Dear Phillip,

Your points are well taken. I agree that looking at any single etiology or exasberator for a depressed or hypomanic mood is futile. All the regression models I do to explain mood states are multivariate and have many factors in the model.

Are there many factors in the model that they adjusted for as covariates, and then are just focusing on smoking (i think the estimates for smoking are probably adjusted for all the other factors for whith they have data)?

I can't believe anyone would fit a model looking at the relationship between smoking and depression and not adjust those estimates.

I think your point about the epidemiology of smoking or nicotine dependence and depression is a no brainer. Unfortunately, in this type of research, they are not looking for the cause. It is well known that nicotine is a dopamine boast. And when I am hurting... i need my dope :)

I think kids who start smoking at a young age, ARE trying to treat their mood state. It doesn't EXPLAIN their mood state, rather it is an INDICATOR of their mood state.

I was hoping to hear who won the contest :)

Thanks for the great postings

Dr. BK

Neural Inhibition as a Mechanism of Nicotine Dependence Among Persons With Schizophrenia.

How are they finding all these twins to do studies on? Seriously, just google bipolar twins.

"However, this mechanism is still relatively unknown. Thus, there is need for further research and evidence in order to make an unambiguous statement that 'smoking cigarettes cause depression'." Something cannot be "relatively unknown". Relative means in comparison to something else. There is no else if something is unknown. Bleh.

Smoking is a poor way of coping with stress.
Our innate coping style dictates how well we cope.
Generally, if not always a depressed person has a marked tendency to be depressed. He or she has definitive coping style that will inevitably lead to an eventual depression. Depressed people may not always be depressed. They will certainly invariably enjoy poor quality of life. This is due to their innate and specific coping style. They will also smoke more.
These people ‘are good for others and terrible for themselves’.
We can improve poor quality of life and prevent the impending depressions. We can easily change the coping style. Cognitive Behaioural Therapy [CBT] is the way to change coping styles.
If a patient is suffering but functioning fully should be offered CBT.
Online Self- Help is a very easy, effective and efficient way of receiving CBT.
You can receive free Online Self-Help CBT at http://www.myRay.com
You can receive a fuller explanation of my treatment philosophy at http://www.MyDoctorExplains.com
With kindest regards
Dr. Michael Benjamin
Psychiatrist

Weird... when I was first hospitalized the schizophrenics and the manic depressives were the only people allowed to smoke on our floor, in fact we were kind of encouraged to smoke... although the schizophrenics weren't allowed to carry lighters or matches, which made for some bizarre manic depressive/schizophrenic relationships. Everybody else had to wait for the assigned time and had to be outside to spark up. This was back in '89 though so maybe we were still in the "smoking excercises the lungs" phase.

You know, Dr.Mike--I've been thinking. My Grandmother lived to be 90 years old, and was a total chain smoker. Grandchildren in their 20's couldn't keep up with her walking, and she died totally healthy. She was the most optimistic person I ever met. Her doctor told her that her lungs were clear, clean, heart was healthy. Coping? hell--she taught me HOW to cope. If I ever would have told her I was depressed, she would have kicked my ASS.

It wouldn't surprise me if smoking were associated with depression in several directions of cause, effect, and co-occurrence. Smoking can make people feel like crap (which they may or may not notice against the background of whatever other crappiness they may be feeling), and feeling like crap for any reason, including physical illness, can lead to depression. On the other hand, many people find smoking helps reduce painful feelings like anxiety, which I think is one reason, maybe the main reason, why so many people with schizophrenia smoke.

But in any case it wouldn't follow that depression is mainly caused by smoking--smoking would have to be, at most, one factor among very many possible or potential instigators of depression.

BTW I don't subscribe to the idea that "depression" is a disease--as David Healy says in his book The Antidepressant Era, I think "depression" a name for a symptom that can be caused by a lot of different factors. Depression takes so many different forms and affects people in such different ways, and varies so widely in how it responds to attempts to treat it (diet, exercise, psychotherapy, drugs, etc.) that I don't see how any single cause or explanation can account for it.

Nicotine is a known antidepressant (as I've posted previously). The study is epidemological hogwash.

I do agree that smoking is not a coping mechanism for stress or depression additionally.

Excellent post...and I agree with your thoughts on the matter completely.

Seems like the perfect vehicle for GSK to jump on.

Quit smoking with their patch or solve your depression with their 'wonder drug', Paxil