Outcome 7: Subgroups: comparing study designs
4.8
4.8. Analysis
Comparison 4: Change in stress, Outcome 8: Subgroups: length of longest follow‐up
5.1
5.1. Analysis
Comparison 5: Change in positive affect, Outcome 1: Main continuous data analysis
5.2
5.2. Analysis
Comparison 5: Change in positive affect, Outcome 2: Sensitivity analysis: no biochemical validation
5.3
5.3. Analysis
Comparison 5: Change in positive affect, Outcome 3: Sensitivity analysis: point prevalence or no abstinence definition
5.4
5.4. Analysis
Comparison 5: Change in positive affect, Outcome 4: Sensitivity analysis: psychoactive/psychological treatment used
5.5
5.5. Analysis
Comparison 5: Change in positive affect, Outcome 5: Sensitivity analysis: differing Ns analysed
5.6
5.6. Analysis
Comparison 5: Change in positive affect, Outcome 6: Subgroups: comparing clinical populations
5.7
5.7. Analysis
Comparison 5: Change in positive affect, Outcome 7: Subgroups: motivation to quit
5.8
5.8. Analysis
Comparison 5: Change in positive affect, Outcome 8: Subgroups: comparing adjusted & unadjusted estimates
5.9
5.9. Analysis
Comparison 5: Change in positive affect, Outcome 9: Subgroups: comparing study designs
5.10
5.10. Analysis
Comparison 5: Change in positive affect, Outcome 10: Subgroups: length of longest follow‐up
5.11
5.11. Analysis
Comparison 5: Change in positive affect, Outcome 11: Subgroups: primary versus secondary outcome
6.1
6.1. Analysis
Comparison 6: Change psychological quality of life, Outcome 1: Main continuous data analysis
6.2
6.2. Analysis
Comparison 6: Change psychological quality of life, Outcome 2: Sensitivity analysis: no biochemical validation
6.3
6.3. Analysis
Comparison 6: Change psychological quality of life, Outcome 3: Sensitivity analysis: point prevalence or no abstinence definition
6.4
6.4. Analysis
Comparison 6: Change psychological quality of life, Outcome 4: Sensitivity analysis: psychoactive/psychological treatment used
6.5
6.5. Analysis
Comparison 6: Change psychological quality of life, Outcome 5: Sensitivity analysis: differing Ns analysed
6.6
6.6. Analysis
Comparison 6: Change psychological quality of life, Outcome 6: Subgroups: comparing clinical populations
6.7
6.7. Analysis
Comparison 6: Change psychological quality of life, Outcome 7: Subgroups: motivation to quit
6.8
6.8. Analysis
Comparison 6: Change psychological quality of life, Outcome 8: Subgroups: comparing adjusted & unadjusted estimates
6.9
6.9. Analysis
Comparison 6: Change psychological quality of life, Outcome 9: Subgroups: comparing study designs
6.10
6.10. Analysis
Comparison 6: Change psychological quality of life, Outcome 10: Subgroups: length of longest follow‐up
6.11
6.11. Analysis
Comparison 6: Change psychological quality of life, Outcome 11: Subgroups: primary versus secondary outcome
7.1
7.1. Analysis
Comparison 7: Change in social quality of life, Outcome 1: Main continuous data analysis
7.2
7.2. Analysis
Comparison 7: Change in social quality of life, Outcome 2: Sensitivity analysis: no biochemical validation
7.3
7.3. Analysis
Comparison 7: Change in social quality of life, Outcome 3: Sensitivity analysis: point prevalence or no abstinence definition
7.4
7.4. Analysis
Comparison 7: Change in social quality of life, Outcome 4: Sensitivity analysis: psychoactive/psychological treatment used
7.5
7.5. Analysis
Comparison 7: Change in social quality of life, Outcome 5: Sensitivity analysis: differing Ns analysed
7.6
7.6. Analysis
Comparison 7: Change in social quality of life, Outcome 6: Subgroups: comparing clinical populations
7.7
7.7. Analysis
Comparison 7: Change in social quality of life, Outcome 7: Subgroups: motivation to quit
7.8
7.8. Analysis
Comparison 7: Change in social quality of life, Outcome 8: Subgroups: comparing adjusted & unadjusted estimates
