Depression, smoking, and lung cancer vulnerability: Bridging mental-physical comorbidity through population-based evidence.

Abstract

Introduction: The complex relationship between smoking, depression, and lung cancer remains inadequately understood, particularly regarding smoking's association with depression risk among lung cancer patients. This study examines these interactions in a nationally representative sample.

Methods: This secondary dataset analysis used cross-sectional data from 1539 US adults aged ≥20 years from the pooled 2005-2016 National Health and Nutrition Examination Survey (NHANES). We employed survey-weighted logistic regression analyses to assess associations, adjusting for sociodemographic factors and clinical comorbidities.

Results: Weighted prevalence estimates were 3.14% (95% CI: 2.78-3.55) for lung cancer, 29.4% for current smoking (95% CI: 28.0-30.9), and 11.18% (95% CI: 10.12-12.34) for clinically significant depression (PHQ-9 ≥10) Females had significantly higher depression prevalence than males (AOR=2.18; 95% CI: 1.63-2.91; p<0.01). Current smokers demonstrated 3.12-fold higher odds of depression compared to non-smokers (AOR=3.12, 95% CI: 2.18-4.47; p<0.001). Recent quitters (<1 year) also showed elevated depression risk (AOR=2.89; 95% CI 1.15-7.25; p=0.024). Among participants with lung cancer, current smokers had a significantly higher prevalence of depression compared to non-smokers (16.82% vs 4.12%; p=0.0008).

Conclusions: Smoking was strongly associated with depression in lung cancer patients, with recent cessation representing a high-risk period. Integrated smoking cessation and mental health interventions are needed, particularly for young females.