Smoking and mental health - NCSCT

Smoking and mental health
Relative risk (RR)
Relative risk (RR)
Study or subgroup IV, random, 95% Cl IV, random, 95% Cl
Males
Choi 1997 1.86 [1.19, 2.92]
Duncan 2005 1.05 [0.77, 1.43]
Flensborg-Madsen 2011 2.14 [1.11, 4.13]
Korhonen 2007 1.42 [1.07, 1.89]
Paffenbarger 1994 1.43 [1.12, 1.83]
Tanaka 2011 1.01 [0.50, 2.05]
Subtotal (95% CI) 1.39 [1.15, 1.68]
Heterogeneity, tau 2 = 0.02; chi 2 = 7.35, df = 5 (p = 0.20); I 2 = 32%
Test for overall effect: Z = 3.45 (p = 0.0006)
Females
Choi 1997 2.05 [1.38, 3.04]
Duncan 2005 1.79 [1.34, 2.39]
Flensborg-Madsen 2011 2.33 [1.49, 3.65]
Korhonen 2007 0.95 [0.75, 1.21]
Pasco 2008 2.52 [1.29 4.95]
Tanaka 2011 2.09 [0.97, 4.51]
Subtotal (95% CI) 1.79 [1.24, 2.58]
Heterogeneity, tau 2 = 0.15; chi 2 = 24.34, df = 5 (p = 0.0002); I 2 = 79%
Test for overall effect: Z = 3.12 (p = 0.0002)
Males and females
Albers 2002 1.74 [0.96, 3.14]
Batterham 2009 2.51 [1.94, 3.24]
Brook 2002 1.08 [0.96, 1.21]
Brown 1996a 1.89 [1.04, 3.45]
Brown 1996b i 1.90 [1.48, 1.70]
Brown 1996b ii 1.80 [1.05, 3.10]
Clark 2006 1.29 [0.97, 1.72]
Georigades 2007 0.69 [0.26, 1.85]
Gilpin 2004 1.46 [1.04, 2.05]
Kang 2010 5.83 [1.68, 20.28]
Koster 2006 1.27 [0.95, 1.69]
Lam 2005 2.17 [1.40, 3.36]
Luijendijk 2008 1.89 [0.91, 3.92]
Melchior 2009 1.33 [1.13, 1.57]
Murphy 2003 1.33 [0.91, 1.95]
Park 2009b 0.91 [0.29, 2.89]
Strawbridge 2002 2.23 [1.33, 3.74]
Van der Velden 2007 1.05 [0.60, 1.84]
Van Gool 2006 1.49 [0.91, 2.44]
Wu 1999 1.66 [1.28, 2.16]
Subtotal (95% CI) 1.51 [1.29, 1.75]
Heterogeneity, tau 2 = 0.06; chi 2 = 62.80, df = 19 (p < 0.00001); I 2 = 70%
Test for overall effect: Z = 5.27 (p < 0.00001)
Total (95% CI) 1.52 [1.36, 1.71]
Heterogeneity, tau 2 = 0.06; chi 2 = 96.18, df = 31 (p < 0.00001); I 2 = 68%
Test for overall effect: Z = 7.08 (p = 0.00001)
0.1 0.2 0.5 1 2 5 10
Test for subgroup differences: chi 2 = 1.51, df = 2 (p = 0.47); I 2 = 0% Smoking reduces risk Smoking increases risk
Fig 4.4 Smoking behaviour on onset of depression.
4.9.2 Depression and onset of smoking
A meta-analysis of 10 studies found that depression was significantly associated
with the onset of smoking by 43% (RR = 1.43, 95% CI 1.17–1.74, I 2 = 71% – Fig
4.7). 24,27,70,77,79–83,87 One cohort of individuals, included in the meta-analysis, also
reported a 30% significant increase in smoking initiation in those with a high
baseline depressive symptom score (OR = 1.3, 95% CI 1.1–1.6). 78 One further
study, which could not be included in the meta-analysis, found no significant
association between high depressive symptoms and onset of smoking in
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