7.9
7.9. Analysis
Comparison 7: Change in social quality of life, Outcome 9: Subgroups: comparing study designs
7.10
7.10. Analysis
Comparison 7: Change in social quality of life, Outcome 10: Subgroups: length of longest follow‐up
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    1. Xue C, Bian L, Xie YS, Yin ZF, Xu ZJ, Chen QZ, et al. Impact of smoking on health-related quality of life after percutaneous coronary intervention treated with drug-eluting stents: a longitudinal observational study. Health and Quality of Life Outcomes 2017;15(1):1-10. [DOI: 10.1186/s12955-016-0578-4] - DOI - PMC - PubMed
Zhou 2016 {published data only}
    1. Zhou ZM, Xu XH, Liang J, Hu B, Cheng YJ, Shi C, et al. The impact of cigarette cessation intervention on mental state of patients with coronary heart disease. Chung-Hua Nei Ko Tsa Chih [Chinese Journal of Internal Medicine] 2016;55(11):854-8. [DOI: 10.3760/cma.j.issn.0578-1426.2016.11.008] - DOI - PubMed
Zillich 2002 {published data only (unpublished sought but not used)}
    1. Zillich AJ, Ryan M, Adams A, Yeager B, Farris K. Effectiveness of a pharmacist-based smoking-cessation program and its impact on quality of life. Pharmacotherapy 2002;22(6):759-65. [DOI: 10.1592/phco.22.9.759.34073] - DOI - PubMed

References to studies excluded from this review

Abrams 1987 {published data only}
    1. Abrams DB, Monti PM, Pinto RP, Elder JP, Brown RA, Jacobus SI. Psychosocial stress and coping in smokers who relapse or quit. Health Psychology 1987;6(4):289-303. [DOI: 10.1037/0278-6133.6.4.289] - DOI - PubMed
Abrantes 2018 {published data only}
    1. Abrantes AM, Farris SG, Minami H, Strong DR, Riebe D, Brown RA. Acute effects of aerobic exercise on affect and smoking craving in the weeks before and after a cessation attempt. Nicotine & Tobacco Research 2018;20(5):575-82. [DOI: 10.1093/ntr/ntx104] - DOI - PMC - PubMed
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Acri 1992 {published data only}
    1. Acri JB, Grunberg NE. A psychophysical task to quantify smoking cessation-induced irritability: the reactive irritability scale (RIS). Addictive Behaviors 1992;17(6):587-601. [DOI: 10.1016/0306-4603(92)90068-7] - DOI - PubMed
Almeida 2011 {published data only}
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Auer 2014 {published data only}
    1. Auer R, Vittinghoff E, Kiefe C, Reis JP, Rodondi N, Khodneva YA, et al. Change in physical activity after smoking cessation: The Coronary Artery Risk Development in Young Adults Study (CARDIA) study. Addiction 2014;109(7):1172-83. [DOI: 10.1111/add.12561] - DOI - PMC - PubMed
Bakhshaie 2015 {published data only}
    1. Bakhshaie J, Zvolensky MJ, Goodwin RD. Cigarette smoking and the onset and persistence of depression among adults in the United States: 1994-2005. Comprehensive Psychiatry 2015;60:142-8. [DOI: 10.1016/j.comppsych.2014.10.012] - DOI - PMC - PubMed
Balduyck 2011 {published and unpublished data}
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Balfour 2017 {published data only}
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Bekele 2017 {published data only}
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Billert 2006 {published data only}
    1. Billert H, Gaca M, Adamski D, Miluska J, Breborowicz G. Significance of smoking and cigarette abstinence regarding anxiety in gynecologic patients in a perioperative period. Przeglad Lekarski 2006;63(10):870-7. [PMID: ] - PubMed
Bock 2014 {published data only}
    1. Bock BC, Papandonatos GD, De Dios MA, Abrams DB, Azam MM, Fagan M, et al. Tobacco cessation among low-income smokers: motivational enhancement and nicotine patch treatment. Nicotine & Tobacco Research 2014;16(4):413-22. [DOI: 10.1093/ntr/ntt166] - DOI - PMC - PubMed
