, 2010; Picciotto et al., 2002; Shytle et al., 2002). Many studies in our review excluded smokers taking antidepressants. selleck inhibitor We previously found that few studies examine antidepressant drug response by smoking status (Weinberger, McKee, Picciotto, & Mazure, 2011) and, conversely, few studies examine the impact of antidepressants on smoking cessation outcomes although preliminary data suggest that smokers taking antidepressants have more trouble quitting (Gravely-Witte, Stewart, Suskin, & Grace, 2009; Japuntich et al., 2007; Weinberger, McKee, & George, 2012). It remains unclear how smokers taking antidepressants respond to pharmacological and behavioral smoking cessation treatments that have been found to be effective in general populations (Fiore et al., 2008).

Second, few studies have examined the interactive impact of gender and depression on smoking cessation outcomes consistent with reviews showing that smoking treatment research rarely examine outcomes by gender (Dickerson et al., 2009; Piper et al., 2001). Women appear to have more trouble quitting smoking than men (Perkins, 2001; Perkins & Scott, 2008; Schnoll, Patterson, & Lerman, 2007; Wetter et al., 1999) and the majority of studies in this review that considered gender reported that depression had a greater negative impact on smoking cessation outcomes for women as compared with men. Gender differences were found for several pharmacological agents (e.g., naltrexone, clonidine, and nortriptyline; Covey et al., 1999; Glassman et al., 1993; Hall et al.

, 1998) and additional research examining gender difference is needed for both pharmacological and behavioral treatments. Our analyses of epidemiological data (Weinberger et al., 2012a, 2012b) found that overall smoking cessation rates over a 3-year period in the general U.S. adult population were similarly impacted by depression for men and women, however, depression would still be expected to have a greater impact on female smokers due to the fact that women experience depression at higher rates than men (Grant et al., 2004). At this time, treatments and treatment-related variables that can be used to best help women with depression to successfully quit smoking are still not identified. Third, no study included in this review examined racial differences in the relationship between depression and smoking cessation.

Most studies included a small number of participants from minority groups, or included samples that were entirely from a minority population, both of which preclude GSK-3 the statistical analysis of outcomes by race. One study published in 2011 (Castro et al., 2011) found that higher baseline depressive symptoms were associated with lower quit rates at 1, 2, and 4 weeks for Caucasian and African-American smokers, but not Hispanic smokers, in a sample of 389 adults (n = 133 Caucasian, n = 130 African Americans, n = 126 Hispanic) receiving counseling, self-help materials, and transdermal nicotine patch.