Changes in Affect Following Smoking Cessation in Depressed Smokers

Smoking cessation for individuals with Major Depressive Disorder (MDD) represents an important clinical issue. It often has been hypothesized that withdrawing from cigarettes exacerbates affective disturbances in this population. However, studies testing the impact of smoking cessation on changes in affect in smokers with MDD are limited and equivocal. The current study examined affective processes in smokers with MDD undergoing a 12-week smoking cessation intervention (N = 49). The Positive and Negative Affect Scale (PANAS) was used to measure participants’ positive affect (PA) and negative affect (NA) trajectories over the course of a quit attempt. Prolonged smoking abstinence was examined as a predictor of affective changes over time. Models also were run to examine pre-quit affective treatment response and the interaction of pre-quit affective response and abstinence status in predicting post-quit affect. Those who were prolonged abstainers at the 3-month follow-up showed significant increases in PA over the course of a quit attempt, as compared to nonabstainers. No significant differences in NA were found between prolonged abstainers and nonabstainers. Prequit affective trajectories significantly predicted post-quit affect, for measures of both PA and NA. Lastly, the interaction of abstinence status and early affective response was significant in predicting affect over time for NA, but not for PA. This suggests that, for those with less pre-quit improvement in NA, being abstinent at any given timpoint following the quit date is associated with lower values of NA than being nonabstinent. The current study highlights important differences in affect between prolonged abstainers and nonabstainers. Study results are discussed with regard to etiological models of smoking-MDD as well as implications for tailoring interventions to this at-risk group of smokers.