Bolliger 2002 {published data only (unpublished sought but not used)}
    1. Bolliger CT, Zellweger JP, Danielsson T, Van Biljon X, Robidou A, Westin A, et al. Influence of long-term smoking reduction on health risk markers and quality of life. Nicotine & Tobacco Research 2002;4(4):433-9. [DOI: 10.1080/1462220021000018380] - DOI - PubMed
Breslau 1998 {published data only}
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Brody 2017 {published data only}
    1. Brody AL, Zorick T, Hubert R, Hellemann GS, Balali S, Kawasaki SS, et al. Combination extended smoking cessation treatment plus home visits for smokers with schizophrenia: a randomized controlled trial. Nicotine & Tobacco Research 2017;19(1):68-76. [DOI: 10.1093/ntr/ntw190] - DOI - PMC - PubMed
Brook 2012 {published data only}
    1. Brook DW, Rubenstone E, Zhang C, Brook JS. Trajectories of cigarette smoking in adulthood predict insomnia among women in late mid-life. Sleep Medicine 2012;13(9):1130-7. [DOI: 10.1016/j.sleep.2012.05.008] - DOI - PMC - PubMed
Brown 2014 {published data only}
    1. Brown RA, Abrantes AM, Strong DR, Niaura R, Kahler CW, Miller IW, et al. Efficacy of sequential use of fluoxetine for smoking cessation in elevated depressive symptom smokers. Nicotine & Tobacco Research 2014;16(2):197-207. [DOI: 10.1093/ntr/ntt134] - DOI - PubMed
Brunette 2018 {published data only}
    1. Brunette MF, Pratt SI, Bartels SJ, Scherer EA, Sigmon SC, Ferron JC, et al. Randomized trial of interventions for smoking cessation among medicaid beneficiaries with mental illness. Psychiatric Services 2018;69(3):274-80. [DOI: 10.1176/appi.ps.201700245] - DOI - PubMed
Burris 2014 {published data only}
    1. Burris JL. Cigarette smoking among recently diagnosed head and neck cancer patients: a prospective study. Dissertation Abstracts International: Section B: The Sciences and Engineering 2014;75(5-B(E)):No pagination specified.
Campbell 2018 {published data only}
    1. Campbell B, Yip D, Le T, Gubner N, Guydish J. Relationship between tobacco use and health-related quality of life (hrqol) among clients in substance use disorders treatment. Journal of Psychoactive Drugs 2018;51(1):48-57. [DOI: 10.1080/02791072.2018.1555651] - DOI - PMC - PubMed
Caponnetto 2013 {published data only}
    1. Caponnetto P, Auditore R, Russo C, Cappello GC, Polosa R. Impact of an electronic cigarette on smoking reduction and cessation in schizophrenic smokers: a prospective 12-month pilot study. International Journal of Environmental Research and Public Health 2013;10(2):446-61. [DOI: 10.3390/ijerph10020446] - DOI - PMC - PubMed
Carter 2014 {published data only}
    1. Carter KN, Van der Deen FS, Wilson N, Blakely T. Smoking uptake is associated with increased psychological distress: results of a national longitudinal study. Tobacco Control 2014;23(1):33-8. [DOI: 10.1136/tobaccocontrol-2012-050614] - DOI - PubMed
Chen 2012 {published data only}
    1. Chen J, Qi Y, Wampfler JA, Jatoi A, Garces YI, Busta AJ, et al. Effect of cigarette smoking on quality of life in small cell lung cancer patients. European Journal of Cancer 2012;48(11):1593-601. [DOI: 10.1016/j.ejca.2011.12.002] - DOI - PMC - PubMed
Chengappa 2014 {published data only}
    1. Chengappa KN, Perkins KA, Brar JS, Schlicht PJ, Turkin SR, Hetrick ML, et al. Varenicline for smoking cessation in bipolar disorder: a randomized, double-blind, placebo-controlled study. Journal of Clinical Psychiatry 2014;75(7):765-72. [DOI: 10.4088/JCP.13m08756] - DOI - PubMed
Dalack 1999 {published data only}
    1. Dalack GW, Becks L, Hill E, Pomerleau OF, Meador-Woodruff JH. Nicotine withdrawal and psychiatric symptoms in cigarette smokers with schizophrenia. Neuropsychopharmacology 1999;21(2):195-202. [DOI: 10.1016/S0893-133X(98)00121-3] - DOI - PubMed
Dickson‐Spillmann 2012 {published data only}
