Associations between Smoking and Depression in Adolescence: An Integrative Review

  • Park, Sun-Hee (Kyung Hee University, College of Nursing Science) ;
  • Romer, Dan (Communication Institute at the Annenberg Public Center, University of Pennsylvania)
  • Published : 2007.03.31

Abstract

Background. Although research has established the existence of an association between smoking and depression among adolescents, researchers have not reached consensus on the nature of the association. Objectives. The purpose of this paper is to review the literature, to examine the nature of the relationship between smoking and depression in adolescence, and to suggest future research directions. Methods. A literature search was conducted from the following six databases: (a) Ovid MEDLINE, (b) CINAHL, (c) PubMed Unrestricted, (d) PsycINFO, (e) ERIC, and (f) Sociological Abstracts. The combinations of the words, "depression," "smoking," "tobacco," "adolescent," and "teen" were used for keyword searches to find relevant articles. Results. In 47 of 57 studies, significant associations between smoking and depression were found. However, these significant relationships may either be spurious or unrelated to depression because a substantial number of studies did not adjust for confounders or did not use validated instruments to measure depression. Additionally, if the relationship is causal, its direction remains controversial. Five relationships have been suggested: (a) Depression causes smoking, (b) smoking causes depression, (c) there is a bidirectional relationship between smoking and depression, (d) smoking and depression occur due to confounders, and (e) subgroups with different relationships between the two conditions exist. Conclusions. It is necessary to further explore the relationship between smoking and depression. Future research should consider the need for: (a) longitudinal research designs, (b) more accurate measurement of depression, and (c) the control of confounders between smoking and depression.

References

  1. Acierno, R, Kilatrick, D.G., Resnick, H., Saunders, B., De Arellano, M., & Best, C. (2000). Assault, PTSD, family substance use, and depression as risk factors for cigarette use in youth: Findings from the National Survey of Adolescents. J Trauma Stress, 13(3),381-396 https://doi.org/10.1023/A:1007772905696
  2. Albers, AB., & Biener, L. (2002). The role of smoking and rebelliousness in the development of depressive symptoms among a cohort of Massachusetts adolescents. Prev Med, 34, 625-631 https://doi.org/10.1006/pmed.2002.1029
  3. Arday, D.R., Giovino, G.A., Schulman, J., Nelson, D.E., Mowery, P., & Samet, J.M. (1995). Cigarette smoking and self-reported health problems among U.S. high school seniors, 1982-1989. Am J Health Promot, 10(2),111-116
  4. Audrain-McGovern, J., Lerman, C., Wileyto, E.P., Rodriguez, D., & Shields, P.G. (2004). Interacting effects of genetic predisposition and depression on adolescent smoking progression. Am J Psychol, 161,1224-1230 https://doi.org/10.1176/appi.ajp.161.7.1224
  5. Berkson, J. (1946). Limitations to the application of fourfold table analysis to hospital data. Biometrics Bulletin, 2(3),47-53 https://doi.org/10.2307/3002000
  6. Boys, A, Taylor, F.C., Marsden, J., Brugha, T., Bebbington, P., Jenkins, R., et al. (2003). Psychiatric morbidity and substance use in young people aged 13-15 years: Results from the Child and Adolescent Survey of Mental Health. Br J Psychiatry, 182, 509-517 https://doi.org/10.1192/bjp.182.6.509
  7. Breslau, N., Kilbey, M., & Andreski, P. (1993). Nicotine dependence and major depression. Arch Gen Psychiatry, 30, 31-35
