Relationship of Mood Disturbance to Cigarette Smoking Status Among 252 Patients With a Current Mood Disorder

Background: The relationship between cigarettesmoking and mood has received increasing attention. Thisretrospective study evaluated the relationship between mooddisturbance and cigarette smoking status among patients with acurrent mood disorder. The association between level of nicotinedependence and severity of mood disturbance was also evaluatedamong current smokers.

Method: Retrospective data for 252 patients(63.5% male, 85.0% white) admitted for treatment of a mooddisorder at the San Diego Veteran Affairs Mental Health ClinicalResearch Center between November 1988 and June 1997 were studied.All current cigarette smokers at admission (N = 126) were matchedwith nonsmokers (N = 126) on the primary DSM-IV Axis I mooddisorder diagnosis, admission status (inpatient or outpatient),gender, age (± 5 years), and ethnicity. The Hamilton RatingScale for Depression (HAM-D), the Beck Depression Inventory, andthe Profile of Mood States (POMS) were administered to patientson admission. Conditional logistic regression analysis formatched sets with a backward elimination was used to identifyfactors independently predictive of current smoking status.

Results: A greater number of cups of coffeeconsumed per day (p = .002), a history of alcoholism (p = .004),and higher POMS fatigue subscale scores (p = .007) werepredictive of current smoking status. Among current smokers, theHAM-D terminal insomnia item was positively associated with meannumber of cigarettes smoked per day (p = .012).

Conclusion: Cigarette smoking should beaddressed in the treatment of patients with a current mooddisorder. Smokers experience greater levels of fatigue thannonsmokers. In addition, higher cigarette consumption levels areassociated with mild-to-severe symptoms of terminal insomnia.