    1. Dickson-Spillmann M, Kraemer T, Rust K, Schaub M. Group hypnotherapy versus group relaxation for smoking cessation: an RCT study protocol. BMC Public Health 2012;12:271. [DOI: 10.1186/1471-2458-12-271] - DOI - PMC - PubMed
Duffy 2012 {published data only}
    1. Duffy SA, Ronis DL, Titler MG, Blow FC, Jordan N, Thomas PL, et al. Dissemination of the nurse-administered Tobacco Tactics intervention versus usual care in six Trinity community hospitals: study protocol for a comparative effectiveness trial. Trials 2012;13:125. [DOI: 10.1186/1745-6215-13-125] - DOI - PMC - PubMed
El Hajj 2015 {published data only}
    1. El Hajj MS, Kheir N, Al Mulla AM, Al-Badriyeh D, Al Kaddour A, Mahfoud ZR, et al. Assessing the effectiveness of a pharmacist-delivered smoking cessation program in the State of Qatar: study protocol for a randomized controlled trial. Trials 2015;16:65. [DOI: 10.1186/s13063-015-0570-z] - DOI - PMC - PubMed
Etter 2006 {published data only}
    1. Etter J-F, Hughes JR. A comparison of the psychometric properties of three cigarette withdrawal scales. Addiction 2006;101(3):362-72. [DOI: 10.1111/j.1360-0443.2005.01289.x] - DOI - PubMed
Faseru 2013 {published data only}
    1. Faseru B, Nollen NL, Mayo MS, Krebill R, Choi WS, Benowitz NL, et al. Predictors of cessation in African American light smokers enrolled in a bupropion clinical trial. Addictive Behaviors 2013;38(3):1796-803. [DOI: 10.1016/j.addbeh.2012.11.010] - DOI - PMC - PubMed
Flensborg‐Madsen 2011 {published data only}
    1. Flensborg-Madsen T, Von Scholten MB, Flachs EM, Mortensen EL, Prescott E, Tolstrup JS. Tobacco smoking as a risk factor for depression. A 26-year population-based follow-up study. Journal of Psychiatric Research 2011;45(2):143-9. [DOI: 10.1016/j.jpsychires.2010.06.006] - DOI - PubMed
Fond 2013 {published data only}
    1. Fond G, Guillaume S, Artero S, Bernard P, Ninot G, Courtet P, et al. Self-reported major depressive symptoms at baseline impact abstinence prognosis in smoking cessation program. A one-year prospective study. Journal of Affective Disorders 2013;149(1-3):418-21. [DOI: 10.1016/j.jad.2012.11.066] - DOI - PubMed
Frederick 1998 {published data only}
    1. Frederick S, Reus V, Ginsberg D, Hall S, Munoz R, Ellman G. Cortisol and response to dexamethasone as predictors of withdrawal distress and abstinence success. Biological Psychiatry 1998;43(7):525-30. [DOI: 10.1016/S0006-3223(97)00423-X] - DOI - PubMed
Garces 2004 {published data only}
    1. Garces YI, Yang P, Parkinson J, Zhao XH, Wampfler JA, Ebbert JO. The relationship between cigarette smoking and quality of life after lung cancer diagnosis. Chest 2004;126(6):1733-41. [DOI: 10.1378/chest.126.6.1733] - DOI - PubMed
George 2002 {published data only (unpublished sought but not used)}
    1. George TP, Vessicchio JC, Termine A, Sahady DM, Head CA, Pepper WT, et al. Effects of smoking abstinence on visuospatial working memory function in schizophrenia. Neuropsychopharmacology 2002;26(1):75-85. [DOI: 10.1016/S0893-133X(01)00296-2] - DOI - PubMed
Gilbert 1998 {published data only}
    1. Gilbert DG, McClernon FJ, Rabinovich NE, Plath LC, Jensen RA, Meliska CJ. Effects of smoking abstinence on mood and craving in men: influences of negative-affect-related personality traits, habitual nicotine intake and repeated measurements. Personality and Individual Differences 1998;25(3):399-423. [DOI: 10.1016/S0191-8869(98)00003-8] - DOI
Gilbert 1999 {published data only}
    1. Gilbert DG, McClernon FJ, Rabinovich NE, Dibb WD, Plath LC, Hiyane S. EEG, physiology, and task-related mood fail to resolve across 31 days of smoking abstinence: relations to depressive traits, nicotine exposure, and dependence. Experimental and Clinical Psychopharmacology 1999;7(4):427-43. [DOI: 10.1037//1064-1297.7.4.427] - DOI - PubMed
