Smoking May Cause Teen Depression
10/07/00
FRIDAY, Oct. 6 (HealthSCOUT) -- If you think kids smoke cigarettes because they're depressed, think again.
It may be the other way around.
Smoking actually ups the risk of depression in kids, claims a new study in this month's issue of Pediatrics. In fact, teens who smoke may be four times more likely to get the blues than teen's who don't smoke.
Not everyone agrees with this idea, however.
Whether smoking causes depression or vice versa is still up for grabs, says a spokesman for the National Mental Health Association. Some type of link between depression and smoking is not to be argued with, experts say, but they add that smoking is just one of the risky behaviors that point to psychological problems.
"Studies have shown there's an association between smoking and depression," says Dr. Elizabeth Goodman, director of research in the division of adolescent medicine at Children's Medical Center in Cincinnati. "The common dictum is that depressed people smoke to feel better, to self medicate."
But to test which came first, Goodman and colleagues analyzed the results of the 1995 National Longitudinal Study of Adolescent Health, which she describes as a "huge study of teen-agers, which looked at what adolescents do, what they think and what they feel." Teens were asked questions via headphones and then answered the questions "on a laptop computer, so that no one looked at these kids as they responded," Goodman says.
To see whether smoking predicted the development of depression within a year of the initial interview, the researchers looked at a group of 8,704 adolescents -- some smokers, some nonsmokers -- who were not depressed when first interviewed.
"Those who smoked had almost four times greater risk of depression than those who didn't smoke," Goodman says.
They then looked at 6,947 teens who were not current smokers. The aim, she says, was to determine whether being depressed at the time of the first interview would predict who would be smoking a pack of cigarettes a week after a year.
"We found it didn't, and we were surprised," Goodman says. "We had hypothesized that we would find a more interactive relationship between smoking and depression." She says the researchers statistically accounted for other things that could lead to smoking or depression -- from anxiety and low self-esteem to alcohol and drug use.
"Nicotine or some smoking byproduct plays funny with brain chemistry," Goodman says. "The fact that drugs can treat both depression and cigarette addiction certainly points to some kind of connection between smoking and depression."
Now more studies need to be done to better understand this link, she says.
But Kevin Dwyer, a senior adviser in prevention and children's mental health with the National Mental Health Association, says the jury's still out.
"There's one thing we do know," Dwyer says, "and that's that kids who smoke are more likely to engage in more risky behaviors during adolescence, and those behaviors can end up increasing the chances of these kids feeling depressed."
"Basically this research suggests a possibility," he says. "But we need to do further work here to prove this hypothesis."
What To Do
For more information on helping kids stop smoking or on preventing them from starting in the first place, take a look at TeensTrashTobacco and the Center for Disease Control and Prevention's Tobacco Information Prevention Source.
Or, you might want to read previous HealthSCOUT articles on teens and smoking.