Smoking Relapse in Spanish Adults: The Influence of Depression Symptomatology

Background: The relationship between smoking cessation outcomes and depression is well-known. Previous studies have found that current depressive symptomatology is a predictor of relapse. However, some authors highlight that the nature of this relationship is unclear and that more research is needed regarding those smokers with depressive symptomatology who initially quit but who relapse later on. The aim of this study is to examine the time to relapse for smokers in treatment during 12 months follow-up according to depressive symptomatology level at posttreatment.

Methods: The initial sample consisted of 475 smokers (61.6% women; Mage=44.15; SE=11.07) who received a cognitive-behavioural treatment for smoking cessation. They were abstinent at the end of treatment and relapsed during the following year. Abstinence was self-reported at the end of treatment and at 1-, 3-, 6-, and 12-months follow-up. To assess depressive symptomatology at posttreatment, the BDI-II was administered. Differences in time to relapse between participants with a BDI-II score < 14 or BDI-II score  ≥ 14 at post-treatment were examined using Kaplan-Meier analysis.

Results: A significant difference between groups regarding the time of relapse (X2 = 9.07; p ≤ .003) was found. Specifically, time to relapse was significatively lower for those with BDI-II scores equal or greater than 14 at post-treatment. than those with scores lower than 14.

Conclusion: Significant differences in time to relapse were found between people with different levels of depressive symptoms at posttreatment, with those with higher symptomatology relapsing earlier.

These findings have several clinical implications for increasing the long-term efficacy of smoking cessation treatments. Therefore, smoking cessation treatments should consider posttreatment depressive symptomatology and offer support or specific sessions for people with higher depressive symptoms after quitting.