Secondhand Smoke Exposure and Depressive Symptoms

Department of Epidemiology and Public Health, University of Miami Miller School of Medicine, Miami, FL 33101, USA.
Psychosomatic Medicine (Impact Factor: 3.47). 11/2009; 72(1):68-72. DOI: 10.1097/PSY.0b013e3181c6c8b5
Source: PubMed


To evaluate the association between secondhand smoke (SHS) exposure and depression. Tobacco smoking and depression are strongly associated, but the possible effects of SHS have not been evaluated.
The 2005 to 2006 National Health and Nutrition Examination Survey (NHANES) is a cross-sectional sample of the noninstitutionalized civilian U.S. population. SHS exposure was measured in adults aged > or =20 years by serum cotinine and depressive symptoms by the Patient Health Questionnaire. Zero-inflated Poisson regression analyses were completed with adjustment for survey design and potential confounders.
Serum cotinine-documented SHS exposure was positively associated with depressive symptoms in never-smokers, even after adjustment for age, race/ethnicity, gender, education, alcohol consumption, and medical comorbidities. The association between SHS exposure and depressive symptoms did not vary by gender, nor was there any association between SHS smoke exposure and depressive symptoms in former smokers.
Findings from the present study suggest that SHS exposure is positively associated with depressive symptoms in never-smokers and highlight the need for further research to establish the mechanisms of association.

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    • "depression and anxiety disorders, the etiology of these disorders still remains poorly understood. One recent study has found strong associations between SHS exposure and increased depression among adults (Bandiera et al., 2010). These associations persist longitudinally and after adjusting for a range of confounding demographic and social factors. "
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    ABSTRACT: Introduction The aim of this paper was to investigate the association between childhood and adulthood exposure to secondhand smoke (SHS) and depression, panic attack, and generalized anxiety disorder among adults in the United States over a 10-year period. Methods Data were drawn from the Midlife Development in the United States (MIDUS) Waves 1 and 2 (N=2053). Self-reported childhood and adulthood SHS exposure at Wave 1 (1994) was examined in relation to incident depression, panic attack, and generalized anxiety disorder 10 years later at Wave 2 (2005). Results Childhood SHS alone was not associated with mood and anxiety disorders in adulthood. Exposure to SHS in both childhood and adulthood was associated with increased depression and panic attack in adulthood. These associations did not appear to be due to confounding. Limitations SHS exposure was measured via self-report; biological data confirming exposure were not collected. More objective measures of SHS exposure are needed in future studies. Conclusions In summary, persistent exposure to SHS across the life course may be associated with increased risk of depression and panic attacks. Our results are consistent with prior findings and extend earlier results by showing a relationship between SHS exposure and mental health problems over time. Replication with biological measures of SHS over time is a necessary next step toward better understanding the pathways explaining these relationships.
    Full-text · Article · Oct 2014 · Journal of Affective Disorders
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    • "As mentioned above, depression can be seen as having an inflammatory component, and smoking also aggravates inflammation and provokes marked oxidative stress [103]. Additionally, evidence from a cross-sectional study indicates that second-hand cigarette smoke is positively associated with depressive symptoms in smoking-naive people (even after adjustment for age, race/ethnicity, gender, education, alcohol consumption, and medical comorbidities) [104]. "
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    ABSTRACT: The prevalence of depression appears to have increased over the past three decades. While this may be an artefact of diagnostic practices, it is likely that there are factors about modernity that are contributing to this rise. There is now compelling evidence that a range of lifestyle factors are involved in the pathogenesis of depression. Many of these factors can potentially be modified, yet they receive little consideration in the contemporary treatment of depression, where medication and psychological intervention remain the first line treatments. "Lifestyle Medicine" provides a nexus between public health promotion and clinical treatments, involving the application of environmental, behavioural, and psychological principles to enhance physical and mental wellbeing. This may also provide opportunities for general health promotion and potential prevention of depression. In this paper we provide a narrative discussion of the major components of Lifestyle Medicine, consisting of the evidence-based adoption of physical activity or exercise, dietary modification, adequate relaxation/sleep and social interaction, use of mindfulness-based meditation techniques, and the reduction of recreational substances such as nicotine, drugs, and alcohol. We also discuss other potential lifestyle factors that have a more nascent evidence base, such as environmental issues (e.g. urbanisation, and exposure to air, water, noise, and chemical pollution), and the increasing human interface with technology. Clinical considerations are also outlined. While data supports that some of these individual elements are modifiers of overall mental health, and in many cases depression, rigorous research needs to address the long-term application of Lifestyle Medicine for depression prevention and management. Critically, studies exploring lifestyle modification involving multiple lifestyle elements are needed. While the judicious use of medication and psychological techniques are still advocated, due to the complexity of human illness/wellbeing, the emerging evidence encourages a more integrative approach for depression, and an acknowledgment that lifestyle modification should be a routine part of treatment and preventative efforts.
    Full-text · Article · Apr 2014 · BMC Psychiatry
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    • "Other explanations point to genetics, where shared pathways link both poor mental health and a heighted sensitivity to the effects of smoking. For example, there is an observed genetic predisposition for some individuals to have lower levels of resting intrasynaptic dopamine and a heightened release of dopamine due to smoking, which has also been linked to higher levels of depression (Bandiera et al., 2010); SHS exposure could similarly trigger this heightened release of dopamine in depression vulnerable individuals. There is, however, only a small amount of research conducted on the mental health effects of SHS exposure. "
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    ABSTRACT: Introduction: The aim of this paper was to examine the association between exposure to second-hand smoke (SHS) among non-smokers, in the home and the vehicle, and poor mental health outcomes (mood disorder, anxiety disorder, poor/fair mental health, and high stress). Methods: Data were drawn from the 2010 Canadian Community Health Survey, a representative sample of 62,909 Canadians 12years and older. Measures of SHS exposure are drawn from self-reported daily or near daily exposure in the home or in the vehicle. Mental health indicators include self-reported diagnosed mood and anxiety disorders, and self-report measures of overall mental health and experiences of stress. Associations between SHS exposure and poor mental health among non-smokers were examined in a series of logistic regression models. Additional analyses stratified on respondent's smoking status, physical health, and gender. Results: Analyses revealed that SHS exposure among non-smokers was associated with increased anxiety disorders, poor/fair mental health, and high stress, with no association to mood disorders. Stratified analyses demonstrated that associations between SHS and poor mental health are contextualized by respondent's gender, physical health, and smoking status. Conclusions: Beyond changes to physical health, SHS exposure in private spaces was negatively associated with the mental health of non-smokers. Public health efforts to reduce SHS exposure in private spaces are warranted. Findings also reveal additional targets for decreasing and eliminating the societal burden of mental health disorders. Further research is needed to examine causality and to explore associations between SHS exposure and specific mental health outcomes.
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