BACKGROUND: Although research has established the existence of an association between smoking and depression among adolescents, researchers have not reached consensus on the nature of the association. OBJECTIVES: The purpose of this paper is to review the literature, to examine the nature of the relationship between smoking and depression in adolescence, and to suggest future research directions. METHOD: A literature search was conducted from the following six databases: (a) Ovid MEDLINE, (b) CINAHL, (c) PubMed Unrestricted, (d) PsycINFO, (e) ERIC, and (f) Sociological Abstracts. The combinations of the words, "depression," "smoking," "tobacco," "adolescent," and "teen" were used for keyword searches to find relevant articles. RESULTS: In 47 of 57 studies, significant associations between smoking and depression were found. However, these significant relationships may either be spurious or unrelated to depression because a substantial number of studies did not adjust for confounders or did not use validated instruments to measure depression. Additionally, if the relationship is causal, its direction remains controversial. Five relationships have been suggested: (a) Depression causes smoking, (b) smoking causes depression, (c) there is a bidirectional relationship between smoking and depression, (d) smoking and depression occur due to confounders, and (e) subgroups with different relationships between the two conditions exist. CONCLUSIONS: It is necessary to further explore the relationship between smoking and depression. Future research should consider the need for: (a) longitudinal research designs, (b) more accurate measurement of depression, and (c) the control of confounders between smoking and depression.
Adolescent ; Age of Onset ; Causality ; Depressive Disorder/*epidemiology/psychology ; Disease Progression ; Humans ; Smoking/*epidemiology/psychology

BACKGROUND/AIMS: Patients with chronic airway lung diseases often experience depression and anxiety, but little information is available regarding Koreans with these conditions. We thus assessed depression and anxiety in Korean patients with chronic airway lung diseases. METHODS: The degree of depression and anxiety in 84 outpatients with chronic obstructive pulmonary disease (COPD), 37 with asthma, 33 with bronchiectasis, and 73 healthy controls were evaluated by the Beck Depression Inventory (BDI) and the State-Trait Anxiety Inventory (STAI). RESULTS: The patients with COPD and bronchiectasis had higher BDI scores and were more likely than controls to experience depression ([COPD, 17; range, 0 to 42; prevalence, 55%], [bronchiectasis, 16; range, 3 to 51; prevalence, 55%], [controls, 13; range, 0 to 31; prevalence, 30%], p < 0.05). The state-anxiety scores of the patients were higher than those of the controls, but only the bronchiectasis group demonstrated a higher frequency of state-anxiety compared with the controls (39 vs. 16%, patients vs. controls, p = 0.015). Among all patients, 22% presented with concomitant depression and state-anxiety, and 25% demonstrated depression and trait-anxiety. Depression was positively correlated with both state-anxiety (r = 0.644) and trait-anxiety (r = 0.597, p < 0.0001). Irrespective of individual diagnosis, post-bronchodilator FEV1 (odds ratio [OR], 0.972; p = 0.027) and smoking history (OR, 3.894; p = 0.018) were independent risk factors for depression in patients with chronic airway lung diseases. CONCLUSIONS: Chronic airway lung diseases are associated with depression and/or anxiety, particularly in those with a higher airflow limitation and/or history of smoking.
Aged ; Aged, 80 and over ; Anxiety/*epidemiology ; Asthma/epidemiology/psychology ; Bronchiectasis/epidemiology/psychology ; Chronic Disease ; Depression/*epidemiology ; Female ; Humans ; Male ; Middle Aged ; Prevalence ; Pulmonary Disease, Chronic Obstructive/*epidemiology/*psychology ; Risk Factors ; Smoking/epidemiology/psychology

We conducted this cross-sectional study to elucidate factors that predict persistent smoking of the Korean cancer survivors. The subjects were 130 adult (> or =19 yr old) cancer survivors who were smokers at the diagnosis of cancer and have participated in the Korean National Health and Nutrition Examination Surveys conducted from 2007 to 2011. We categorized them into the persistent smokers and the quitters, according to change in smoking status between the time of cancer diagnosis and the time of the survey. Factors associated with persistent smoking were evaluated using the multiple logistic regression analysis. During 7.52 yr (standard deviation = 0.34) after the cancer diagnosis, 59.6% of the 130 cancer survivors have continued to smoke. After adjusting for covariates, following factors were independently associated with the risk of persistent smoking: female, low income, high-risk alcohol use, high body mass index (> or = 25 kg/m2), presence of household members who smoke, and longer duration of smoking. Alcohol Use Disorders Identification Test showed a positive association with the risk of persistent smoking (P for trend = 0.012). In conclusion, more efforts for smoking cessation should be in place for the cancer survivors with those risk factors associated with the persistent smoking.
Adult ; Alcohol Drinking ; Cross-Sectional Studies ; Female ; *Health Behavior ; Humans ; Male ; Neoplasms/*mortality ; Republic of Korea/epidemiology ; Risk Factors ; Smoking/*epidemiology ; Smoking Cessation/psychology ; Surveys and Questionnaires ; Survivors/*psychology

