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Risk of depressive disorders after tobacco smoking cessation: a retrospective cohort study in Fukuoka, Japan
  1. Takako Fujita1,2,
  2. Akira Babazono1,3,
  3. Yumi Harano1,
  4. Peng Jiang1
  1. 1 Department of Healthcare Administration and Management, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
  2. 2 Department of Health Sciences, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
  3. 3 Department of Healthcare Administration and Management, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
  1. Correspondence to Ms Takako Fujita; tafujita{at}


Objective We sought to examine the effect of smoking cessation on subsequent development of depressive disorders.

Design This was a retrospective cohort study.

Methods We used administrative claim and health check data from fiscal years 2010 to 2014, obtained from the largest health insurance association in Fukuoka, Japan. Study participants were between 30 and 69 years old. The end-point outcome was incidence of depressive disorders. Survival analysis and Cox proportional hazards models were conducted. The evaluated potential confounders were sex, age, standard monthly income and psychiatric medical history.

Results The final number of participants was 87 255, with 7841 in the smoking cessation group and 79 414 in the smoking group. The result of survival analysis showed no significant difference in depressive disorders between the two groups. The results of Cox proportional hazards models showed no significant difference by multivariate analysis between participants, including users of smoking cessation medication (HR 1.04, 95% Cl 0.89 to 1.22) and excluding medication use (HR 0.97, 95% Cl 0.82 to 1.15).

Conclusions The present study showed that there were no significant differences with respect to having depressive disorders between smoking cessation and smoking groups. We also showed that smoking cessation was not related to incidence of depressive disorders among participants, including and excluding users of smoking cessation medication, after adjusting for potential confounders. Although the results have some limitations because of the nature of the study design, our findings will provide helpful information to smokers, health professionals and policy makers for improving smoking cessation.

  • public health
  • epidemiology
  • mental health

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:

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  • Contributors TF lead the study design, conducted the literature search, extracted and analyzed the data, and wrote the manuscript. AB contributed to the study design, analysis and manuscript revision. YH and PJ contributed to the study design and analysis.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Ethics approval This study was approved by the Institutional Review Board of Kyushu University (Clinical Bioethics Committee of the Graduate School of Healthcare Sciences, Kyushu University).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement No additional data are available.

  • Patient consent for publication Not required.

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