Introduction: Smokers with a past or current depression are less likely to quit smoking successfully than smokers without depression. However not many studies have investigated the reasons for this inequality. Therefore, the present study investigated the association of depressive symptoms with smoking-related cognitions and their influence on actual smoking cessation behaviour among Dutch adult smokers.
Materials and methods: Smokers (N = 571) in the control group of a randomised controlled trial investigating the effectiveness of a web-based smoking cessation intervention were included. Linear regression analyses were conducted to identify associations between depressive symptoms and the smoking-related cognitions attitude, social influence, self-efficacy and intention to quit. Logistic regression analyses were conducted to determine the influence of depressive symptoms on smoking abstinence measured two days after a set quit date and at six-week follow-up.
Results: The number of depressive symptoms was positively associated with the perceived pros (β = .10; p < .05) and cons (β = .33; p < .001) of non-smoking and perceived social modelling (β = .09; p < .05). A negative association was identified with perceived social support (β = –.18; p < .01) and level of self-efficacy (β = –.22; p < .001). No association was found between perceived social norm, intention to quit and smoking cessation behaviour. However, the level of self-efficacy predicted smoking abstinence at the first (OR = 1.14;p < .001) and second (OR = 1.12–1.22;p < .001) follow-up.
Conclusion: While the influence of depressive symptoms on smoking abstinence could not be replicated, significant associations between depressive symptoms and several smoking-related cognitions were identified. Most importantly, a strong negative association was found with smokers’ self-efficacy to quit. As self-efficacy was the most important predictor of smoking abstinence, it might be important to investigate whether smokers with low levels of self-efficacy suffer from depressive symptoms and to treat these symptoms, if required, to increase the chances of a successful quit attempt.
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