Moderation of gender on smoking and depression in Chinese Americans

This study examined the moderating role of gender in the association between smoking status and depression in a nationwide convenience sample of Chinese American current, former, and never smokers (N = 1393). Participants were recruited in smoker–supporter dyads. Multilevel modeling was used to take into account the dyadic nature of the data. Depressive symptoms were measured by a 10-item CES-D (Center of Epidemiological Studies-Depression Scale). Results showed significant effects of smoking status by gender interaction and smoking status on depression after adjusting for acculturation and social support. Among Chinese females, current smokers reported elevated depression level than both former and never smokers. Among Chinese males, current smokers reported more depressive symptoms when compared to former smokers only. Chinese females reported higher depression level than males among current smokers; no gender difference in depression was observed among former or never smokers. The association between smoking and depression is moderated by gender among Chinese Americans where substantial gender difference in smoking prevalence exists. Findings highlight the importance of addressing depression in treating tobacco use among Chinese American smokers, especially among females.

Research Highlights
► The smoking and depression association differed by gender in Chinese Americans.
► Gender difference in depression was observed in Chinese current smokers only.
► In females, current smokers were more depressed than never and former smokers.
► Male current smokers had more depressive symptoms than male former smokers only.
► Depression can be a key issue in Chinese American smokers especially in females.