The Relationship between Smoking and Depression Post-Acute Coronary Syndrome
- PDF / 159,543 Bytes
- 9 Pages / 595.276 x 790.866 pts Page_size
- 31 Downloads / 186 Views
SMOKING (HILARY A. TINDLE, SECTION EDITOR)
The Relationship between Smoking and Depression Post-Acute Coronary Syndrome Andrew M. Busch & Belinda Borrelli & Adam M. Leventhal
Published online: 2 September 2011 # Springer Science+Business Media, LLC 2011
Abstract The purpose of the current article is to review research on the relationship between smoking cessation and depressed mood post-acute coronary syndrome (ACS; myocardial infarction or unstable angina). Emerging evidence regarding the effect of anhedonia—a specific subcomponent of mood disturbance characterized by reduced pleasure—on post-ACS outcomes is also discussed. There is strong evidence that depression prospectively predicts post-ACS relapse to smoking. Weaker evidence suggests that smoking at the time of ACS is related to post-ACS depression. Bupropion is a particularly promising treatment for this population because of its smoking cessation and anti-depressant effects. Future research should focus on the relative risk of using nicotine replacement therapies post-ACS, the efficacy of bupropion for smoking cessation and depression reduction in postACS patients, the role of anhedonia in post-ACS smoking cessation, and the development and testing of integrated behavioral treatments (smoking cessation plus interventions targeting mood management) for ACS patients. Keywords Smoking . Depression . Anhedonia . Acute coronary syndrome A. M. Busch (*) : B. Borrelli Centers for Behavioral and Preventive Medicine, Program in Nicotine and Tobacco, Alpert Medical School of Brown University and The Miriam Hospital, Coro Bldg West, Suite 314, One Hoppin St, Providence, RI 02903, USA e-mail: [email protected] A. M. Leventhal Departments of Preventive Medicine and Psychology, University of Sothern California Keck School of Medicine, Los Angeles, CA, USA
Introduction Cigarette smoking and depression are independently linked to both the development and exacerbation of cardiovascular disease (CVD) [1]. Recent reviews have discussed the relationships among depression, smoking, and CVD in general [1, 2]. This article focuses on the relationship of depression and smoking specifically among those hospitalized for acute coronary syndrome (ACS; myocardial infarction or unstable angina). Hospitalization for ACS is a unique opportunity to initiate smoking cessation treatment, but smoking cessation may be complicated by depressed mood. In addition, recent studies indicate that anhedonia, a specific component of depressed mood that involves lack of positive affect, is an independent risk factor for failure to quit smoking and predicts post-ACS morbidity and mortality. Anhedonia has not been included in previous reviews. Thus, this review also highlights the effect of anhedonia on both quitting smoking and poor health outcomes post-ACS.
Depression and Smoking Depression Smokers have a higher incidence of depressed mood, major depression, and history of major depression than nonsmokers [3]. Smokers with high levels of current depressed mood are significantly less likely to q
Data Loading...
