Abstract
Objectives
To understand the association between depressive symptoms and smoking. In addition, we investigate how smokers with and without depressive symptoms may respond to cigarette price change differently.
Methods
We used data drawn from a nationally representative survey in Taiwan. Totally, 13,030 male adults were included in the analysis. Depressive symptoms were measured using the Taiwanese depression questionnaire. A logistic regression model was estimated to examine the odds ratio of smoking for those with depressive symptoms versus those without depressive symptoms. Focused on smokers, the ordinary least squares multivariate regression method was used to estimate the cigarette price elasticity.
Results
Compared to those without depressive symptoms, those with depressive symptoms were more likely to smoke (44.5 vs. 50.1%) and consume more cigarettes per day (18.4 vs. 21.0). The odds ratio of smoking for those with depressive symptoms, adjusted for demographic variables, was 1.3 (95% confidence interval, 1.1–1.6). The cigarette price elasticity was estimated at −0.82 and −0.41 for depressive smokers and non-depressive smokers, respectively.
Conclusions
Although the association between depression and smoking had been documented, this study contributes to previous literature by investigating the extent to which cigarette price elasticities may differ between smokers with and without depressive symptoms. Results indicate that depressive smokers are more sensitive to the change of cigarette price. Therefore, tax/price increases can also be a very effective means of tobacco control for depressive smokers.
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References
Chaloupka FJ, Hu TW, Warner KE, Jacobs R, Yurekli A (2000) The taxation of tobacco products. In: Jha P, Chaloupka F (eds) Tobacco control in developing countries. Oxford University Press, London, pp 237–272
Frank RH, Bernanke B (2003) Principles of economics, 2nd edn. McGraw-Hill/Irwin, New York
Franks P, Jerant AF, Leigh P, Lee D, Chiem A, Lewis I, Lee S (2007) Cigarette prices, smoking, and the poor: implications of recent trends. Am J Public Health 97:1873–1877
Goodman E, Capitman J (2000) Depressive symptoms and cigarette smoking among teens. Pediatrics 106:748–755
Grant BF, Hasin DS, Chou SP, Stinson FS, Dawson DA (2004) Nicotine dependence and psychiatric disorders in the United States: results from the National epidemiologic survey on alcohol and related conditions. Arch Gen Psychiatry 61:107–115
Jha P, Chaloupka F (2000) The economics of global tobacco control. Br Med J 321:358–361
Jorm AF (1999) Association between smoking and mental disorders: results from an Australian National Prevalence Survey. Aust NZ J Public Health 23:245–248
Klitzke M, Irwin R, Lombardo T, Christoff K (1990) Self-monitored smoking motives. J Subst Abuse 2:121–127
Klungsoyr O, Nygard JF, Sorensen T, Sandanger I (2006) Cigarette smoking and incidence of first depressive episode: an 11-year population-based follow-up study. Am J Epidemiol 163:421–432
Lasser K, Boyd JW, Woolhandler S, Himmelstein DU, McCormick D, Bor DH (2000) Smoking and mental illness: a population-based prevalence study. JAMA 284:2606–2610
Lee Y, Yang MJ, Lai TJ, Chiu NM, Chau TT (2000) Development of the Taiwanese depression questionnaire. Chang Gung Med 23:688–694
Lee LM, Hwang TC, Ye CY, Chen SH (2004) The effect of cigarette price increase on the cigarette consumption in Taiwan: evidence from the National Health Interview Surveys on cigarette consumption. BMC Public Health 4:61
Lee JM, Liao DS, Ye CY, Liao WZ (2005) Effect of cigarette tax increase on cigarette consumption in Taiwan. Tob Control 14:71–75
Mykletun A, Overland S, Aaro LE, Liabo HM, Stewart R (2008) Smoking in relation to anxiety and depression: evidence from a large population survey: the HUNT study. Eur Psychiatry 23:77–84
ROC Bureau of Health Promotion (2008a) Taiwan tobacco control: 2008 annual report. Bureau of Health Promotion, Taichung
ROC Bureau of Health Promotion (2008b) National survey on knowledge, attitude, and practice of health promotion documents (in Chinese). http://www.bhp.doh.gov.tw/BHPnet/Portal/Them.aspx?No=200712270001/. Accessed 2009 June 15
Schoenborn C, Horm J (1993) Negative moods as correlates of smoking and heavier drinking: implications for health promotion. Advanced data from vital and health statistics no. 236. National Center for Health Statistics, Hyattsville
Spielberger C (1986) Psychological determinants of smoking behavior. In: Tollison R (ed) Smoking and society: toward a more balanced assessment. Health, Lexington, pp 89–134
Tobias M, Templeton R, Collings S (2008) How much do mental disorders contribute to New Zealand’s tobacco epidemic? Tob Control 17:347–350
Tsai YW, Yang CL, Chen CS, Liu TC, Chen PF (2005) The effect of Taiwan’s tax-induced increases in cigarette prices on brand-switching and the consumption of cigarettes. Health Econ 14:627–641
Warner KE (2007) Charting the science of the future: where tobacco-control research must go? Am J Prev Med 33(6S):S314–S316
World Health Organization (2003) WHO framework convention on tobacco control. World Health Organization, Geneva
World Health Organization (2008) WHO report on the global tobacco epidemic, 2008: the MPOWER package. World Health Organization, Geneva
Wu LT, Anthony JC (1999) Tobacco smoking and depressed mood in late childhood and early adolescence. Am J Public Health 89:1837–1840
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Chang, HH., Chiang, Tl. Depressive symptoms, smoking, and cigarette price elasticity: results from a population-based survey in Taiwan. Int J Public Health 54, 421–426 (2009). https://doi.org/10.1007/s00038-009-0080-4
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DOI: https://doi.org/10.1007/s00038-009-0080-4