Relationship between Smoking and Anxiety and Depression in Primary Care

Helder Farinha, Joana Raposo de Almeida, Ana Rita Aleixo, Hugo Oliveira, Filomena Xavier, Ana Isabel Santos


Introduction: Smoking prevalence in Portugal is estimated to be 19.7% (2005). Smoking is prevalent in anxiety disorders. Studies report that 60% of smokers have a history of depression. The Fagerström scale can be used to assess smoke dependence. The Hospital Anxiety and Depression Scale allows an estimate of anxiety and depression. Our goal was to find whether there is a relationship between smoking and anxiety / depression in eight clinics within primary care practice.
Material and Methods: We designed an observational, descriptive, cross-sectional, analytical study. Anonymous survey. We considered as inclusion criteria the over 18 years of age and literate clinic users and as exclusion criteria the under 18 years old users or incomplete surveys. We defined as variables: Fagerström, Hospital Anxiety and Depression Scale, age, marital status, gender, profession, schooling.
Results: We obtained a total of 608 valid surveys of which there were 64% women and 21% smokers. We found no differences in the prevalence of anxiety or depression when comparing non-smokers, ex-smokers and smokers. We found that the degree of nicotine addiction varies directly with anxiety and depression, however, the only statistically significant relationship observed was in women, even after correcting the effect of age.
Discussion: There is a relationship between nicotine dependence and the severity of symptoms of anxiety and depression, most relevant in women. Limitation: selection bias.
Conclusion: This study supplies information regarding psychological factors associated with tobacco consumption, allowing for its inclusion in treatment options for nicotine dependence.

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