Cigarette smoking, alcohol intoxication and major depressive episode in a representative population sample

doi:10.1136/jech.55.8.573

Journal of Epidemiology and Community Health 2001;55:573-576; doi:10.1136/jech.55.8.573

J Epidemiol Community Health 2001;55:573-576 ( August )

Research report

Cigarette smoking, alcohol intoxication and major depressive episode in a representative population sample J Hämäläinen^a, J Kaprio^a ^b, E Isometsä^a, M Heikkinen^a, K Poikolainen^a ^d, S Lindeman^a ^c, H Aro^a ^e

^a National Public Health Institute, Department of Mental Health and Alcohol Research, Mannerheimintie 166, 00300, Helsinki, Finland, ^b Department of Public Health and General Practice, University of Oulu, Oulu, Finland, ^c Department of Psychiatry, University of Oulu, ^d Finnish Foundation for Alcohol Studies, Finland, ^e Tampere School of Public Health, University of Tampere, Tampere, Finland

Correspondence to: Dr Hämäläinen (Juha.Hamalainen{at}ktl.fi)

Accepted for publication 5 April 2001

OBJECTIVE $---$ This study investigated the associations of cigarette smoking and alcohol intoxication with major depressiveepisode.
DESIGN $---$ Major depressive episode during the past 12 months was assessed in a national representative cross sectional study using theShort Form of the University of Michigan version of the CompositeInternational Diagnostic Interview (the UM-CIDI ShortForm).
SUBJECTS $---$ A random sample of 5993 non-institutionalised Finnish people aged 15-75 years was interviewed as a part of the 1996 FinnishHealth CareSurvey.
RESULTS $---$ In logistic regression models the factors associated with major depressive episode in the past 12 months were smoking 10 ormore cigarettes daily (odds ratio (OR) 2.26; 95% confidence intervals(95% CI) 1.68, 3.04) and alcohol intoxication at least once aweek (OR 2.99; 95%CI 1.70, 5.25). Their effects were independentof each other, and remained significant even after adjusting forother major risk factors (marital status, education, unemploymentand chronic diseases). The attributable proportion (a measureof the impact of the risk factors of the disease on the population)for daily smoking of 10 or more cigarettes was 0.15, and for alcoholintoxication at least once a week 0.04.
CONCLUSION $---$ Cigarette smoking and alcohol intoxication seem to be important risk factors for major depressive episode. In this populationthe impact of smoking wasgreater.

Keywords: depression; smoking; alcohol

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