  8. Brook, J.S., Schuster, E., & Zhang, C. (2004). Cigarette smoking and depressive symptoms: A longitudinal study of adolescents and young adults. Psychol Rep, 95, 159-166
  9. Brooks, T.L., Harris, S.K., Thrall, J.S., & Woods, E.R. (2002). Association of adolescent risk behaviors with mental health systems in high school students. J Adolesc Health, 31, 240-246
  10. Brown, RA., Lewinsohn, P.M., Seeley, J.R, & Wagner, E.F. (1996). Cigarette smoking, major depression, and other psychiatric disorders among adolescents. J Am Acad Child Adolesc Psychiatry, 35(12), 1602-1610 https://doi.org/10.1097/00004583-199612000-00011
  11. Center for Disease Control and Prevention (2002). Annual smoking- attributable mortality, years of potential life lost, and economic costs-United States, 1995-1999, MMWR Morb Mortal Wkly Rep, 51(14), 300-303
  12. Center for Disease Control and Prevention (2004). Cigarette use among high school students: United States, 1991-2003. MMWR Morb Mortal Wkly Rep, 53(23), 499-502
  13. Cicchetti, D., & Toth, L. (1998). The development of depression in children and adolescents. Am Psychol, 53(2), 221-241 https://doi.org/10.1037/0003-066X.53.2.221
  14. Coelho, R, Martins, A., & Barros, H. (2002). Clinical profiles relating gender and depressive symptoms among adolescents ascertained by the Beck Depression Inventory II. Eur Psychiatry, 17,222-226
  15. Coogan, P.F., Adams, M., Geller, AC., Brooks, D., Miller, D.R., Lew, R.A., et al. (1998). Factors associated with smoking among children and adolescents in Conneticut. Am J Prev Med, 15(1), 17-24
  16. Costello, E.J., Erkanli, A., Federman, E., & Angold, A (1999). Development of psychiatric comorbidity with substance abuse in adolescents: effects of timing and sex. J Clin Child Psychol. 28(3):298-311 https://doi.org/10.1207/S15374424jccp280302
  17. Covey, L.S., & Tam, D. (1990). Depressive mood, the single-parent home, and adolescent cigarette smoking. Am J Public Health, 80(11),1330-1333 https://doi.org/10.2105/AJPH.80.11.1330
  18. Dierker, L.C., Avenevoli, S., Goldberg, A, & Glantz, M. (2004). Defining subgroups of adolescents at risk for experimental and regular smoking. Prev Sci, 5(3), 169-183 https://doi.org/10.1023/B:PREV.0000037640.66607.6b
  19. Dusek, J.B. (1996). Adolescent development and behavior (3 rd Eds.). Upper Saddle River, N.J: Prentice Hall
  20. Fergusson, D.M., Lynskey, M.T., & Horwood, L.J. (1996). Comorbidity between depressive disorders and nicotine dependence in a cohort of 16-year-olds. Arch Gen Psychiatry, 53(11),1043-1047 https://doi.org/10.1001/archpsyc.1996.01830110081010
  21. Fleming, C.B., Kim, H., Harachi, T.W., & Catalano, R.F. (2002). Family processes for children in early elementary school as predictors of smoking initiation. J Adolesc Health, 30, 184-189 https://doi.org/10.1016/S1054-139X(01)00327-5
  22. Gilpin, E.A., Lee, L., & Pierce, J.P. (2004). Does adolescent perception of difficulty in getting cigarettes deter experimentation? Prev Med, 38, 485-491 https://doi.org/10.1016/j.ypmed.2003.12.001
  23. Glassman, A.H., Stetner, F., Walsh, T., Raizman, P.S., Fleiss, J.L., Cooper, T.B., et al. (1988). Heavy smokers, smoking cessation, and clonidine. JAMA, 259(19), 2863-2866 https://doi.org/10.1001/jama.259.19.2863
  24. Goodman, E., & Captman, J. (2000). Depressive symptoms and cigarette smoking among teens. Pediatrics, 106,748-755 https://doi.org/10.1542/peds.106.4.748
  25. Hall, S.M., Humfleet, G.L., Reus, V.I., Munoz, RF., Hartz, D.T., & Maude-Griffin, M. (2002). Psychological intervention and antidepressant treatment in smoking cessation. Arch Gen Psychiatry, 59, 930-936 https://doi.org/10.1001/archpsyc.59.10.930