Gilbert 2002 {published data only}
    1. Gilbert DG, McClernon FJ, Rabinovich NE, Plath LC, Masson CL, Anderson AE, et al. Mood disturbance fails to resolve across 31 days of cigarette abstinence in women. Journal of Consulting and Clinical Psychology 2002;70(1):142-52. [DOI: 10.1037//0022-006x.70.1.142] - DOI - PubMed
Gilbert 2003 {published data only}
    1. Gilbert HM, Warburton DM. Individual variation in psychological and psychomotor symptoms following smoking cessation: the implications for treatment. Psychology & Health 2003;18(5):613-24. [DOI: 10.1080/0887044032000069892] - DOI
Guiterrez‐Bedmar 2009 {published data only}
    1. Guiterrez-Bedmar M, Segui-Gomez M, Gomez-Gracia E, Bes-Rastrollo M, Martinez- Gonzalez MA. Smoking status, changes in smoking status and health-related quality of life: findings from the SUN ("Seguimiento Universidad de Navarra") cohort.. International Journal of Environmental Research & Public Health 2009;6(1):310-20. [DOI: 10.3390/ijerph6010310] - DOI - PMC - PubMed
Haibach 2016 {published data only}
    1. Haibach JP, Homish GG, Collins RL, Ambrosone CB, Giovino GA. Fruit and vegetable intake as a moderator of the association between depressive symptoms and cigarette smoking. Substance Abuse 2016;37(4):571-8. [DOI: 10.1080/08897077.2016.1179703] - DOI - PubMed
Hall 1990 {published data only}
    1. Hall SM, Munoz R, Reus V. Smoking cessation, depression and dysphoria. NIDA Research Monograph 1990;105:312-3. - PubMed
Heffner 2012 {published data only}
    1. Heffner JL, DelBello MP, Anthenelli RM, Fleck DE, Adler CM, Strakowski SM. Cigarette smoking and its relationship to mood disorder symptoms and co-occurring alcohol and cannabis use disorders following first hospitalization for bipolar disorder. Bipolar Disorders 2012;14(1):99-108. [DOI: 10.1111/j.1399-5618.2012.00985.x] - DOI - PMC - PubMed
Hendricks 2014 {published data only}
    1. Hendricks PS, Delucchi KL, Benowitz NL, Hall SM. Clinical significance of early smoking withdrawal effects and their relationships with nicotine metabolism: preliminary results from a pilot study. Nicotine & Tobacco Research 2014;16(5):615-20. [DOI: 10.1093/ntr/ntt204] - DOI - PMC - PubMed
Hirdes 1994 {published data only}
    1. Hirdes JP, Maxwell CJ. Smoking cessation and quality of life outcomes among older adults in the Campbell's survey on well-being. Canadian Journal of Public Health 1994;85(2):99-102. [PMID: ] - PubMed
Hsu 2015 {published data only}
    1. Hsu H, Chang W. Reducing the risks of morbidity, disability, and mortality using successful aging strategies. Journal of the American Geriatrics Society 2015;63(11):2426-8. [DOI: 10.1111/jgs.13817] - DOI - PubMed
Hughes 1992 {published data only}
    1. Hughes JR. Tobacco withdrawal in self-quitters. Journal of Consulting and Clinical Psychology 1992;60(5):689-97. [DOI: 10.1037//0022-006x.60.5.689] - DOI - PubMed
Hurt 1997 {published data only}
    1. Hurt RD, Sachs DP, Glover ED, Offord KP, Johnston JA, Dale LC, et al. A comparison of sustained-release bupropion and placebo for smoking cessation. New England Journal of Medicine 1997;337(17):1195-202. [DOI: 10.1056/NEJM199710233371703] - DOI - PubMed
Hwang 2012 {published data only}
    1. Hwang GS, Jung HS, Yi Y, Yoon C, Choi JW. Smoking cessation intervention using stepwise exercise incentives for male workers in the workplace. Asia-Pacific Journal of Public Health 2012;24(1):82-90. [DOI: 10.1177/1010539510370991] - DOI - PubMed
IRCT20100127003210N16 2019 {published data only}
    1. IRCT20100127003210N16. Cytisine versus nicotine for smoking cessation in hospitalized psychiatric patients. www.who.int/trialsearch/Trial2.aspx?TrialID=IRCT20100127003210N16 (first received 14 January 2019).
