Tobacco Use and Depression: A Hidden Epidemic among Smokers 18 Years and Older, Puerto Rico, 2018-2020.

Objective: According to the literature, depression and tobacco use are closely linked. This study's main objectives were to provide the first population-based epidemiological profile of smokers with depression (SWD) who were 18 years and older and living in Puerto Rico (PR) from 2018 to 2020 and identify any statistically significant differences between SWD and smokers without depression (SWOD).

Methods: A descriptive cross-sectional study was carried out using PR Behavioral Risk Factor Surveillance System (PRBRFSS) data (2018-2020). Univariate analysis was performed to obtain an epidemiological profile of smokers who had depression. Likewise, using bivariate analysis, SWD and SWOD were compared to identify statistically significant differences in terms of chronic conditions, risk factors, and quit attempts.

Results: Depression prevalence among smokers 18 years and over in PR from 2018-2020 was 23.7%. Smokers with depression were more likely to be physically inactive (P < .001), overweight or obese (P < .001), have arthritis (P < .001), chronic obstructive pulmonary disease (P < .001), asthma (P < .001), high cholesterol (P < .001), hypertension (P < .001), coronary heart disease (P < .001), diabetes (P < .001), stroke (P < .001), and heart attack (P < .001) compared with SWOD. Likewise, SWD made more quitting attempts in the past year than did SWOD (P < .001).

Conclusion: Our results indicate that SWD should be targeted in any health-based tobacco-control efforts to develop evidence-based strategies to reduce or eliminate tobacco use in this same population.