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The Potential Impact of Widespread Cessation Treatment for Smokers With Depression

  • Jamie Tam
    Correspondence
    Address correspondence to: Jamie Tam, PhD, Department of Health Policy and Management, Yale School of Public Health, 60 College Street, New Haven CT 06510.
    Affiliations
    Department of Health Policy and Management, Yale School of Public Health, New Haven, Connecticut
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  • Kenneth E. Warner
    Affiliations
    Department of Health Management and Policy, School of Public Health, University of Michigan, Ann Arbor, Michigan
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  • Kara Zivin
    Affiliations
    Department of Health Management and Policy, School of Public Health, University of Michigan, Ann Arbor, Michigan

    Department of Psychiatry, University of Michigan Medical School, Ann Arbor, Michigan

    Center for Clinical Management Research (CCMR), VA Ann Arbor Healthcare System, Ann Arbor, Michigan
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  • Gemma M.J. Taylor
    Affiliations
    Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, Bath, United Kingdom
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  • Rafael Meza
    Affiliations
    Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan

    Cancer Epidemiology and Prevention Program, University of Michigan Rogel Cancer Center, Ann Arbor, Michigan
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      Introduction

      Experts recommend integrating smoking-cessation treatments within U.S. mental health settings, but the population health benefits of doing so have not been estimated. This study simulates the impact of widespread cessation treatment for patients with depression under best-case treatment and maximum potential cessation scenarios.

      Methods

      Cessation interventions were simulated for U.S. adult smokers seeing a health professional for depression from 2020 to 2100. Interventions included (1) Any Treatment (behavioral counseling, pharmacological, combination) and (2) Pharmacological Treatment (including counseling), combined with increased mental health service utilization each. These were compared with a maximum potential cessation scenario where all patients with major depression quit smoking. Analyses were conducted in 2016–2020.

      Results

      Widespread uptake of Any Treatment among patients with depression would avert 32,000 deaths and result in 138,000 life-years gained by 2100; Any Treatment combined with 100% mental health service utilization would result in 53,000 and 231,000, respectively. Pharmacological Treatment would avert 125,000 deaths, with 540,000 life-years gained. Pharmacological Treatment combined with 100% mental health service utilization would result in 203,000 deaths averted and 887,000 life-years gained. Health gains under best-case treatment scenarios represent modest fractions of those projected under maximum potential cessation scenarios at current mental health service utilization levels (835,000 deaths averted, 3.73 million life-years gained) and at 100% utilization (1.11 million deaths averted, 5.07 million life years gained).

      Conclusions

      Providing smoking-cessation treatment to patients with depression and increasing mental health service utilization would reduce the toll of tobacco on this population. These gains would be considerably larger if cessation treatments were more effective.
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