Jang 2010 {published data only}
    1. Jang A-S, Park S-W, Kim D-J, Uh S, Kim YH, Whang HG. Effects of smoking cessation on airflow obstruction and quality of life in asthmatic smokers. Allergy, Asthma and Immunology Research 2010;2(4):254-9. [DOI: 10.4168/aair.2010.2.4.254] - DOI - PMC - PubMed
John 2004 {published data only}
    1. John U, Meyer C, Rumpf HJ, Hapke U. Smoking, nicotine dependence and psychiatric comorbidity -a population-based study including smoking cessation after three years. Drug and Alcohol Dependence 2004;76(3):287-95. [DOI: 10.1016/j.drugalcdep.2004.06.004] - DOI - PubMed
Kaetsu 2002 {published data only}
    1. Kaetsu A, Fukushima T, Moriyama M, Shigematsu T. Change of the smoking behaviour and related lifestyle variables among physicians in Fukuoka, Japan: a longitudinal study. Journal of Epidemiology 2002;12(3):208-16. [DOI: 10.2188/jea.12.208] - DOI - PMC - PubMed
Kahler 2004 {published data only}
    1. Kahler CW, Strong DR, Niaura R, Brown RA. Hostility in smokers with past major depressive disorder: relation to smoking patterns, reasons for quitting, and cessation outcomes. Nicotine & Tobacco Research 2004;6(5):809-18. [DOI: 10.1080/1462220042000282546] - DOI - PubMed
Kahler 2009 {published data only}
    1. Kahler CW, Spillane NS, Leventhal AM, Strong DR, Brown RA, Monti PM. Hostility and smoking cessation treatment outcome in heavy social drinkers. Psychology of Addictive Behaviors 2009;23(1):67-76. [DOI: 10.1037/a0012655] - DOI - PMC - PubMed
Kerkvliet 2015 {published data only}
    1. Kerkvliet JL, Wey H, Fahrenwald NL. Cessation among state quitline participants with a mental health condition. Nicotine & Tobacco Research 2015;17(6):735-41. [DOI: 10.1093/ntr/ntu239] - DOI - PubMed
Khaled 2009 {published data only}
    1. Khaled SM, Bulloch A, Exner DV, Patten SB. Cigarette smoking, stages of change, and major depression in the Canadian population. Canadian Journal of Psychiatry 2009;54(3):204-8. [DOI: 10.1177/070674370905400309] - DOI - PubMed
Khaled 2012 {published data only}
    1. Khaled SM, Bulloch AG, Williams JVA, Hill JC, Lavorato DH, Patten SB. Persistent heavy smoking as risk factor for major depression (MD) incidence: evidence from a longitudinal Canadian cohort of the National Population Health Survey. Journal of Psychiatric Research 2012;46(4):436-43. [DOI: 10.1016/j.jpsychires.2011.11.011] - DOI - PubMed
Kim 2019 {published data only}
    1. Kim SJ, Chae W, Park WH, Park MH, Park EC, Jang SI. The impact of smoking cessation attempts on stress levels. BMC Public Health 2019;19(1):267. [DOI: 10.1186/s12889-019-6592-9] - DOI - PMC - PubMed
Kinnunen 2006 {published data only}
    1. Kinnunen T, Haukkala A, Korhonen T, Quiles ZN, Spiro A, Garvey AJ. Depression and smoking across 25 years of the normative aging study. International Journal of Psychiatry in Medicine 2006;36(4):413-26. [DOI: 10.2190/G652-T403-73H7-2X28] - DOI - PubMed
Kocak 2015 {published data only}
