summary
background Nicotine dependence and depression often occur together in the same patient. It is surprising, therefore, that psychiatry does not do more to persuade these patients to stop smoking.
aim To ascertain whether a stop-smoking programme should be a standard module of a treatment programme for depression.
method A literature search was conducted with the help of PubMed, Embase and the Cochrane Library and using the search terms: 'major depressive disorder', 'nicotine dependence', 'smoking and smoking cessation'.
results There is high comorbidity between daily smoking and depression. Genetic factors and acute life-events are risk factors for this comorbidity. Very little research has been done to find out whether depressed patients who quit smoking attain long-lasting abstinence and what the effects of quitting are on their depressive symptoms. Smokers with a history of depression seem to benefit from a stop-smoking programme but it is uncertain whether they also run an increased risk of a new depressive episode.
conclusion There are good reasons for adding a stop-smoking programme to a programme for treating depression in patients who smoke. However, before this plan is implemented we need to find out whether patients who stop smoking are more likely to develop more depressive symptoms and attain long-lasting abstinence.