Affective symptoms in smokers applying for smoking cessation clinic: are they related to specific socio-demographic and clinical characteristics?

Aim: to evaluate socio-demographic and clinical characteristics associated to high levels of affective (i.e. depressive/anxious) symptoms in smokers applying for smoking cessation clinic. Method: current smokers applying for smoking cessation clinic at the University Hospital of Pisa were evaluated (n = 146). Socio-demographic and clinical (e.g. carbon monoxide of expired air - CO, attempts to quit, history of diseases) data were collected during their first visit. Self-administered rating scales were used to assess the level of nicotine dependence (Fagerstrom Test for Nicotine Dependence - FTND) and the level of affective symptoms (Hospital Anxiety Depression scale – HADS). Data were analyzed comparing the subjects with high HADS total score (HADS+) with those having low HADS total score (HADS-) (cut-off = 13, median). Results: compared to HADS- (n = 70), the HADS+ subjects (n = 76) were more likely to be female, low educated (≤ 13 years of school), with not executive working activity. Moreover, they had a higher rate of lifetime cancer, respiratory, psychiatric disorders, and higher CO, FTND scores. Running the multivariate logistic analysis adjusted for age and sex, the risk to be HADS+ versus HADS – was significantly related to education (OR = 0.37, 95%CI 0.161- 0.876), CO (OR = 10.53, 95% CI 1.003-1.105) and the lifetime history of psychiatric disease (OR = 2.67, 95% CI 1.206-5.893). Conclusion: subjects with low education, high levels of CO, and a lifetime history of psychiatric disease were at high risk to experience affective symptoms when they apply for smoking cessation clinics.