Smoking cessation in individuals with depression - Recommendations for treatment

Current, historical and subclinical depression have been linked to a high incidence of cigarette smoking and smoking cessation relapse. This review discusses the efficacy, suitability and other treatment issues involved in using nicotine replacement therapy, antidepressant treatment and cognitive-behavioural interventions to help depressed smokers quit smoking. It is recommended that prior to choosing a smoking cessation treatment regimen; assessment should be made of: (i) current and past history of depression; (ii) nicotine dependency; and (iii) other risk factors (e.g. family history of depression, past difficulty in quitting) for relapse. For those individuals who are highly nicotine dependent and who have a current or past history of major depressive disorder or who have several risk factors, a combination of antidepressants or cognitive-behavioural treatment and nicotine replacement therapy is recommended For those individuals who have fewer risk factors, a single modality of treatment may be sufficient.