Academic journal article New Zealand Journal of Psychology

Descriptions of Depression among a Sample of Maori Smokers

Academic journal article New Zealand Journal of Psychology

Descriptions of Depression among a Sample of Maori Smokers

Article excerpt

Information about depression was extracted from a PhD study on Maori smoking cessation behaviour. Participants were asked to define and report on their experience of depression. One hundred and thirty Maori smokers aged 16-62, who were intending to quit, were interviewed prior to their quit attempt and on average four months later. Over a third believed they had experienced depression at some time. Qualitative responses were collected from eighty eight participants (68%). Participants described the range of generally recognisable symptoms of a Major Depressive Disorder. They attributed a number of other behaviours to depression, such as, korero about injustice they had experienced and preoccupation with a close relative who had died. Participants said there were many types of depression ranging from mild to severe. Depression was believed to worsen over time if an initial violation was not resolved. Whanau aroha, being able to talk about their feelings and injustices, learning self-help skills and learning about themselves were important for healing. Participants were generally resistant towards the use of medication.


Tiwhatiwha te po, tiwhatiwha te ao.

Gloom and sorrows prevail day and night.

(Brougham and Reed, 1963)

Both smoking and depression are major public health problems. The combination of these factors in the same person is risky, because immune function is reduced in depression and the adjusted relative risks of cancer at sites associated with smoking has been reported to be especially high--nearly 20-fold in heavy, depressed smokers compared with never smokers without depression. In addition, the most important risk factor for suicide is treatment resistant depression. However, smoking has also been implicated as a risk factor for suicide both in men and women (Tanskanen, Korhonen, Uutela, Viinamaki and Puska, 1996).

In New Zealand, about one in seven people (one in five women) will develop a depressive disorder some time in their lifetime (National Advisory Council on Health and Disability, 1996). There is some evidence suggesting Maori suffer higher rates of depression or are disproportionately admitted to psychiatric hospitals for schizophrenia, alcohol dependence or abuse and drug dependence or abuse (Pomare et al., 1995). In 2002, half(49%) of all Maori adults smoked (Ministry of Health, 2003). Even among people who may not meet the strict criteria for a clinical diagnosis of depression, depressive symptoms are related to higher rates of smoking (Tanskanen et al., 1996).

There have been suggestions that people with psychiatric disorders smoke as a form of self medication (Covey et al., 1994). Some studies have identified a genetic predisposition for addiction to nicotine. For example, a study of 1566 female twins showed "that shared genes, rather than a common environment, more convincingly explained the relationship between major depression and cigarette smoking" (cited in Covey et al., 1994, p.227).

Not only do people with schizophrenia, dysthymia, depression, generalised anxiety disorders, alcohol dependence and other drug addictions, smoke more, research has shown a consistently adverse relationship between these disorders and quitting (Covey et al., 1994; Dale et al., 1997; Fiore et al., 1996). People with depression may also experience more withdrawal symptoms (Gritz et al., 1995). As well, nicotine withdrawal can exacerbate a comorbid condition (Fiore et al., 1996).

The little information that exists on Maori and depression suggests that Maori have different views of the cause and treatment of depression (National Health Committee, 1996). Durie (cited in National Health Committee, 1996) states that "explanations of illness based on a possible breach of tapu continue to have meaning for Maori and therefore have implications for health workers."


One hundred and thirty self-identified Maori smokers, aged 16-62, who were intending to quit, were interviewed during 1997-1998. …

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