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

描述（由申请人提供）：在美国，吸烟是导致死亡和发病的主要可预防原因（CDC 2005）。虽然戒烟可以减少健康风险和残疾天数，但女性戒烟更困难，而且现有的治疗方法对女性的效果不如男性。了解增加戒烟失败的性别敏感风险因素对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。女性在吸烟和重度抑郁症之间的关系比男性强；因此，抑郁症可能对女性戒烟的能力产生更大的影响。性别差异在抑郁症和吸烟行为之间的关系还没有使用纵向人口为基础的数据集进行彻底的检查。对于目前的项目，我们建议通过对全国酒精及相关疾病流行病学调查（NESARC）第1波（2001-2002年，n=43,093）和第2波（2004-2005年，n=34,653）数据库的二次分析，对抑郁与吸烟和尼古丁依赖转变之间关系的性别差异进行详细调查。目前的研究将通过检查与吸烟行为相关的多种情绪障碍（终生和当前的重度抑郁症，终生和当前的心境恶劣，终生轻度抑郁症），多种形式的吸烟行为（戒烟，吸烟复发，尼古丁依赖）以及可能调解抑郁症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过渡研究中的空白。这项研究的发现将对治疗提供者具有实际意义，并可能刺激研究，最终导致针对尼古丁依赖的性别特异性治疗的发展。

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.