Longitudinal Associations Between Smoking and Depressive Symptoms Among Adolescent Girls

Abstract

Adolescence is an important period for initiation of smoking and manifestation of depression, which are often comorbid. Researchers have examined associations between depressive symptoms and smoking to elucidate whether those with increased depressive symptoms smoke more to self-medicate, whether those who smoke experience increased subsequent depressive symptoms, or both. Collectively, there have been mixed findings; however, studies have been limited by a) cross-sectional or short-term longitudinal data, or b) the use of methods that test associations, or only one direction in the associations, rather than a fully-reciprocal model to examine directionality. This study examined the associations between smoking and depressive symptoms in a sample of adolescent girls using latent dual change scores to model 1) the effect of smoking on change in depressive symptoms, and simultaneously, 2) the effect of depressive symptoms on change in smoking across ages 11 to 20. Data were from a cohort-sequential prospective longitudinal study (N = 262). Girls were enrolled by age cohort (11, 13, 15, and 17 years) and were primarily White (61%) or African American (31%). Data were restructured by age. Every 6 months, girls reported depressive symptoms and cigarette use. Results indicated that, controlling for socio-demographic characteristics, higher levels of smoking predicted a greater increase in depressive symptoms across adolescence. These findings suggest that a higher level of cigarette smoking does contribute to more depressive symptoms, which has implications for prevention of depression and for intervention and future research.

The Association of Cigarette Smoking With Depression and Anxiety: A Systematic Review

“…127 One study investigated the association of baseline anxiety with subsequent smoking heaviness and found no evidence of an association. 124 Eight studies investigated the association of heaviness of smoking with later depression, of which seven (88%) found evidence to support this association, 11,82,95,102,125,127,128 while one (13%) found no evidence of an association. 129 One study investigated the association of heaviness of smoking with later anxiety and found evidence to support this association.…”

Adolescent Substance Use and the Brain: Behavioral, Cognitive and Neuroimaging Correlates

“…Depression and depressive symptoms are consistently observed in smoking adolescents compared to their non-smoking peers (Wu and Anthony, 1999 ; Goodman and Capitman, 2000 ; Albers and Biener, 2002 ; Jacobsen et al, 2007c ; Needham, 2007 ; Ilomäki et al, 2008 ; Audrain-Mcgovern et al, 2009 ; Morrell et al, 2010 ; Slomp et al, 2019 ). Most studies of this age group found smoking positively predicted the development of depression and depressive symptoms (Brown et al, 1996 ; Stein et al, 1996 ; Choi et al, 1997 ; Goodman and Capitman, 2000 ; Windle and Windle, 2001 ; Albers and Biener, 2002 ; Brook et al, 2002 , 2004 ; Galambos et al, 2004 ; Duncan and Rees, 2005 ; Rodriguez et al, 2005 ; Boden et al, 2010 ; Moon et al, 2010 ; Jamal et al, 2011 ; Beal et al, 2014 ; Gage et al, 2015 ), but not all findings have supported this association (Wang et al, 1996 ; Repetto et al, 2005 ; Clark et al, 2007 ; Munafò et al, 2008 ; Hu et al, 2011 ; Strong et al, 2014 ). Importantly, the relationship between smoking and depression in adolescence has been suggested to be bidirectional, such that baseline depression contributes to the risk for future smoking habits just as baseline smoking predicts depression (Brown et al, 1996 ; Windle and Windle, 2001 ; Galambos et al, 2004 ; Needham, 2007 ; Audrain-Mcgovern et al, 2009 ; Moon et al, 2010 ).…”

Cigarette smoking, depressive symptoms, and social cognitions

“…Similarly, Clark, Ringwalt, & Shamblen (2011) investigated whether depressive symptoms predicted future smoking among middle school students and found that depressed mood while in 6 th grade predicted cigarette use in the 8 th grade. In contrast, Beal, Negriff, Dorn, Pabst, and Schulenberg (2014) explored the association in a sample of adolescents girls from ages 11 to 20 using latent dual change scores. They found that higher levels of smoking predicted an increase in depressive symptoms across the years.…”

“…The relationship between depression and smoking in adolescents is complex. The way the relationship has been studied varies based on distinct methodologies used, which is further complicated by a variety of distinct population characteristics that have been studied (e.g., younger vs. older adolescents, girls vs. boys, and clinical vs. non-clinical samples) (Beal et al, 2014;Wilkinson et al, 2016). Researchers have been investigating the mechanisms and the nuances of this association among adults and adolescents.…”

“…Furthermore, those adolescents who were regular smokers showed the highest levels of depression. Beal et al (2014) found that the higher the number of cigarettes used, the higher the depression scores, In another longitudinal study, Meng and D'Arcy (2014) studied risks for depression by different factors. In the youngest group, including individuals from 12 to 24 years old, smoking regularly was associated with increased risk of having episodes of major depression 12 years later.…”