Quite awhile ago now, bupropion (Welbutrin) was first used on people who suffered from depression. Researchers were surprised to discover a mis-intended, but beneficial side effect, that being smoking cessation. There is strong long-standing evidence that links depression with smoking behavior and nicotine addiction. I remember there were lots of patients in the 'psych ward' at our hospital that would go outside for their smoke break. I don't mean that to be a mischaracterization, but rather just an anecdotal observation from my hospital days.
Now there are questions as to whether a tendency to anxiety and depressive reactions is some how involved in the clinical presentation of someone with a nicotine addiction. Researchers in Polan sought to answer this question in a study titled, "Anxiety, depression and methods of stress coping in patients with nicotine dependence syndrome". It was published in the Medical Science Monitor: international medical journal of experimental and clinical research - [2011 May 2;12(5):CR272-276] by Pietras, T and others.
Here they compared two groups: smokers with no serious systemic co-morbidities and healthy subjects. Each individual was assessed in the same manner using the same behavioral tools for measuring anxiety, depression and coping abilities. Their results show the average intensity of anxiety as a trait and anxiety as a state were different in these two groups. Depression was also demonstrated to be more intensive in the nicotine addiction group. Finally, those with the nicotine addiction used more emotion-based coping behavior than did the healthy control group subjects.
They concluded that anxiety and depression, along with differences in coping, distinguished those who were addicted to nicotine from their non-smoking, healthy counterparts. So, which came first, the chicken or the egg?
Do people smoke because they're depressed or are they depressed, therefore, they smoke? I don't believe this study answers that rather complex question. Rather, it simply delineates the differences between these two groups. I'm sure bother ends of the argument are true. It is interesting to note, however, that there is a linking between a person's sense of well-being with oneself and his/her environment, with their nicotine addiction.
This fact tells us there is more to smoking cessation than simply quitting cold turkey. Although, for some it is that easy. For many others, it is seemingly complex weave of behavior, genetic predisposition, culture and brain chemistry. This isn't surprising, since most addictions are viewed in those terms already.
