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Symptoms of depression and active smoking among survivors of stroke and myocardial infarction: An NHANES analysis.

TitleSymptoms of depression and active smoking among survivors of stroke and myocardial infarction: An NHANES analysis.
Publication TypeJournal Article
Year of Publication2020
AuthorsParikh NS, Omran SSalehi, Kamel H, Elkind MSV, Willey J
JournalPrev Med
Date Published2020 Aug

Historic concerns about the cardiovascular and neuropsychiatric side effects of smoking-cessation pharmacotherapy have in part limited their use. We sought to evaluate whether depressive symptoms are associated with active smoking among survivors of stroke and myocardial infarction (MI). To do this, we performed a cross-sectional analysis using data from the National Health and Nutrition Examination Survey (2005-2016). We included participants ≥20 years old with prior stroke or MI and any history of smoking. Symptoms of depression, at survey participation, were ascertained using the Patient Health Questionnaire-9. Active smoking was defined using self-report and, secondarily, with cotinine measures. We used logistic regression to evaluate the association between depression and active smoking after adjusting for demographics, smoking-related medical conditions, and health-related behaviors. We found that, among stroke and MI survivors with any history of smoking, 37.9% (95% CI, 34.5-41.3%) reported active smoking and 43.8% (95% CI, 40.3-47.3%) had biochemical evidence of smoking. Rates of active smoking were similar for stroke and MI survivors. Twenty-one percent screened positive for depression. In adjusted models, depression was associated with active smoking in the combined group of stroke and MI survivors (odds ratio, 2.28; 95% CI, 1.24-4.20) and in stroke survivors (odds ratio, 2.97; 95% CI, 1.20-7.38). Tests of heterogeneity by event type did not reveal an interaction. Findings were similar when using cotinine measures. We conclude that symptoms of depression were associated with active smoking among stroke and MI survivors. Stroke and MI survivors with symptoms of depression may require targeted smoking-cessation interventions.

Alternate JournalPrev Med
PubMed ID32439489
PubMed Central IDPMC7309407
Grant ListT32 NS007153 / NS / NINDS NIH HHS / United States
U24 NS107237 / NS / NINDS NIH HHS / United States

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