Elsevier

Addictive Behaviors

Volume 31, Issue 1, January 2006, Pages 133-136
Addictive Behaviors

Short communication
Adolescent smoking and depression: Which comes first?

https://doi.org/10.1016/j.addbeh.2005.04.010Get rights and content

Abstract

Despite the well-known health risks of smoking, adolescents continue to smoke at alarming rates. Smoking is also known to be associated with depression, but the direction of this relation is unclear. This study used data from the National Longitudinal Study of Adolescent Health (Add Health) to evaluate the direction of the relation between cigarette smoking and depression among adolescents. A total of 14,634 adolescents (7132 males and 7502 females) completed in-home surveys in 1995 and 1996 and were split into four smoking status groups. Adolescents who were Starters, Quitters, and Maintainers were found to be 1.5, 1.4, and 2.0 times more likely, respectively, than Nevers to be depressed at Time 2. In addition, females showed a striking pattern of increases in depression around the onset of smoking and decreases around the time of quitting. While these findings do not prove that smoking leads to depression, they are consistent with such a prediction.

Section snippets

Methods

Adolescents in Grades 7–12 who completed Add Health in-home surveys in both 1995 and 1996 were split into four smoking status groups based upon self-report of any cigarette use during the 30 days preceding the interviews. Adolescents who were Nevers indicated that they had not smoked within the last 30 days both at Time 1 and at Time 2; Starters indicated not smoking at Time 1 but smoked at Time 2; Quitters indicated smoking at Time 1 but not Time 2; and Maintainers indicated smoking at Time 1

Results

The subjects' demographic data, by smoking status group, are presented in Table 1. Logistic regression was conducted to obtain the odds ratios of being depressed at Time 2 as a function of smoking status group. After controlling for age, sex, race, and depression at Time 1, adolescents who were Starters, Quitters, and Maintainers were found to be 1.5, 1.4, and 2.0 times more likely, respectively, than Nevers to be depressed at Time 2. However, the relation between smoking status and depression

Discussion

Results of the analyses revealed that adolescents who smoked currently or in the past were more likely to experience depression, with regular smokers showing the highest levels of depression, even after controlling for previous depression. Consistent with previous findings, females showed a much higher level of depression despite smoking status (Goodman & Capitman, 2000, Kubik et al., 2003). The present study revealed a striking pattern of increases in depression around the onset of smoking and

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