Evidence map›Paper›PMID 41413802›Full record

ArticleBMC public health2025

From cigarettes to symptoms: the association between smoking and depression in the German National Cohort (NAKO).

Maja P Völker, Carolin M Callies, Josef Frank, Jerome C Foo, Iris Reinhard, Lea Zillich, Johanna Klinger-König, Hans Jörgen Grabe, Achim G Beule, Angelika Erhardt-Lehmann and 29 more

Abstract read
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In one paragraph

Article in BMC public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

39 authors.

Maja P VölkerDepartment of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany. maja.voelker@zi-mannheim.de.
Carolin M CalliesHealth Psychology, School of Social Sciences, University of Mannheim, Mannheim, Germany.
Josef FrankDepartment of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
Jerome C FooDepartment of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
Iris ReinhardCore Facility Biostatistics, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
Lea ZillichDepartment of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
Johanna Klinger-KönigDepartment of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany.
Hans Jörgen GrabeDepartment of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany.
Achim G BeuleDepartment of Otorhinolaryngology, Head and Neck Surgery, University Medicine Münster, Münster, Germany.
Angelika Erhardt-LehmannMax Planck Institute for Psychiatry, Munich, Germany.
Alexander PabstInstitute of Social Medicine, Occupational Health and Public Health, Medical Faculty, University of Leipzig, Leipzig, Germany.
Steffi G Riedel-HellerInstitute of Social Medicine, Occupational Health and Public Health, Medical Faculty, University of Leipzig, Leipzig, Germany.
Bernhard T BauneDepartment of Psychiatry, University of Münster, Münster, Germany.
Claudia TrenkwalderParacelsus -Elena Hospital, Kassel, Germany.
Michael WagnerGerman Center for Neurodegenerative Diseases (DZNE), Bonn, Germany.
Lilian KristInstitute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmeditzin Berlin, Berlin, Germany.
Thomas KeilInstitute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmeditzin Berlin, Berlin, Germany.
Tobias PischonMax Delbrück Center for Molecular Medicine in the Helmholtz Association (MDC), Molecular Epidemiology Research Group, Berlin, Germany.
Katharina NimptschMax Delbrück Center for Molecular Medicine in the Helmholtz Association (MDC), Molecular Epidemiology Research Group, Berlin, Germany.
Matthias B SchulzeDepartment of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany.
Börge SchmidtInstitute for Medical Informatics, Biometry and Epidemiology, University of Duisburg Essen, University Hospital of Essen, Essen, Germany.
Rafael MikolajczykInstitute for Medical Epidemiology, Biometrics, and Informatics, Interdisciplinary Center for Health Sciences, Medical Faculty of the Martin, Luther University Halle-Wittenberg, Halle (Saale), Germany.
Nadia ObiInstitute for Occupational and Maritime Medicine (ZfAM), University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Volker HarthInstitute for Occupational and Maritime Medicine (ZfAM), University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Carolina J Klett-TammenDept. of Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany.
Heiko BecherHeidelberg Institute of Global Health, University Hospital Heidelberg, Heidelberg, Germany.
Karin H GreiserGerman Cancer Research Center (DKFZ) Heidelberg, Division of Cancer Epidemiology, Heidelberg, Germany.
André KarchInstitute of Epidemiology and Social Medicine, University of Münster, Münster, Germany.
Sabine SchipfInstitute for Community Medicine, University Medicine Greifswald, Greifswald, Germany.
Claudia Meinke-FranzeInstitute for Community Medicine, University Medicine Greifswald, Greifswald, Germany.
Patricia BohmannDepartment of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany.
Michael LeitzmannDepartment of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany.
Hermann BrennerGerman Cancer Research Center (DKFZ), Heidelberg, Germany.
Ute MonsDivision Primary Cancer Prevention, German Cancer Research Center (DKFZ), Heidelberg, Germany.
Emanuel SchwarzCentre for Mental Health (DZPG), Partner Site Mannheim-Heidelberg-Ulm, Mannheim, Germany.
Klaus BergerInstitute of Epidemiology and Social Medicine, University of Münster, Münster, Germany.
Jutta MataHealth Psychology, School of Social Sciences, University of Mannheim, Mannheim, Germany.
Stephanie H Witt *Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
Fabian Streit *Centre for Mental Health (DZPG), Partner Site Mannheim-Heidelberg-Ulm, Mannheim, Germany. fabian.streit@zi-mannheim.de.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAlthough the association between smoking and depression is well-established, the underlying mechanisms and contextual factors remain insufficiently understood. We examined the association between smoking and depression, including detailed dose-response and timing-related relationships, using baseline data from a large population-based cohort, the German National Cohort (NAKO).

methodsThe analysis comprised 173,890 participants (19-72 years, 50.21% female). Lifetime and current depression were assessed via self-reported physician's diagnosis, the Major Depressive Disorder module of the MINI International Neuropsychiatric Interview (MINI), and the depression scale of the Patient Health Questionnaire (PHQ-9). Smoking behavior was assessed using self-reported smoking status, age at initiation, cigarettes per day, and time since smoking cessation. Associations between smoking and depression measures were analyzed using regression models adjusted for sex, age, age², education, Body Mass Index, and alcohol consumption.

resultsLifetime depression was more prevalent among individuals who currently or formerly smoked compared to those who never smoked. Currently smoking individuals also reported most current depressive symptoms, followed by formerly smoking individuals and those who never smoked. A dose-response relationship was observed, with more cigarettes per day being associated with more current depressive symptoms. Later age at smoking initiation was associated with later depression onset. Time since smoking cessation was positively associated with time since last depressive episode and negatively with current depressive symptoms.

conclusionsOur findings support an association between smoking and depression. Robust dose-response relationships were found, with higher cigarette consumption associated with more severe depressive symptoms, and longer time since cessation linked to lower depression levels. These results highlight smoking as a meaningful and modifiable contributor to current and lifetime depression, suggesting that quitting smoking or reducing cigarette consumption may benefit mental health. Early prevention of smoking initiation, along with integrated approaches that combine smoking cessation support with mental health care, may help reduce both smoking rates and depression burden.

Indexed as

DepressionSmokingAdultAgedCohort StudiesFemaleGermanyHumansMaleMiddle AgedPrevalenceYoung AdultAge of onsetCigarette smokingDepressive disorderSmoking cessation

Identifiers

PMID41413802
PMCPMC12831396

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.