| Summary: | Background
There are mixed reports as to whether depression is
associated with quitting among smokers, but almost all of these studies have
been conducted in high income countries (HICs); nothing is known about this association
in low- and middle-income countries (LMICs) including African countries. This
is the first population-based study in Africa to examine the relationship
between depression symptoms and key cessation variables—quit intentions and
quit attempts.
Methods
Data were analyzed from the International Tobacco
Control (ITC) Kenya Wave 1 (2012) and Zambia Wave 2 (2014) surveys of nationally
representative samples of adult smokers (N=2,055). This study examined the
relation between five symptoms of depression and quit intentions and quit
attempts. Logistic regression analyses adjusted for sex, age, location, smoking
status, and time-in-sample.
Results
40% of Kenyan smokers and 51% of Zambian smokers had “ever” tried to quit smoking;17% of Kenyan and 27% of Zambian smokers planned to quit smoking within the next 6 months. Quit attempts were positively associated with 4 depressive symptoms: having a poor appetite (OR=2.43; 95% CI 1.61-3.67), not being able to control important things of life (OR=1.69; 95% CI 1.15-2.48), feeling sad (OR=1.59; 95% CI 1.15-2.19), and feeling that people disliked them (OR=1.39; 95% CI 1.05-2.85). Intending to quit was positively associated with 1 symptom—having a poor appetite (OR=1.76; 95% CI 1.22-2.54). Moreover, being hopeful about the future was positively associated with both quit attempts (OR=1.50; 95% CI 1.17-1.90) and intending to quit (OR=1.41; 95% CI 1.06-1.87). There were no significant differences between Zambia and Kenya.
Conclusions
In both Kenya and Zambia, depression symptoms were
positively associated with quit attempts and quit intentions, consistent with findings
from high-income ITC countries (Canada, United Kingdom, USA, Australia),
suggesting that this association between depression and quit attempts/intentions
is considerably broader than being limited to HICs.
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