Smoking and drinking in relation to depressive symptoms among persons with oral cancer or oral epithelial dysplasia

BACKGROUND: We examined whether smoking or drinking during or before the diagnosis-year of oral cancer or oral epithelial dysplasia (OED) was related to "subsequent depression" measured months after the oral diagnosis. METHODS: Incident cases of oral cancer or OED were identified via 3 oral pathology laboratories. A telephone-administered questionnaire included questions on smoking/drinking history through the diagnosis-year and measured depressive symptoms using the Center for Epidemiologic Studies-Depression Scale (CES-D); scores of 16+ indicated clinical depression. "Subsequent depression" was defined as a CES-D score of 16+, measured at the time of assessment several months after the diagnosis of oral cancer or OED. RESULTS: Patients who smoked during their diagnosis-year had twice the odds of subsequent depression relative to former/never smokers. Diagnosis-year (vs never/former) drinking was not associated with depression; however, average alcohol consumption of >1.5 drinks/week was negatively associated with subsequent depression for both diagnosis-year and ex-drinkers (past reported drinking) even among heavy drinkers. CONCLUSION: Our findings suggest that subsequent depression is positively associated with diagnosis-year smoking and negatively associated with alcohol consumption of >1.5 drinks/week among both diagnosis-year and ex-drinkers.