  26. Hall, S.M., Munoz, RF., Reus, V.I., & Sees, K.L (1993). Nicotine, negative affect, and depression. J Consult Clin Psychol, 61(5), 761-767 https://doi.org/10.1037/0022-006X.61.5.761
  27. Hawkins, W.E., Hawkins, M.J., & Seeley, J. (1992). Stress, healthrelated behavior and quality of life on depressive symptomatology in a sample of adolescents. Psychol Rep. 71(1):183-186
  28. Hennekens, C.H., & Buring, J.E. (1987). Epidemiology in medicine. Philadelphia, PA: Lippincott Williams & Wilkins
  29. Kane, R.L. (1997). Understanding health care outcomes research. Gaithersburg, MD: Aspen Publishers
  30. Kaplan, S.L., Landa, B., Weinhold, C., & Shenker, I.R. (1984). Adverse health behaviors and depressive symptomatology in adolescents. J Am Acad Child Psychiatry, 23(5), 595-601 https://doi.org/10.1016/S0002-7138(09)60353-8
  31. Kelder, S.H., Murray, N.G., Oprinas, P., Prokhorov., A., McReynolds, L., & Roberts, R. (2001). Depression and substance use in minority middle-school students. Am J Public Health, 91,761-766 https://doi.org/10.2105/AJPH.91.5.761
  32. Kendler, K.S., Neale, M.C., MacLean, C.J., Heath, A.C., Eaves, L.J., & Kessler, RC. (1993). Smoking and major depression: A causal analysis. Arch Gen Psychiatry, 50, 36-43 https://doi.org/10.1001/archpsyc.1993.01820130038007
  33. Killen, J.D., Robinson, T.N., Haydel, F., Hayward, C., Wilson, D.M., Hammer, L.D., et al. (1997). Prospective study of risk factors for the initiation of cigarette smoking. J Consult Clin Psychol, 65(6),1011-1016 https://doi.org/10.1037/0022-006X.65.6.1011
  34. Landrine, H., Richardson, J.L., Klonoff, E.A, & Flay, B.R (1994). Cultural diversity in the predictors of adolescent cigarette smoking: The relative influence of peers. J Behav Med, 17(3), 331-346 https://doi.org/10.1007/BF01857956
  35. Lerman, C., Audrain-McGovern, J., Orleans, C.T., Boyd, R, Gold, K, Main, D., et al. (1996). Investigation of mechanisms linking depressed mood to nicotine dependence. Addict Behav, 24(1), 9-19
  36. Lloyd-Richardson, E.E., Papandonatos, G., Kazura, A., Stanton, C., & Niaura, R (2002). Differentiating stages of smoking intensity among adolescents: Stage-specific psychological and social influences. J Consult Clin Psychol, 70(4),998-1009 https://doi.org/10.1037/0022-006X.70.4.998
  37. Martini, S., Wagner, F.A., & Anthony, J.C. (2002). The association of tobacco smoking and depression in adolescence: Evidence from the United States. Subst Use Misuse, 37(14), 1853-1867 https://doi.org/10.1081/JA-120014087
  38. Mash, E.J., & Wolfe, D.A. (2002). Abnormal child psychology. Belmont, CA: Wadsworth
  39. McCandless, B.R, & Coop, RH. (1979). Adolescents: Behavior and development (2nd Eds.). New York: Holt, Rinehart, and Winston
  40. Millgan,RA.K, Burke, V., Beiling, L.J., Dunbar, RD., Spencer, M., Balde, E., et al. (1997). Health-related behaviors and psychosocial characteristics of 18 year-old Australians. Soc Sci Med, 45(10),1549-1562 https://doi.org/10.1016/S0277-9536(97)00092-0
  41. Parrott, A.C. (1999). Does cigarette smoking cause stress? Am Psychol, 54(10), 817-20 https://doi.org/10.1037/0003-066X.54.10.817
  42. Parry-Jones, W.L. (1991). Historical aspects of mood and its disorders in young people. In I.M. Goodyer. (2nd Eds.), The depressed child and adolescent (pp.1-23). New York, NY: Cambridge University Press
  43. Patton, G.C., Carlin, J.B., Coffey, C., & Wolfe, R. (1998). Depression, anxiety, and smoking initiation: A prospective study over 3 years. Am J Public Health, 88(10), 1518-1522 https://doi.org/10.2105/AJPH.88.10.1518
