Smoking has physical and psychoactive effects, and heavy smoking is associated with depression

The effects of smoking on physical and mental health were assessed in a cohort of 3,376 middle-aged men by a health questionnaire, the Total Health Index, and by mortality risk ratio. Participants were grouped into the four following smoking classes: never smoked, smoke 1-19, 20-29, and ≥30 cigarettes a day. The Index has 15 physical and mental symptom scales that assess his perceived health of respiratory organs, digestive organs, short temper, depression, aggressiveness, et al. Each scale score was calculated as the sum of the positive number of symptoms, and a higher score indicates more symptoms. Starting from never smoked class, mean respiratory organ scale score increase linearly depending on the heavier smoking classes. Mean digestive organ scale score and the other three scale scores also showed linear dose-response relationship with the three classes of increasing number of cigarettes smoked a day.The other seven scale scores showed not a linear but J-shaped dose-response relationship. The never-smoked, smoke 1-19, and 20-29 cigarettes per day classes showed no increased response; only the heaviest class, smoke ≥30 cigs or more a day, had significantly higher mean scores for vague complaints, short temper, anxiety, depression, mouth, eye, and neurotics. Mortality risk of lung cancer was also high in heavy smokers (RR＝3.71). Men of depression included more heavy smokers than the other non-depression men (P＝0.0014).