9 Conversely, there is also evidence that chronic smoking increases a person’s risk of depression as a result of changes in neurophysiology. bidirectional causality: young adults with a history of depression are three times more likely to commence smoking than those without a history of depression.It can improve attention and cognitive function, reduce stress and act as a distraction Nicotine has some positive effects, which may be of benefit in depression. It also increases the bioavailability of serotonin, acting in a similar manner to some antidepressant drugs. 8 Nicotine releases dopamine in the mesolimbic reward pathway, elevating mood and improving wellbeing. self medication: nicotine has central antidepressant properties and depressed patients could be using it as a form of selfmedication to relieve symptoms.shared environmental influences: social difficulties or stressful events may trigger both smoking and depression 7.shared genetic factors: there is some evidence from twin studies for shared genes that predispose individuals to both smoking and depression 7.There are a number of models to explain the high rate of smoking in people with depression. Smokers with depression can achieve long term abstinence in many cases and success rates could be greatly enhanced by evidence based therapies, 6 although they are more nicotine dependent and may experience more challenges when attempting to quit. They are at higher risk of smoking related disease than the general population of smokers. 3 But quitting is an important health priority for smokers with depression. 3 It is often falsely assumed that people with depression are not motivated, or able, to quit and that quitting is bound to exacerbate their depression. However, in this population the focus of health professionals tends to be on depression and smoking behaviour is frequently neglected.
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