Long-term Effects of Adolescent Smoking on Depression and Socioeconomic Status in Adulthood in an Urban African American Cohort

Abstract

Despite known adverse causal effects of cigarette smoking on mental health, findings for the effects of adolescent cigarette smoking on later depression and socioeconomic status remain inconclusive. Previous studies have had shorter followup periods and did not have a representative portion of the African American population. Using an analytical method that matches adolescent smokers with nonsmokers on childhood and background variables, this study aims to provide evidence on the effects of adolescent regular smoking on adult depression and socioeconomic status. Our longitudinal study is from the Woodlawn Study that followed 1,242 African Americans in Chicago from 1966-1967 (at age 6-7) through 2002-2003 (at age 42-43). We used a propensity score matching method to find a regular and a non-regular adolescent smoking group with similar childhood socioeconomic and family background and first grade academic and behavioral performance. We compared the matched samples to assess the longitudinal effects of adolescent smoking on adult outcomes. Comparing the matched 199 adolescent regular smokers and 199 non-regular smokers, we found statistical support for the effects of adolescent cigarette smoking on later educational attainment (OR, 2.13; 95 % CI, 1.34, 3.39) and long-term unemployment (OR, 1.74; 95 % CI, 1.11, 2.75), but did not find support for the effects on adulthood major depressive disorders. With a community population of urban African Americans followed for 40 years, our study contributes to the understanding of the relationships between adolescent smoking and later educational attainment and employment.

Effect of Adolescent Cigarette Smoking on Adulthood Substance Use and Abuse: The Mediating Role of Educational Attainment

“…Data from the National Longitudinal Study of Adolescent Health indicate that, after adjusting for age and race, men who had no further education and were economically inactive had four times greater odds of heavy smoking than men with further education (Yang et al, 2008). We also previously demonstrated the association of adolescent smoking on later educational attainment with the same study sample as this paper using a propensity score matching method (Strong, Juon, & Ensminger, 2014). On the other hand, educational attainment was found to be associated with the use of alcohol (Melotti et al, 2011), marijuana (Grant et al, 2012), and other drugs (Fothergill et al, 2008).…”

“…At that time, it was composed of 99% African Americans and 51.2% females (Kellam, Branch, Agrawal, & Ensminger, 1975). More detail on attrition analyses can be found in our previous publication (Strong et al, 2014). …”

“…We used the propensity score matching method to account for early-life or childhood covariates in relation to adolescent smoking, and to obtain a matched sample, following the methods used in our previous study on the same sample of this study (Strong et al, 2014). Propensity score matching was conducted with psmatch2 in Stata statistical software (StataCorp, 2007).…”

Active smoking and exposure to secondhand smoke and their relationship to depressive symptoms in the Korea national health and nutrition examination survey (KNHANES)

“…Nevertheless, there are some contradicting results. Studies conducted with African Americans failed to find any harmful physical effects of cigarette smoking on major adulthood depressive disorders [ 44 , 45 ].…”

Smoking, alcohol consumption, and illicit substances use among adolescents in Poland

“…Exposure to high levels of nicotine during adolescence may result in damage to sensitive developmental phases and may have a cumulative effect over time. Strong et al [ 8 ] showed, that early cigarette smoking among African Americans is correlated with later educational problems and long-term unemployment. Daily smoking increases the likelihood of remaining or becoming physically inactive over time [ 9 ].…”