Effect of Depressive Symptoms and Sex on the Relationship Between Loneliness and Cigarette Dependence: A Moderated Mediation

Abstract

Loneliness is a subjective and emotionally unpleasant experience of perceiving insufficient social relationships. Previous research has revealed that loneliness constitutes a psychosocial risk factor for depression, and is also related to unhealthy behaviors such as smoking. This study aims to examine the relation between loneliness, depression, and cigarette dependence, and to explore the role of sex in this relationship. A total sample of 275 adult treatment-seeking daily smokers (Mage = 45.3; 61.5% females) was used. Our results showed a significant correlation between higher scores of loneliness, depressive symptoms, and cigarette dependence. In addition, mediation analysis showed a significant indirect effect of loneliness on cigarette dependence, via depressive symptoms. Regarding the effect of sex, we found that this variable significantly moderated the relationship between depressive symptoms and cigarette dependence. Results of this study extend previous literature by showing that, in treatment seeking smokers, loneliness is a significant predictor of depressive symptoms, and through this relation, it predicts cigarette dependence. Additionally, sex was a significant moderator of this relation. These findings have several clinical implications, and also contribute to the understanding of cigarette dependence, which is a well-known barrier for smoking cessation.

Keywords:

• Cigarette dependence
• loneliness
• depressive symptoms
• sex

Additional information

Funding

This research was supported by the Spanish Ministry of Economy and Competiveness and by ERDF (European Regional Development Fund) (Project reference: PSI2015-66755-R).

Notes on contributors

Carmela Martínez-Vispo

Carmela Martínez-Vispo, PhD student in Neuroscience and Clinical Psychology, University of Santiago de Compostela, and therapist of the Smoking Cessation and Adictive Disorders Unit (University of Santiago de Compostela, Spain). Her research interests are related to smoking cessation treatment, health psychology, depression and smoking comorbidity.

Ana López-Durán

Ana López Durán, PhD, Associated Professor in University of Santiago de Compostela, and coordinator of the Smoking Cessation and Adictive Disorders Unit (University of Santiago de Compostela, Spain). Her research interests are related to additive behaviors, and psychological treatment of smoking, cannabis and cocaine.

Rubén Rodríguez-Cano

Rubén Rodríguez-Cano, PhD, therapist of the Smoking Cessation and Adictive Disorders Unit (University of Santiago de Compostela, Spain). His research interest areas are addictive behaviors, cancer prevention, health psychology and transdiagnostic processes underlying emotional disorder-substance use disorder comorbidity.

Elena Fernández del Río

Elena Fernández del Río, PhD, Assistant Professor in the Department of Psychology and Sociology in the University of Zaragoza (Spain). Her research interests are health psychology, personality, and addictive behaviors.

Carmen Senra

Carmen Senra, PhD, titular professor in Psychopathology in University of Santiago de Compostela (Spain). Her research interests are related to clinical psychology, psychopathology and development of depressive disorders and eating disorders.

Elisardo Becoña

Elisardo Becoña, PhD, Professor in Clinical Psychology, and Director of the Smoking Cessation and Addictive Disorders Unit, University of Santiago de Compostela (Spain). His research interest areas are psychological treatment of smoking, cannabis, cocaine, gambling and new technologies.