Smoking linked to teen depression
Teenagers who are heavy smokers are more likely to suffer from depression than their peers, according to researchers at the University of Alabama at Birmingham.
Teenagers who smoked more than 20 cigarettes a day for six months were more likely to have more depressive symptoms than teenagers who smoked less or not at all, said UAB psychologist Michael Windle and his research assistant and wife, Rebecca C. Windle.
Teenagers who are heavy smokers reported feeling lonely and helpless, seeing themselves as failures more frequently than those who smoke less. The researchers said those symptoms are associated more with depression.
The UAB study looked at the depression levels and smoking habits of 1,218 teenagers in western New York for two years. The average age of those studied was 15. The research was published in the April issue of the Journal of Consulting and Clinical Psychology, a periodical of the American Psychological Association.
In addition to smoking levels, Windle and researchers measured students' family involvement and support, delinquent behavior, family history of smoking and their use of alcohol and illicit drugs.
Earlier studies showed a link between depression and smoking, but the Windles' research ruled out factors such as behavior and family history that could cause depressive symptoms. They also studied the participants for a longer period of time, Windle said.
Smoking and depression appear to reciprocally influence each other, the Windles said.
It could be that teenagers or even adults with high levels of depression significantly increase cigarette smoking in attempts to alleviate their depressive symptoms, the authors said. Because nicotine is a stimulant, it makes a person feel better for a while, but the body requires more nicotine over time to continue its effect, Michael Windle said.
"In adolescence there are a lot of changes that make them more subject to depression," he said. "They start smoking to self-medicate."
Windle said when a teen stops smoking, depression can follow.
"There is an increase of depression that leads to a tendency to increase smoking and then an increase in depression," he said. "It's not just willpower to stop. ... There's a lot of things going on here."
Some high schools offer smoking cessation programs, but rarely address depression. "It's important as far as any efforts to encouraging smoking cessation to also treat depression symptoms after."
Programs also should look at how teenagers internalize problems, realizing that those who have excessive negative moods, low self-esteem and suicidal thoughts could be at risk for starting to smoke. Arming these teenagers with ways to cope with problems without smoking could make all the difference, the Windles found in their study.
Windle said he plans to continue studying smoking and depression in a long-term study. The researchers will follow participants from age 8 to 20, observing those who initiate smoking and its progression over time.