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Key Question 1: For patients with a history of a depressive disorder or current significant depressive symptoms, what is the comparative effectiveness of different smoking cessation strategies on smoking abstinence rates?


The combined literature search of PubMed, Embase, PsycINFO, and Cochrane databases, minus duplicates, contained 884 unique citations, of which we excluded 792 after reviewing titles and abstracts. We then conducted full-text reviews of 92 articles and pulled 6 additional papers in order to retrieve supplemental methodological or background information on studies included in the full-text review. Of these 98 papers, we excluded 75. Figure 2 summarizes the literature flow. The 23 included reports encompassed 16 unique trials with a total of 3,553 depressed and nondepressed participants. Table 3 summarizes study characteristics. In studies that included depressed and nondepressed participants, we report information for the depressed subgroup when available.


There is a synergistic and potentially bidirectional relationship between depression and smoking.,,,, Smokers with depression are significantly less likely to quit smoking, and depressed individuals are more likely to be smokers. Consequently, there is a need to identify effective smoking cessation interventions for this disproportionately affected population. We conducted a systematic review of smoking cessation intervention strategies for persons with depression. We also sought to examine differential effects of smoking cessation treatment by depression status, gender, and treatment sequencing and to characterize adverse effects of smoking cessation treatments in patients with depression. We found insufficient evidence to examine moderator effects and to characterize adverse effects. However, findings suggest several promising smoking cessation strategies for persons with depression. We summarize and discuss our findings here.

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