    1. Kocak ND, Eren A, Boga S, Akturk UA, Ozturk UA, Arinc S, et al. Relapse rate and factors related to relapse in a 1-year follow-up of subjects participating in a smoking cessation program. Respiratory Care 2015;60(12):1796-803. [DOI: 10.4187/respcare.03883] - DOI - PubMed
Lam 2012 {published data only}
    1. Lam CY, Robinson JD, Versace F, Minnix JA, Cui Y, Carter BL. Affective reactivity during smoking cessation of never-quitters as compared with that of abstainers, relapsers, and continuing smokers. Experimental and Clinical Psychopharmacology 2012;20(2):139-50. [DOI: 10.1037/a0026109] - DOI - PMC - PubMed
Lappan 2018 {published data only}
    1. Lappan S, Thorne CB, Long D, Hendricks PS. Longitudinal and reciprocal relationships between psychological well-being and smoking. Nicotine & Tobacco Research 2018;22(1):18-23. [DOI: 10.1093/ntr/nty185] - DOI - PMC - PubMed
Lerman 2004 {published data only}
    1. Lerman C, Niaura R, Collins BN, Wileyto P, Audrain-McGovern J, Pinto A. Effect of bupropion on depression symptoms in a smoking cessation clinical trial. Psychology of Addictive Behaviors 2004;18(4):362-6. [DOI: 10.1037/0893-164X.18.4.362] - DOI - PubMed
Lewis 2011 {published data only}
    1. Lewis SJ, Araya R, Smith GD, Freathy R, Gunnell D, Palmer T, et al. Smoking is associated with, but does not cause, depressed mood in pregnancy--a Mendelian randomization study. PLOS One 2011;6(7):e21689. [DOI: 10.1371/journal.pone.0021689] - DOI - PMC - PubMed
McClure 2009 {published data only}
    1. McClure JB, Swan GE, Jack L, Catz SL, Zbikowski SM, McAfee TA. Mood, side-effects and smoking outcomes among persons with and without probable lifetime depression taking varenicline. Erratum.. Journal of General Internal Medicine 2009;24(10):1173. [PMID: 10.1007/s11606-009-0966-0] - DOI - PMC - PubMed
Miguez 2019 {published data only}
    1. Miguez MC, Pereira B, Pinto TM, Figueiredo B. Continued tobacco consumption during pregnancy and women's depression and anxiety symptoms. International Journal of Public Health 2019;64(9):1355-65. [DOI: 10.1007/s00038-019-01308-y] - DOI - PubMed
Moreno‐Coutino 2007 {published data only}
    1. Moreno-Coutino A, Calderon-Ezquerro C, Drucker-Colin R. Long-term changes in sleep and depressive symptoms of smokers in abstinence. Nicotine & Tobacco Research 2007;9(3):389-96. [DOI: 10.1080/14622200701188901] - DOI - PubMed
Morris 2011 {published data only}
    1. Morris CD, Waxmonsky JA, May MG, Tinkelman DG, Dickinson M, Giese AA. Smoking reduction for persons with mental illnesses: 6-month results from community-based interventions. Community Mental Health Journal 2011;47(6):694-702. [DOI: 10.1007/s10597-011-9411-z] - DOI - PubMed
Myneni 2018 {published data only}
    1. Myneni AA. Dietary factors, smoking cessation and lung cancer. Dissertation Abstracts International: Section B: The Sciences and Engineering 2018;79(8-B(E)):No pagination specified.
NCT01789125 2013 {published data only}
    1. NCT01789125. Smoking Termination / Anxiety Reduction Treatment (ST/ART). clinicaltrials.gov/show/NCT01789125 (first received 11 February 2013).
