"Given the adverse consequences of tobacco smoking and adolescent depression, the association between the two deserves attention early in a child's life," Drs. Li-Tzy Wu and James C. Anthony, of Johns Hopkins University in Baltimore, Maryland, suggest. The duo examined the association between smoking and depression in more than 1,700 youth attending public schools in a metropolitan area and who took part in a 5-year study beginning when they were 8-9 years of age. Teens who smoked were at a "modestly" increased risk of subsequent depression, at 73% higher than other teens. But the converse was not true -- depressed teens did not appear to be more likely than others in the study to start smoking, the investigators report. "The evidence from this sample tends to support a 1-directional relationship from prior tobacco smoking to later depressed mood, but not from depressed mood to initiation of smoking, in the childhood-adolescent transition years," Wu and Anthony say. The new study may lay to rest speculation that the link between depression and tobacco use is the result of a "common factor" in favor of "hypotheses in which nicotine exposure or other components of tobacco smoking are claimed to affect depressed mood," they add. Although the researchers did not observe an association between alcohol use and depression in the youth studied, they believe that a potential link between alcohol, smoking and depression in this population deserves further attention. The findings are reported in the December issue of the American Journal of Public Health: Journal of the American Public Health Association.

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