Other Effects of Tobacco Products/Nicotine

• Author: James G. Wigmore
• Pages: 624-715



 8

Other Ef‌fects of Tobacco

Products/Nicotine

“Impaired ability to recover from injuries in smokers may add to the death

toll. This includes poor wound healing, delayed bone union, decreased

blood f‌low, diminished tissue oxygenation, and diminished immunity,

increased wound infections, and more severe pulmonary complications

among injured smokers. All of these factors increased morbidity and make

complications more serious in smokers, leading to increased mortality.”

—Wen et al, “Excess Injury Mortality Among Smokers:

A Neglected Tobacco Hazard” ()

Nicotine products cause many other harmful ef‌fects to humans, in addi-

tion to the well-known cancers, heart, and lung diseases. Their role in

impairment of driving, other injuries, f‌ires, psychiatric disorders, sexual

dysfunction, and suicides is often not explored. Nicotine is an overlooked

drug in postmortem medicolegal cases as a cause of overdose death, sui-

cide, and injuries.

. DEPRESSION AND ANXIETY

“We observed a fourfold higher risk of depression for heavy smokers com-

pared with never smokers. Failure to explain the smoking–depression

association with other plausible alternatives might ref‌lect a direct causal

inf‌luence of smoking on depression.”

—Klungsøyr et al, “Cigarette Smoking and Incidence of First Depressive

Episode: An -Year, Population-Based Follow-Up Study” ()

Other Ef‌fects of Tobacco Products/Nicotine | 

Reference Number: 

Contrary to common misperceptions, encouraged in part by the tobacco

industry, smoking does not relieve depression and anxiety but actually

causes it, especially in adolescents (–). It is recommended that smok-

ing cessation should be a focus of depression prevention programs ().

Depressed people are more likely to be smokers and more unlikely to

stop smoking. Reduced nicotine cigarettes (to a minimally addictive level)

did not increase depressive symptoms ().

Not only cigarettes are associated with depression, anxiety, and ADHD,

but e-cigarettes (ECs), waterpipes, and other tobacco products as well, and

they should all should be a focus for the mental health population ().

Secondhand smoke exposure at home is associated with depressive

symptoms in male students ()

Reference Number: 

, .., .. , .. ,  .. . “Association of

Cigarette Smoking With Anxiety, Depression, And Suicidal Ideation

Among Brazilian Adolescents.” Neuropsychiatric Disease and Treatment,

: –,  ( tables,  f‌igure,  references)

Abstract: The association between depression and cigarette smoking

was determined in  students (aged – years) in  schools in Brazil.

There were  smokers (%) who had smoked at least  cigarettes per

day (CPD) in the past years. Smokers had higher anxiety and depression

scores than non-smokers and were .× as likely to have suicidal idea-

tion than non-smokers.

Smoking was found to be associated with anxiety symptoms, depressive

symptoms, and poor school performance in Brazilian adolescents; and

female smokers reported more suicidal ideation than male smokers.

Reference Number: 

, .., .. , .. , .. ,  .. . “Cigarette

Smoking Predicts Development of Depressive Symptoms Among US

Adolescents.” Annals of Behavioral Medicine, : –,  ( tables,

 f‌igures,  references)

Abstract: A -year longitudinal study was conducted examining the

relationship between smoking and depression in , adolescents who

had no depressive symptoms at baseline (). About .% of the girls

 | Wigmore on Nicotine and Its Drug Delivery Systems

Reference Number: 

developed depressive symptoms compared to .% of the boys. By the

end of the study, those who were current established smokers at base-

line had a rate of depressive symptoms of .% compared to .% of

the non-smokers. Smoking status was the most signif‌icant predictor of

depression in both girls and boys. Adolescents who stopped smoking

between the two interviews were less likely to have depressive symptoms

than those who continued to smoke or started smoking.

Adolescent cigarette smoking may have marked health consequences in

terms of depressive symptoms. The reduction of cigarette smoking among

adolescents should be a focus of depression prevention interventions. In

addition, the development of gender-specif‌ic components of prevention

interventions may be warranted.

Reference Number: 

, ..., .. ,  .. . “Depression Vulner-

ability Predicts Cigarette Smoking Among College Students: Gender

and Negative Reinforcement Expectancies as Contributing Factors.”

Addictive Behaviors, : –,  ( tables,  f‌igures,  references)

Abstract: The association between vulnerability to depression, smoking

behavior, and other factors was studied in , college students (median

age  years) in the United States. Approximately % of the male stu-

dents and % of the female students reported that they were current

smokers. Some college students may be more likely to smoke because

they expect smoking and nicotine will relieve a negative mood. A history

of depression was associated with a greater risk of smoking in female but

not male students.

Table: Incidence of Depression and Anhedonia (inability to feel

pleasure) by Number of Cigarettes Per Day in College Students

Cigarettes Per Day Depression Anhedonia

 .% .%

.% .%

– .% .%

– .% .%

– .% .%

 .% .%

> .% .%

Source: Adapted from Morrell et al, 2010