  44. Patton, G.C., Marienne, H., Macolm, J.R, Carlin, J.B, Caust, J., & Bowes, G. (1996). Is smoking associated with depression and anxiety in teenagers? Am J Public Health, 86(2),225-230 https://doi.org/10.2105/AJPH.86.2.225
  45. Pederson, L.L.., Koval, J.J., & O'connor, K (1997). Are psychosocial factors related to smoking in grade-6 students? Addict Behav, 22(2), 169-181 https://doi.org/10.1016/S0306-4603(96)00014-7
  46. Pesa, J.A., Cowdery, J.E., Wang, M.Q., & Fu, Q. (1993). Self-reported depressive feelings and cigarette smoking among Mexican-American Adolescents. Health Educ Res, 7, 69-80
  47. Rodriguez, D., Moss, H.B., & Audrain-McGovern, J. (2005). Developmental heterogeneity in adolescent depressive symptoms: Associations with smoking behavior. Psychosom Med, 67,200-210 https://doi.org/10.1097/01.psy.0000156929.83810.01
  48. Rohde, P., Lewinsohn, P.M., & Seeley, J.R (1994). Are adolescents changed by an episode of major depression? J Am Acad Child Adolesc Psychiatry, 33(9), 1289-1298 https://doi.org/10.1097/00004583-199411000-00010
  49. Otsuki, T.A. (2003). Substance use, self-esteem, and depression among Asian American adolescents. J Drug Educ, 33(4),369-390 https://doi.org/10.2190/RG9R-V4NB-6NNK-37PF
  50. Silberg, J., Rutter, M., D'Onofrio, B., & Eaves, L. (2003). Genetic and environmental risk factors in adolescent substance use. J Child Psychol Psychiatry, 44(5):664-676 https://doi.org/10.1111/1469-7610.00153
  51. Simantov, E., Schoen, C., & Klein, J.D. (2000). Health-compromising behaviors: Why do adolescents smoke or drink? Arch Pediatr Adolesc Med, 154,1025-1033 https://doi.org/10.1001/archpedi.154.10.1025
  52. Stefanis, C.N., & Kokkevi, A. (1986). Depression and drug use. Psychopathology, 19(2),124-131 https://doi.org/10.1159/000285143
  53. Tercyak, KP., & Audrain-McGovern, J. (2002). Psychosocial correlates of alternates tobacco product use during early adolescence. Prev Med, 35, 193-198 https://doi.org/10.1006/pmed.2002.1060
  54. Unger, J.B., Yan, L., Johnson, A., Gong, J., Chen, X., Li, C.Y., et al. (2001). Stressful life events among adolescents in Wuhan, China: Associations with smoking, alcohol use, and depressive symptoms. lnt J Behav Med, 8(1), 1-18 https://doi.org/10.1207/S15327558IJBM0801_01
  55. Vogel, J.S., Hurford, D.P., Smith, J.V., & Cole, A. (2003). The relationship between depression and smoking in adolescents. Adolescence, 38(149),57-74
  56. Wang, M.Q., Fitzhugh, E.C., Turner, L., Fu, Q., & Westerfield, RC. (1996). Association of depressive symptoms and school adolescents' smoking: a cross-lagged analysis. Psychol Rep, 79(1), 127-130
  57. Wang, M.Q., Fitzhugh, E.C., Westerfield, R.C., & Eddy, J.M. (1994). Predicting smoking status by symptoms of depression for U.S. adolescents. Psychol Rep. 75(2):911-914
  58. Whalen, C.K, Jamner, L.D., Henker, B., & Delfino, R.J. (2001). Smoking and moods in adolescents with depressive and aggressive dispositions: Evidence from surveys and electronic diaries. Health Psychol, 20(2), 99-111 https://doi.org/10.1037/0278-6133.20.2.99
  59. Windle, M., & Windle, RC. (2001). Depressive symptoms and cigarette smoking among middle adolescents: Prospective associations and intra personal and interpersonal influences. J Consult Clin PsychoI, 69(2),215-226 https://doi.org/10.1037/0022-006X.69.2.215
  60. Wu, L.T., & Anthony, J.C. (1999). Tobacco smoking and depressed mood in late childhood and early adolescence. Am J Public Health, 89(12), 1837-1840 https://doi.org/10.2105/AJPH.89.12.1837
  61. Yunis, F.A., Mattar, T., & Wilson, A.K. (2003). The association between tobacco smoking and reported psychiatric symptoms in an adolescent population in the United Arab Emirates. Soc Behav Pers, 31(5), 461-466 https://doi.org/10.2224/sbp.2003.31.5.461