Ethnic group differences in the relationship between depressive symptoms and smoking

Objectives. A relationship between depression and smoking has been documented; however, little attention has focused on ethnic variability in how this relationship is manifested. Thus, we examined the interaction between ethnicity and significant depressive symptoms on smoking status. Design. A random digit dial survey (Minnesota Needs Assessment Survey) that oversampled ethnic minorities assessed demographics, smoking status, and depressive symptoms (Patient Health Questionnaire-2 [PHQ-2]). We examined the prevalence of current smoking between individuals with and without depressive symptoms within ethnic group and the interaction of depressive symptoms by ethnic group on smoking status. Results. Of 16,981 participants, 20.8% were current smokers, and 7.7% reported significant depressive symptoms on the PHQ-2 (score ≥ 3). Ethnic differences were observed in smoking rates (Asians 17.2%, Latinos 19.0%, Whites 20.4%, African-Americans 23.4%, American Indians 51.2%) and depressive symptoms (Asians 4.9%, Latinos 13.1%, Whites 7.0%, African-Americans 19.1%, American Indians 12.5%). Depressive symptoms were associated with a higher prevalence of smoking among Whites (34.5% vs. 19.4%), African-Americans (43.6% vs. 18.9%), and American Indians (81.9% vs. 47.1%), but not among Latinos (14.5% vs. 19.7%) or Asians (19.6% vs. 17.1%). The interaction between ethnicity and depressive symptomatology on current smoking was significant (p=0.02) among Latinos relative to Whites, controlling for other demographics. Conclusion. The relationship between depressive symptoms and smoking differs by ethnicity, particularly for Latinos. Understanding these differences may contribute to the development of culturally specific interventions.