Depressive symptoms and suicidal behaviours in adolescent non-daily smokers compared to daily smokers and never-smokers in Korea: National cross-sectional study

Abstract

IntroductionWe aimed to investigate the association of non-daily smoking with depressive symptoms and suicidal behaviours among adolescents by analysing data from the 2016 Korean Youth Risk Behavior Web-based Survey (KYRBWS), a national school-based survey.MethodsWe analysed data from a nationally representative sample of Korean adolescents aged 12–18 years (n = 65,528). We investigated the risks of depressive symptoms, suicide ideation, plan and attempt in adolescent non-daily smokers using multiple logistic regression analyses after adjusting for confounding factors. Taking into account the trajectory of smoking patterns in adolescents, we assessed all analyses with stratification by early (aged 12–15) and late (aged 16–18) adolescents.ResultsAmong early adolescents, non-daily smokers were more likely to have depressive symptoms, suicide ideation and plan compared with never smokers and even more likely to have depressive symptoms compared with daily smokers. Among late adolescents, non-daily smokers had higher risks of depressive symptoms, suicide ideation, plan and attempt than never smokers, whereas the risk for suicide attempts was lower than daily smokers.ConclusionsOur findings suggest that non-daily smoking in adolescents was associated with risks for depressive symptoms and suicidal behaviours, and the association was more prominent in early adolescents. Careful attention on the mental health of adolescent non-daily smokers is needed because this is an increasing and easily overlooked group.

Cigarette smoking, depressive symptoms, and social cognitions

“…These findings differ to what has been found in most studies with cross-sectional analyses in which different smoking behaviors have been related to depressive symptoms (Lee et al, 2018;Moon et al, 2010;Tjora et al, 2014). For example, Tjora et al, (2014) found that daily smoking was associated with depressive symptoms in cross-sectional analyses in almost all waves of data from the study, starting during early adolescence when participants were 13 years old to adulthood when they were 30 years old.…”

“…Not only has daily smoking been associated with depressive symptoms, but also occasional smoking. In a more recent study conducted in Korea, Lee et al (2018) showed that adolescents ages 12 to 18 with depressive symptoms were more likely to occasionally smoke in comparison to those who did not show elevated symptoms of depression.…”

“…Operationalization of smoking behaviors and definitions used vary greatly across studies. For example, researchers in other studies have examined smoking onset (Lechner et al, 2017;Wellman et al, 2016), daily smoking (Berg et al, 2013;Lee et al, 2018), and other variants of occasional smoking, such as lifetime smoking and smoking within the last 30 days (Clark et al, 2011;Fröjd et al, 2013).…”

The Neglected Role of Physical Education Participation on Suicidal Ideation and Stress in High School Adolescents from South Korea

“…and recorded on a five-point Likert scale (low = 1, mid-low = 2, mid = 3, mid-high = 4, high = 5) [39]. The scale was converted into a three-level variable (low/mid-low = 1, mid = 2, mid-high, high = 3) [40]. High scores indicate high academic achievement.…”

Self-reported history of intensity of smoking is associated with risk factors for suicide among high school students

“…A recent systematic review found that current cigarette smokers (i.e., smoked at least 100 cigarettes and smoked in the past 30 days) were nearly twice as likely to report suicidal ideation, suicide planning, and suicide attempts compared to non-smokers [ 6 ]. Moreover, cigarette smoking is associated with depression [ 7 ], a leading predictor of suicidal behavior [ 8 ].…”