Nicotine, negative affect, and depression

J Consult Clin Psychol. 1993 Oct;61(5):761-7. doi: 10.1037//0022-006x.61.5.761.


Depression, whether conceptualized as a trait, symptom, or as a diagnosable disorder, is overrepresented among smokers. Depressed smokers appear to experience more withdrawal symptoms on quitting, are less likely to be successful at quitting, and are more likely to relapse. This article documents these relationships and explores several potential links between smoking and depression. The potential efficacy of antidepressant therapy, cognitive-behavioral therapy, and nicotine replacement therapy for smokers with depressive disorders or traits is discussed. Clinical implications and the role of patient treatment matching are also discussed.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.
  • Research Support, U.S. Gov't, P.H.S.
  • Review

MeSH terms

  • Combined Modality Therapy
  • Depression / physiopathology
  • Depression / psychology*
  • Humans
  • Neurotransmitter Agents / physiology
  • Nicotine / administration & dosage
  • Nicotine / adverse effects
  • Nicotine / pharmacokinetics
  • Smoking / adverse effects
  • Smoking / physiopathology
  • Smoking / psychology*
  • Smoking Cessation / psychology*
  • Substance Withdrawal Syndrome / physiopathology
  • Substance Withdrawal Syndrome / psychology
  • Treatment Outcome


  • Neurotransmitter Agents
  • Nicotine