KTVT CBS 11 Health Alert
Dr. Lewis Pincus
Taping Script, Week of June 22, 2001

Smoking and Depression

Anchor: A new study on the relationship between smoking and depression brings home the point about how very difficult it is for people with emotional illness to quit smoking, and how an understanding of why this is could lead to better drugs to help people stop. Here with the story is our medical expert, Dr. Lewis Pincus.

Doctor: John is 50 years old, a patient of mine for a long time. He is a 2 pack a day smoker for 30 years. He is divorced, lives alone, and also suffers from depression. He was in counseling for a while before and after the divorce. He would like to stop smoking, and actually was able to quit for several months using the drug Wellbutrin. But his HMO wouldn’t pay for the drug, he couldn’t afford it for cash, so he stopped it. His depression, which seemed controlled on the medication, worsened. He started smoking again because, as he told me, “I just couldn’t deal with how bad I felt off the cigarettes.” His embarrassment and frustration fill the room.

Researchers also know that approximately 50% of the United States tobacco market is supported by the 50 million Americans with mental illness. John is not alone as psychiatrist Dr. Alexander Glassman from the New York State Psychiatric Institute reports in a new study in the medical journal Lancet. The study involves a group of 100 smokers with a history of major depression who all participated in a two-month smoking cessation program using Zyban, the smoking cessation marketed form of the drug Wellbutrin. They are the same drug. 76 of the patients were followed for 6 months after they finished the program. Of the 42 patients who successfully quit smoking, 13 of those, or 30%, had an episode of major depression return, while only 2 of the 34 patients, or 5%, who did not quit smoking had a depressive episode.

Study results such as these in adults, and other studies in children, continue to show the strong link between tobacco smoking and depression. Children who are depressed have a very high likelihood of becoming smokers. Depressed adults who smoke have, on medication that affects the same part of the brain as tobacco smoke, an ability to quit smoking about as successfully as smokers who are not depressed. So there is a connection here that is telling us that if you have a child who smokes who you even suspect might be depressed, part of the reason they might be smoking is because they are depressed. So the successful the treatment of the depression is what needs to happen before the child can quit smoking. Same thing for adults.

Studies will now be undertaken to see if the same drugs used successfully short-term can be taken long-term to prevent both the return to smoking and the return of depression. Whether or not insurance companies can be pressured to pay for such treatment will be an issue for another day.

For CBS Health Alert, I’m Dr. Lew Pincus. And back to you.
 

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