Assessment of depressive symptoms in severe smokers with minimal-mild depressive symptomatology receiving pre-smoking abstinence for integrated treatment: a randomized clinical trial

INTRODUCTION: Smoking and depression have a long-history documented of comorbidity. OBJECTIVE: The objective of this study was to develop and test a treatment that could simultaneously achieve smoking abstinence and decrease depressive symptoms in a group of heavy smokers with minimal/mild depressive symptomatology. METHOD: Sixty smokers were randomly assigned to three different treatment settings. Treatment included a pre-abstinence phase, a psychological treatment phase, a pharmacotherapy phase and a follow-up stage. Smokers began the psychological treatment and the pharmacotherapy two weeks before the day they chosen to quit smoking, and monitoring was conducted over a year. Abstinence was confirmed by assessing the levels of urinary cotinine. RESULTS: Using a linear mixed model with individual random effect, baseline data was compared with subsequent assessments; 46% of the patients achieved abstinence. For men, the three treatment settings significantly reduced depressive symptoms and helped smokers to achieve abstinence. For women, only the nicotine patch showed to be effective in the reducing depressive symptoms. DISCUSSION AND CONCLUSION: Integral pre-abstinence treatment is effective in aiding smokers to achieve smoking abstinence and improve depressive symptoms.