Gender differences in the association of depression to transitions in smoking.

说明(由申请人提供)：在美国，吸烟是导致死亡和发病的首要可预防原因(CDC 2005)。虽然戒烟减少了健康风险和残疾天数，但女性戒烟的难度更大，可用的治疗方法对女性的成功程度也低于男性。了解对性别敏感的风险因素会增加戒烟失败的程度，这对于改进干预措施至关重要。抑郁症已被确定为吸烟、尼古丁依赖、戒烟失败和未能保持戒烟的危险因素。在吸烟和严重抑郁症之间，女性比男性表现出更强的相关性；因此，抑郁症可能对女性戒烟的能力产生更大的影响。抑郁和吸烟行为关系中的性别差异还没有使用基于人群的纵向数据集进行彻底的检验。在目前的项目中，我们建议通过对全国酒精及相关疾病流行病学调查(NESARC)第一波(2001-2002年，n=43,093)和第二波(2004-2005，n=34,653)数据库进行二次分析，对抑郁症与吸烟和尼古丁依赖的过渡之间的关系进行详细的性别差异调查。目前的研究将通过检查与吸烟行为有关的多种情绪障碍(一生和当前的严重抑郁、一生和现在的恶劣心境障碍、一生的轻度抑郁)、多种形式的吸烟行为(戒烟、吸烟复发、尼古丁依赖)，以及可能调节抑郁和戒烟之间关系的重要变量(压力、控制和社会支持)，来解决抑郁症和吸烟转变研究中的空白。这项研究的结果将对治疗提供者具有实际意义，并可能刺激最终导致开发针对尼古丁依赖的针对性别的治疗方法的研究。 与公共健康相关：尽管女性戒烟的难度更大，但这种关系的原因还不是很清楚。女性患抑郁症的几率更高，患有抑郁症的吸烟者难以戒烟；然而，目前尚不清楚重度抑郁症、轻度抑郁症和恶劣心境对吸烟者戒烟和保持戒烟的负面影响有多大，也不清楚抑郁症对女性吸烟者的影响比男性更明显。这项拟议的应用程序将检查抑郁症与戒烟和避免再次吸烟能力之间的性别差异。

DESCRIPTION (provided by applicant): Smoking is the leading preventable cause of mortality and morbidity in the United States (CDC 2005). While smoking cessation reduces health risks and disability days, women have more difficulty quitting smoking and available treatments are less successful for women than men. Understanding gender-sensitive risk factors that increase failure to stop smoking is critical for improving interventions. Depression has been identified as a risk factor for smoking, nicotine dependence, smoking cessation failure, and failure to maintain abstinence. Women demonstrate stronger relationships than men between smoking and Major Depression; therefore, depression may exert greater effects on the ability of women to stop smoking. Gender differences in the relationship of depression and smoking behavior have not been thoroughly examined using a longitudinal population-based dataset. For the current project, we are proposing to conduct a detailed investigation into gender differences in the relationship between depression and transitions in smoking and nicotine dependence through a secondary analysis of The National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) Wave 1 (2001-2002, n=43,093) and Wave 2 (2004-2005, n=34,653) databases. The current study will address gaps in research on depression and smoking transitions by examining multiple mood disorders related to smoking behavior (lifetime and current Major Depression, lifetime and current Dysthymia, lifetime Minor Depression), multiple forms of smoking behavior (smoking cessation, smoking relapse, nicotine dependence), and important variables that may mediate the relationship between depression and smoking cessation (stress, control, and social support). The findings of this study will have practical implications for treatment providers and may stimulate research ultimately leading to the development of gender-specific treatments for nicotine dependence. PUBLIC HEALTH RELEVANCE: Although women have a more difficult time quitting smoking, the reasons for this relationship are not well-understood. Women have higher rates of depression and smokers with depression experience difficulty quitting smoking; however, it is unclear to what extent Major Depression, Minor Depression, and Dysthymia negatively impact the ability of smokers to quit smoking and maintain abstinence and to what degree the impact of depression is more pronounced in female smokers than male. The proposed application will examine gender differences in the relationship between depression and ability to quit smoking and avoid smoking relapse.