PURPOSE: The aim of this study was to identify factors associated with early initiation of cigarette smoking among Korean adolescents. METHODS: A secondary analysis was conducted on the 2012 Korea Youth Risk BehaviorWeb-based Survey data using Cox proportional hazards regression. RESULTS: Early smoking initiation was associated with being male, having a positive subjective health status, perceiving oneself as thin or average weight (body image), having an average happiness level, being stressed, consuming alcohol, having suicidal ideation, experiencing sexual intercourse, having low or average academic grades, having a parental education level of high school or below, not taking a family trip in the previous 12 months, and having a family that approves of smoking in the home. CONCLUSIONS: Interventions targeting the prevention of smoking initiation among adolescents should include individual factors such as health status, body weight, perceived mental health status, health-risk behaviors, and academic characteristics as well as family factors that reinforce family cohesion and home smoking bans. Moreover, male adolescents aged 12e13 years and their parents should be the main target of these interventions.
Adolescent ; Adolescent Behavior/*psychology ; Child ; Female ; Humans ; Male ; Proportional Hazards Models ; Republic of Korea ; Risk Factors ; *Smoking/epidemiology/psychology ; Time Factors

OBJECTIVETo study the contribution of puberty maturation to smoking behavior in Chinese adolescents.

METHODSA cross-sectional survey was carried out. One thousand four hundred and fifty-three senior middle school students aged from 15 - 18 years were recruited in Shanghai in 2000. A standardized self-administrated questionnaire was designed to obtain information on smoking, age at first nocturnal ejaculation in boys, age at menarche in girls and variables that might be associated with smoking in adolescents.

RESULTSIn boys, the prevalence of experimental smoking was highest among later maturers (28.6%), followed by the earlier (21.3%) and the average (21.7%), and the prevalence of current smoking was highest among earlier maturers (16.4%), followed by the later (7.1%) and then the average (4.8%). In girls, the prevalence of ever smoked among earlier, average and later maturers were as follows: 24.2%, 12.0%, 6.3% respectively. When psychosocial variables which might be associated with smoking were under control, early maturation was a significant risk factor for current smoking in boys (OR = 3.68, 95% CI: 1.23 - 10.99), and might be a risk factor for ever smoked in girls (OR = 2.23, 95% CI: 0.89 - 5.60). Whereas late maturation might have been a risk factor for boys to experiment smoking (OR = 1.48, 95% CI: 0.72 - 3.06), while in girls it might be protective (OR = 0.64, 95% CI: 0.22 - 1.86).

CONCLUSIONEarlier or later matured boys and earlier matured girls were at higher risk of smoking. Pubertal changes and timing need to be considered in smoking prevention.

Adolescent ; Adolescent Behavior ; Female ; Humans ; Male ; Puberty ; physiology ; psychology ; Risk Factors ; Sexual Maturation ; physiology ; Smoking ; epidemiology ; psychology ; Statistics as Topic

OBJECTIVETo explore the situation of smoking behavior among the students of middle school in Beijing, Hangzhou, Wuhan and Urumchi and to analyze the relationship between smoking behavior and several unhealthy behaviors together with psychological troubles to provide evidence in developing an early intervention plan.

METHODSThe National Health Education Institute (NHEI) of Chinese Center for Disease Control and Prevention (CDC) provided relevant data on all middle schools in the 4 cities and then U.S. CDC randomly sampled 100 common middle schools from them with a special sampling process. The core questionnaire developed by the experts from WHO and other countries was used in the survey among 9015 sampled students.

RESULTSAmong all the sampled students, 29.4% of them had ever attempted cigarettes smoking while 6.6% of them tried tobacco in the 30 days before survey, 27.0% of the students with smoking behavior began smoking at the age of 9 or younger, 31.8% had learned how to refuse smoking from school education. The students with smoking behavior were more likely to drink alcohol, use drugs, bully others, be injured, miss classes, and have some psychological troubles than those without smoking behavior.

