Patterns of Clinically Significant Symptoms of Depression Among Heavy Users of Alcohol and Cigarettes

INTRODUCTION: Depression is among the most prevalent and treatable diseases, and it is associated with cigarette smoking and heavy alcohol use. This study estimates the prevalence of depression, its variation among demographic subgroups, and its association with heavy alcohol use and cigarette smoking in California. METHODS: The 2006 California Behavioral Risk Factor Surveillance System (BRFSS) includes the 8-item Patient Health Questionnaire, a standardized instrument used to measure depressive symptoms. We used findings from the 2006 BRFSS to calculate the prevalence of depression in California; we used logistic models to explore the relationships between depression, alcohol use, and smoking. RESULTS: We found that 9.2% of adults in California had clinically significant depressive symptoms. Logistic models indicated that daily smokers were more than 3 times more likely to have clinically significant depressive symptoms than were nonsmokers, and heavy drinkers were approximately 3 times more likely to have clinically significant depressive symptoms than were nondrinkers. CONCLUSION: Because heavy alcohol use and daily smoking are each associated with depression, people who do both may be at an increased risk for depression. This is a public health issue because people who drink alcohol often also smoke and vice versa. Intervention efforts might target persons who are users of both these drugs, and practitioners should be aware that smokers who are heavy alcohol users are at an increased risk for depression.