Predicting Smoking Status by Symptoms of Depression for U.S. Adolescents

Abstract

Abstract:Summary.-This study examined the predictive relationships between adolescents' smoking and symptoms of depression. A national sample of 6,900 adolescents, ages 14 to 18 years, were selected for analysis. Variables of interest included measures for smoking status and symptoms of depression. Odds ratio and adjusted odds ratio from logistic regression analyses indicated that more of the 885 smokers than of the 6,015 nonsmokers reported feelings of unhappiness, sadness, or depression, hopelessness about the future, and having trouble going to sleep. Article:Despite exposure to smoking prevention programs and the knowledge of adverse effects of cigarettes, many adolescents continue to smoke regularly (Cleary, Hitchcock, Semmer, Flinchbaugh, & Pinney, 1988). Cigarettes are still the number one drug used by adolescents (Flay, 1985) and each day over 3,000 teenagers in the U.S. begin smoking cigarettes (Leventhal & Cleary, 1980). Information about why adolescents smoke is important in increasing the efficacy of current interventions for smoking prevention and cessation. Researchers have reported an association between nicotine dependence and major depression for young adults (U.S. Department of Health and Human Services, 1984;Breslau, Kilbey, & Andreski, 1991). However, no study has examined the association between symptoms of depression and the smoking status of adolescents within a national representative sample. This study investigated the predictive relationships between smoking status and the symptoms of depression among adolescents in the USA. METHODThe 1989 Teenage Attitudes and Practices Survey was conducted by the National Center for Health Statistics (Moss, Allen, Giovino, & Mills, 1992). A nationwide random sample of 9,965 adolescents, ages 12 to 18 years, completed the telephone interview. Initial analysis indicated that the smoking prevalence for adolescents 12 and 13 years old was small (<2%). So, only adolescents ages 14 to 18 years (N = 6 ,900 , boys = 3,514, girls = 3,386) were included in the subsequent analysis.The information obtained from this survey included measures of smoking status and a series of factors related to symptoms of depression among others. The symptoms of depression were probed with questions asking whether during the past year respondents felt unhappy or depressed, felt hopeless about the future, felt nervous or tense, worried too much, or had trouble going to sleep.Crude and adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. The dependent variable of smoking was dichotomized by current regular smoker versus never smoked (n = 6 ,015) . This paper defines regular smokers (n = 885) as those who were currently smoking, had smoked 10 or more days in the past 30 days, and had smoked at least 100 cigarettes in their lifetimes. Table 1 shows the univariate distributions of smoking prevalence by levels of symptoms of depression predictors. The statistics for the crude odds ratios indicate that all six symptoms of predictors of depression RESULTS

Depression and substance use in minority middle-school students

“…3 Depression is a factor that may be important. Cross-sectional studies of adolescents showed that depression was related to a variety of unhealthy behaviors, such as cigarette smoking, 4 alcohol consumption, 5 and substance use. 6,7 In longitudinal studies, depressive symptoms in teenagers aged 15 to 16 years were positively related to the teenagers' smoking status 9 years later, 8 a previous diagnosis of major depressive disorder was 3 to 4 times more common in students with a history of alcohol abuse or substance use than in control subjects, 9 and depressed mood predicted first-time use of marijuana and other illicit drugs in secondary-school students.…”

Associations between Smoking and Depression in Adolescence: An Integrative Review

“…These studies showed that depression was associated with (a) current smoking at the time of the study 3 , (b) the frequency of cigarette use 4 , (c) the progression to higher stages of smoking (LloydRichardson, Papandonatos, Kazura, Stanton, & Niaura, 2002), and (d) regular smoking (Acierno et al, 2000;Boys et al, 2003;Patton et al, 1996;Simantov, Schoen, & Klein, 2000;Wang et al, 1994).…”

“…Among the 18 studies that did not use validated de-pression instruments, 10 were cross-sectional studies, and all of these studies found the statistically significant relationship between smoking and depression (Boys et al, 2003;Brooks et al, 2002;Coogan et al, 1998;Covey & Tam, 1990;Landrine et al, 1994;LloydRichardson et al, 2002;Martini et al, 2002;Otsuki, 2003;Pesa, Cowdery, Wang, & Fu, 1993;Wang et al, 1994). Five of eight longitudinal studies found the statistically significant relationships between smoking and depression: Three studies found depression as an antecedent to smoking, and two studies found the bidirectional relationship between smoking and depression (Dierker et al, 2004;Fleming et al, 2002;Gilpin et al, 2004;Goodman & Captman, 2000;Wang et al, 1996).…”

“…The third hypothesis proposes that the relationship is not unidirectional but bidirectional. This hypothesis suggests that either stress or negative mood can encourage smoking that may then influence the development of depression through a change in a neurochemical system (Wang, Fitzhugh, Westerfield, & Eddy, 1994). The fourth assertion about relationships between smoking and depression is the "comorbidity" hypothesis.…”

Attachment and Depression Differentially Influence Nicotine Dependence Among Male and Female Undergraduates: A Preliminary Study

“…Cross-sectional studies show that symptoms of depression predict initiation, [16][17][18] experimentation, 18,19 and regular cigarette smoking. 20,21 Given that women are twice as likely to experience major depression and that the onset of major depression coincides with the first years of college, 22 the ability of nicotine to dispel depression effectively 23,24 may act as a powerful smoking reinforcer for young first-year college women.…”