The Association between Smoking Initiation and Depressed Mood among South Korean Adolescents

Monday, 7 July 2008
Sunhee Park, PhD, MPH, RN , College of Nursing Science, Kyunghee University, Seoul, South Korea

Learning Objective 1: have information on the causal association between smoking initiation and depressed mood.

Learning Objective 2: know the importance of implementing interventions for depressed feelings in order to prevent experimentation with risk behaviors such as smoking.

Smoking in adolescence needs special attention because of its potentially harmful effects on health (e.g., bronchitis and cancer). Another important health issue during adolescence is depression because of its high prevalence and negative consequences, such as suicide. Researchers have agreed on the existence of the association between smoking and depression. Nevertheless, they have not reached a consensus on a causal association between smoking and depression. There are two suggested relationships, depression as an antecedent of smoking initiation and vice versa. This study examined the relationship between the two factors. Secondary data of the two-wave Korean Youth Panel Study representative of third-year students at middle schools in 2004, were analyzed. Two samples were chosen at Time 1: those who were non-smokers (N=2,958) and those who did not report depressed feelings (N=417). With non-smokers at Time 1, binary logistic regression was used to examine the effect of depressed mood at Time 1 on smoking initiation at Time 2 (one-year later). With those with no depressed mood at Time 1, multiple regression was applied to explore the effect of smoking at Time 1 on depressed mood at Time 2. In addition to a predictor of interest in each analysis, 13 demographics and potential confounders were used to control for their effects. After adjusting for other covariates, a one-unit increase in depressed mood significantly raised the risk of smoking initiation one year later by about 30%. However, the influence of smoking behavior on depressed mood was not statistically significant. The finding implies that a depressed mood in adolescence functions as a cause of smoking. Depressed adolescents tend to smoke to change their mood. With these results, providing other substitutes (e.g., exercise) would be desirable. By doing so, experimentation with smoking may be reduced and ultimately, the harmful consequences of smoking will be prevented.