The interaction of depressive symptoms and hazardous drinking in relation to tobacco craving among treatment seeking depressed smokers: Sex differences

Objectives: The present study sought to address whether there is sex effect in the interactive effect between depressive symptoms and hazardous drinking in the prediction of smoking craving after cognitive-behavioral smoking cessation treatment among those with at least mild depression. Methods: Participants (n=114, mean age 42.0, SD=9.73, 64% women) were treatment-seeking smokers who attended 6 weekly 1-hour sessions involving psychological treatment for cessation. Participants reported depressive symptoms and alcohol use at baseline and reported craving at baseline and after treatment. Results: Results indicated that there was a statistically significant 3-way interaction (depression by alcohol use by sex) for smoking craving (B=-0.30, standard error [SE]=0.14, P=0.042) and appetitive craving (B=-.21, SE=0.09, P=0.031), but not negative reinforcement craving. The form of the significant interactions indicted that higher levels of depressive symptoms and alcohol use were related to greater levels of craving at the end of treatment only among men. Conclusions: The current findings provide novel empirical evidence suggesting that there is a clinically relevant interplay between depressive symptoms and alcohol use regarding general craving and appetitive craving among male treatment-seeking smokers. Although the present results should be replicated in larger samples, this type of research can inform the development of sex-specific interventions for smoking cessation