Abstract and Introduction
Abstract
It is likely that nurse practitioners (NPs) will see patients who are chronic smokers and also depressed. Nicotine-dependent smokers are twice as likely to experience major depression compared to nondependent smokers and non-smokers. Biological and cognitive learning models provide an understanding of the relationship between the 2 conditions. Clinicians in primary care settings can select strategies of assessment, treatment, and education to care for patients presenting with these co-occurring conditions.
Introduction
Although cigarette smoking between 2002 and 2006 declined in the United States, one quarter of Americans continue to smoke despite the risks to health. Some smokers are unable to regulate the use of cigarettes and become physically and psychologically dependent upon nicotine. The lifetime prevalence of nicotine dependence in the United States is 24% and accounts for nearly half of those individuals who have ever smoked cigarettes daily for one month or more in their lives.
The prevalence of a past-year depression among persons with concurrent substance use rose from 10% in 1991–1992 to 15% in 2001–2002. Depression is a risk factor for nicotine dependence. Adults 18 years and older who are nicotine dependent are twice as likely as those who are not nicotine dependent to have experienced a major depressive episode (MDE) in the past year (13.8% vs 6%).