Reward expectations lead to smoking uptake among depressed adolescents

Abstract

Aims While the comorbidity between adolescent depression and smoking has been well documented, less is known about why smoking is disproportionately higher among depressed adolescents. Emerging research suggests that reward-related mechanisms may be important to consider. This study sought to determine whether adolescents with higher depression symptoms have greater smoking reward expectations, which in turn, influence smoking progression. Participants The sample was composed of 1,393 adolescents participating in a longitudinal survey study of adolescent health behaviors. Design and Measurements In this prospective cohort study, variables were measured via self-report every six months from age 14 to age 17 resulting in six waves of data. Findings Parallel processes latent growth curve modeling indicated that higher depression symptoms across mid to late adolescence predicted a 17% increase in smoking reward expectations (β = 3.50, z=2.85, p=.004), which in turn predicted a 23% increase in the odds of smoking progression (β= .206, z=3.29, p=.001). The indirect effect was significant with delta method (βindirect = .72, z= 3.09, p=.002; 95% CI= .26, 1.18) and bootstrap (βindirect = .72, z= 2.10, p=.03; 95% CI= .05, 1.39) standard errors. Conclusions The study provides novel evidence that expectations of smoking reward facilitate smoking uptake among depressed adolescents. Smoking reward expectations may identify depressed adolescents at risk of smoking. Addressing alternative ways to meet the reward expectations rather than smoking may be an important component to consider in the preventing smoking and promoting smoking cessation among adolescents with elevated depression symptoms.

White matter development and tobacco smoking in young adults: A systematic review with recommendations for future research

“…As development of white-matter structures is ongoing during early and middle adulthood (Lebel et al, 2008; Lebel and Beaulieu, 2011; Lebel et al, 2012), further research assessing the relationship between white-matter characteristics, tobacco smoking and co-occurring disorders across different developmental epochs is warranted. Given associations between adolescent smoking and depressive symptoms (Audrain-McGovern et al, 2009, 2012), assessment of these factors in relation to mood disorders specifically appears warranted.…”

Psychiatric comorbidity in adolescent electronic and conventional cigarette use

“…The over-representation of smoking among adolescents with mental health problems generalizes across various conditions (e.g., depressive, mania, anxiety, alcohol/drug use disorders), remains robust after controlling for confounders, and is mediated by theoretically-relevant factors suggesting a causal relation (e.g., beliefs that smoking has mood-modulating effects) (Audrain-McGovern et al, 2012; Upadhyaya et al, 2002). The rapid emergence and appeal of novel tobacco and nicotine products such as electronic (e-) cigarettes raises the question as to whether the same adolescent subgroup with mental health problems is at risk for using these products (Cummins, Zhu, Tedeschi, Gamst, & Myers, 2014).…”

Depressive symptoms, negative urgency and substance use initiation in adolescents

“…In adolescent samples there is evidence that higher level of depressive symptoms associate with an increase in smoking uptake and progression (Audrain-McGovern et al, 2011, 2012) and increased risk for early life initiation of alcohol or illicit drug use (Tang and Orwin, 2009). However, the mechanisms that account for the covariation between depressive symptoms and substance use initiation are unclear.…”