Cigarette smoking and mood disorders in U.S. adolescents: Sex-specific associations with symptoms, diagnoses, impairment and health services use

Abstract

Objective To report sex-specific associations between cigarette smoking and DSM-IV disorders, symptoms, and mental health services use related to depression and anxiety in a nationally representative sample of U.S. adolescents. Methods Data on two samples were drawn from the 1999–2004 National Health and Nutrition Examination Surveys to examine the association of ever smoking (versus never smoking) with depression (n=1884 12–15 year-olds) and anxiety (n=6336 12–19 year-olds). Sex-specific associations between smoking and DSM-IV diagnoses, subthreshold and severe disorder, symptoms, impairment and mental health services use were assessed using logistic regression modeling. Results Rates of DSM-IV depression and anxiety were increased in adolescent female ever smokers as compared to never smokers (OR=3.9, 95% CI: 1.3–11.3 and OR=10.6, 95% CI: 3.1–37.0, respectively). Females also showed statistically significant increases in severe disorder, subthreshold disorder, all symptoms of major depressive disorder, most symptoms of panic disorder, and increases in severe impairment, especially those related to schoolwork and teachers. Male adolescents showed smaller variations in depression and anxiety by smoking status, but were more likely to seek mental health services. Conclusions Smoking prevention efforts may benefit from specifically targeting female youth who show signs of depression or anxiety diagnoses through a school-based program, while greater benefits with males may be evident through programs integrated into mental health services.

Demographic, psychosocial, and genetic risk associated with smokeless tobacco use among Mexican heritage youth

“…Evidence suggests that anxiety is a risk factor for cigarette use [ 33 ] and that regular cigarette smoking is associated with anxiety disorders [ 34 ]. Although several studies have reported no association between anxiety and STU [ 35 , 36 ], in our analysis, we found that higher levels of anxiety were associated with STU at each home assessment.…”

Peer Review #1 of "Association among smoking, depression, and anxiety: findings from a representative sample of Korean adolescents (v0.1)"

“…On the contrary, there have been large-scale epidemiological studies on adolescents that have reported that smoking may influence depression (Park et al, 2010;Patton et al, 1998;Wu & Anthony, 1999). According to a cross-sectional study by Richardson et al (Richardson et al, 2012) conducted on 1,884 adolescents aged 12-15 who participated in the U.S. National Health and Nutrition Survey performed from 1999 through 2004, after the control of socio-demographic factors, smokers were 2.8 times more likely to suffer from depression than non-smokers. In addition, in a study on 1,709 adolescents aged 14-18, smokers were 1.9 times more likely to suffer from major depressions than non-smokers (Brown et al, 1996).…”

“…According to such studies, smokers have a 1.9-2.8 times greater risk of depression than nonsmokers (Brown et al, 1996;Richardson et al, 2012). On the other hand, other studies have reported that smoking is not related with depression or anxiety (Takemura et al, 1999;Williams & Adams-Campbell, 2000).…”

“…Meanwhile, numerous epidemiological studies have reported that smoking affects physical health as well as mental health (Chation et al, 2009;Gilpin, Lee, & Pierce, 2004;Lam et al, 2005;Park et al, 2010;Patton et al, 1998;Richardson et al, 2012;Wu & Anthony, 1999).…”

Cigarette smoking, depressive symptoms, and social cognitions

“…There is comorbidity between depression and smoking (Conway et al, 2017;Polednak, 2014;Weinberger et al, 2016). Richardson, He, Curry, and Merikangas (2012) 2013 for those who experienced depression and were current smokers. These studies suggest a co-segregation of the two syndromes.…”