NCT02845687 {published data only}
    1. NCT02845687. Study on smoking cessation and cost outcomes in the Duke smoking cessation program. clinicaltrials.gov/ct2/show/NCT02845687 (first received 27 July 2016).
Nieva 2017 {published data only (unpublished sought but not used)}
    1. Nieva G, Comin M, Valero S, Bruguera E. Cigarette dependence and depressive symptoms as predictors of smoking status at five-year follow-up after a workplace smoking cessation program. Addictive Behaviors 2017;73:9-15. - PubMed
O'Toole 2018 {published data only}
    1. O'Toole BI, Kirk R, Bittoun R, Catts SV. Combat, posttraumatic stress disorder, and smoking trajectory in a cohort of male Australian Army Vietnam veterans. Nicotine & Tobacco Research 2018;20(10):1198-205. [DOI: 10.1093/ntr/ntx257] - DOI - PubMed
Ong 2016 {published data only}
    1. Ong J, Plueckhahn I, Cruickshank D, Churilov L, Mileshkin L. A smoking cessation programme for current and recent ex-smokers following diagnosis of a potentially curable cancer. Internal Medicine Journal 2016;46(9):1089-96. [DOI: 10.1111/imj.13172] - DOI - PubMed
Park 2009 {published data only}
    1. Park ER, Chang Y, Quinn V, Regan S, Cohen L, Viguera A. The association of depressive, anxiety, and stress symptoms and postpartum relapse to smoking: a longitudinal study. Nicotine & Tobacco Research 2009;11(6):707-14. [DOI: 10.1093/ntr/ntp053] - DOI - PMC - PubMed
Piper 2012 {published data only}
    1. Piper ME, Kenford S, Fiore MC, Baker TB. Smoking cessation and quality of life: changes in life satisfaction over 3 years following a quit attempt. Annals of Behavioral Medicine 2012;43(2):262-70. [DOI: 10.1007/s12160-011-9329-2] - DOI - PMC - PubMed
Roson 2017 {published data only}
    1. Roson NF, Panadero-Paz C, Almadana-Pacheco V, Benito-Bernaldez C, Rodriguez-Martin PJ, Montemayor-Rubio T. Influence of psychiatric disorders in patients treated with varenicline. European Respiratory Journal 2017;50:PA4478. [DOI: 10.1183/1393003.congress-2017.PA4478] - DOI
Schlyter 2016 {published data only}
    1. Schlyter M, Leosdottir M, Engström G, André-Petersson L, Tydén P, Östman M. Smoking cessation after acute myocardial infarction in relation to depression and personality factors. International Journal of Behavioral Medicine 2016;23(2):234-42. [DOI: 10.1007/s12529-015-9514-y] - DOI - PubMed
Schwartz 1968b {published data only}5651704
    1. Schwartz JL, Dubitzky M. One-year follow-up results of a smoking cessation program. Canadian Journal of Public Health 1968;59(4):161-5. [PMID: ] - PubMed
Seghatoleslam 2014 {published data only}
    1. Seghatoleslam T, West R, Habil H, Zahiroddin A. A pilot study of managing depression and controlling smoking. International Medical Journal 2014;21(1):14-7.
Shaw 2001 {published data only}
    1. Shaw JW, Coons SJ, Foster SA, Leischow SJ, Hays RD. Responsiveness of the Smoking Cessation Quality of Life (SCQoL) questionnaire. Clinical Therapeutics 2001;23(6):957-69. [DOI: 10.1016/s0149-2918(01)80083-7] - DOI - PubMed
Shimadu 2016 {published data only (unpublished sought but not used)}27303107
    1. Shimadu S, Hamajima N, Okada Y, Oguri T, Murohara T, Ban N, et al. Factors influencing sustainable efficacy of smoking cessation treatment with varenicline beyond nine months. Nagoya Journal of Medical Science 2016;78(2):205-13. [PMID: ] - PMC - PubMed
Siahpush 2007 {published data only}
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Solak 2018 {published data only (unpublished sought but not used)}
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References to other published versions of this review

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