Journal List > J Korean Acad Nurs > v.49(1) > 1117328

Han and Lee: The Longitudinal Relationships between Depression and Smoking in Hardcore Smokers Using Autoregressive Cross-Lagged Modeling

Abstract

Purpose

This study aimed to identify the directionality of the causal relationship and interaction between depression and amount of smoking over time in hardcore smokers using longitudinal descriptive analysis.

Methods

Secondary data from the Korean Welfare Panel Study were analyzed using autoregressive cross-lagged modeling. Participants included 342 hardcore smokers who participated in the 8th to 11th waves of the panel study.

Results

Analyses revealed that change(s) in depression levels according to time had a significant positive relationship with the total amount of smoking per day (β=.29, β=.19, β=.17, p<.001), while change(s) in total amount of smoking per day according to time had a significant positive relationship with depression (β=.43, β=.50, β=.38, p<.001). Analysis of the cross-lagged effect between depression and total amount of smoking per day showed that depression at one time point had a significantly positive relationship with the total amount of smoking per day at the next time point (β=.14, β=.13, β=.13, p=.021), and that the total amount of smoking per day at one time point had a significant positive relationship with depression at the next time point (β=.04, β=.04, β=.03, p=.044).

Conclusion

The findings in the present study confirmed a cross-interaction between depression and total amount of smoking per day in hardcore smokers. The present findings could be used to develop appropriate smoking-related interventions.

References

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Figure 1.
Autoregressive cross-lagged modeling.
jkan-49-69f1.tif
Table 1.
Descriptive Statistics of Depression and Smoking Amount Over Time
Variables M SD Skewness SE Kurtosis SE
   Depression 8th 2.08 2.38 2.51 0.13 4.53 0.26
   Depression 9th 1.60 1.41 2.56 0.13 9.07 0.26
   Depression 10th 1.96 1.40 2.34 0.13 9.43 0.26
   Depression 11th 2.09 1.54 2.85 0.13 4.84 0.26
   Smoking amount 8th 23.35 7.04 2.37 0.13 6.26 0.26
   Smoking amount 9th 23.12 6.59 2.11 0.13 4.07 0.26
   Smoking amount 10th 22.43 4.27 2.53 0.13 9.05 0.26
   Smoking amount 11th 23.52 4.35 2.09 0.13 9.89 0.26

M=mean; SD=standard deviation; SE=standard error.

Table 2.
The Correlation between Depression and Smoking Amount
Variables X1 X2 X3 X4 X5 X6 X7 X8
r (p) r (p) r (p) r (p) r (p) r (p) r (p) r (p)
   Depression 8th 1
   Depression 9th .395 1
(<.001)
   Depression 10th .385 .474 1
(<.001) (<.001)
   Depression 11th .311 .346 .367 1
(<.001) (.003) (<.001)
   Smoking amount 8th .150 .244 .164 .192 1
(.009) (.007) (.016) (.043)
   Smoking amount 9th .185 .108 .377 .110 .570 1
(.008) (.045) (.007) (.024) (<.001)
   Smoking amount 10th .062 .103 .180 .202 .336 .430 1
(.026) (.006) (.007) (.005) (<.001) (<.001)
   Smoking amount 11th .117 .129 .170 .141 .262 .315 .375 1
(.007) (.003) (.006) (.025) (<.001) (<.001) (<.001)
Table 3.
Multi-Fitness Comparison of ACLM for Depression and Smoking Amount
Model χ2 df NFI CFI TLI RMSEA
   Model 1 296.74 161 0.93 0.99 0.98 0.04
   Model 2 294.15 158 0.93 0.99 0.98 0.05
   Model 3 286.60 157 0.93 0.99 0.98 0.04
   Model 4 306.94 159 0.93 0.99 0.98 0.05
   Model 5 330.24 161 0.93 0.98 0.98 0.05
   Model 6 330.74 163 0.93 0.98 0.98 0.05
   Model 7 332.02 165 0.93 0.98 0.98 0.05
   Model 8 334.32 167 0.93 0.98 0.98 0.05

ACLM=Autoregression Cross-Lagged Model; df=Degree of freedom; NFI=Normal Fit Index; CFI=Comparative Fit Index; TLI=Turker-Lewis Index; RMSEA=Root Mean Squared Error of Approximation.

Table 4.
Parameter Estimation of ACLM between Depression and Smoking Amount
Pathway B β CR p
   Depression 8th → Depression 9th 0.18 0.29 7.45 <.001
   Depression 9th → Depression 10th 0.18 0.19 7.45 <.001
   Depression 10th → Depression 11th 0.18 0.17 7.45 <.001
   Smoking amount 8th → Smoking amount 9th 0.37 0.43 15.99 <.001
   Smoking amount 9th → Smoking amount 10th 0.37 0.50 15.99 <.001
   Smoking amount 10th → Smoking amount 11th 0.37 0.38 15.99 <.001
   Depression 8th → Smoking amount 9th 0.12 0.14 2.31 .021
   Depression 9th → Smoking amount 10th 0.12 0.13 2.31 .021
   Depression 10th → Smoking amount 11th 0.12 0.13 2.31 .021
   Smoking amount 8th → Depression 9th 0.06 0.04 2.01 .044
   Smoking amount 9th → Depression 10th 0.06 0.04 2.01 .044
   Smoking amount 10th → Depression 11th 0.06 0.03 2.01 .044

ACLM=Autoregression Cross-Lagged Model; CR=Construct reliability.

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