Other Effects of Tobacco Products/Nicotine

AuthorJames G. Wigmore
 8
Other Ef‌fects of Tobacco
“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.
“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

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