CONCLUSIONThere were increasing trends noticed on the incidence of attempt and smoking cigarettes. Smoking was closely related to other unhealthy behaviors and psychological troubles. Comprehensive education activities on "no-smoking" should be implemented as early as possible among adolescents, as well as to promote training on life skills.

Adolescent ; Adolescent Behavior ; Child ; China ; epidemiology ; Health Behavior ; Humans ; Incidence ; Mental Disorders ; Smoking ; epidemiology ; Students ; psychology ; Substance-Related Disorders

Objective: To understand the status, attitude and related risk factors on smoking among 18-65 years old patients with hypertension, diabetes, dyslipidemia, chronic obstructive pulmonary disease (COPD) or asthma in Beijing. Methods: Data was gathered from the 2014 Beijing Non-communicable and Chronic Disease Surveillance Program. Multiple classified cluster sampling method was used and 19 815 participants aged 18-65 were sampled from 16 districts in Beijing. Results: Among all the 18 405 participants, male hypertensive patients showed a higher rate on current smoking than the other groups (χ(2)=17.695, P<0.001). Male patients with dyslipidemia had higher current smoking rate than the other groups (χ(2)=39.292, P<0.001). However, female patients with COPD or with asthma showed higher rate on current smoking than the other groups (χ(2)=6.276, P=0.012), (χ(2)=8.245, P=0.004). Among the smokers, hypertensive patients presented lower rate (χ(2)=20.487, P<0.001) on intention of smoking concession, than the other groups. Patients with COPD showed greater intention in quitting smoking (χ(2)=6.085, P=0.048), than the other groups. Male patients with diabetes (χ(2)=9.219, P=0.010) or dyslipidemia (χ(2)=13.513, P=0.001) who had stopped smoking tobacco appeared having higher rates in keeping the current status. Results from logistic regression analyses showed that smoking was the risk factor for hypertension (OR=1.17), dyslipidemia (OR=1.25), COPD (OR=1.78), and asthma (OR=1.57). Conclusions: Patients with certain kinds of chronic diseases showed higher rate of current smoking and lower rate of quitting. Cigarette consumption appeared an important risk factor for patients with hypertension, dyslipidemia, COPD, or asthma in Beijing.
Adolescent ; Adult ; Aged ; Asthma/epidemiology* ; Beijing/epidemiology* ; Chronic Disease/epidemiology* ; Diabetes Mellitus/epidemiology* ; Female ; Humans ; Hypertension/epidemiology* ; Intention ; Male ; Middle Aged ; Pulmonary Disease, Chronic Obstructive/epidemiology* ; Risk Factors ; Smokers ; Smoking/psychology* ; Smoking Cessation ; Nicotiana/adverse effects*

OBJECTIVETo investigate tobacco-related knowledge, attitudes and analyze related factors among the college students in Guangzhou.

METHODSIn May 2012, 11 593 college students from six universities in Guangzhou were selected and investigated by stratified cluster random sampling.Investigation content includes social demographic information, smoking behaviors, tobacco-related knowledge and attitudes. Chi-square test was used to analyze the difference about knowledge of harm of tobacco and awareness of tobacco control related legislation as well as tobacco-related attitudes between smokers and non-smokers. Factors on tobacco-related knowledge were analyzed by using rank sum test.

RESULTSCurrent smoking rate among undergraduates was 6.1% (706/11 593) , 11.5% (622/5388) for males and 1.4% (84/6205) for females. The awareness rate of that smoking addiction was a chronic disease in non-smokers(82.6%, 8954/10 836) was higher than that in smokers (73.1%, 509/696) (χ(2) = 40.09, P < 0.01). The awareness rate about smoking could cause emphysema in college students was 78.6% (8986/11 427) , and the rate was higher in non-smokers(79.3%, 8522/10 741) than that in smokers(67.6%, 464/686)(χ(2) = 52.57, P < 0.01). The awareness rate about passive smoking could cause lung cancer in college students was 84.6% (9636/11 391) , and the rate was higher in non-smokers (85.2%, 9125/10 706) than that in smokers (74.6%, 511/685) (χ(2) = 55.86, P < 0.01). The awareness about Framework Convention on Tobacco Control was 25.7% (2966/11 554) , and the rate was lower in non-smokers (25.3%, 2751/10 856) than that in smokers (30.7%, 215/700) (χ(2) = 9.80, P < 0.01). Among smokers, 54.8% (377/688) considered that smoking was enjoyful. This was higher than that in non-smokers (16.8%, 1802/10 752) (χ(2) = 606.92, P < 0.05). Among non-smokers, 92.2% (9935/10 781) considered that government should strengthen smoking control. The percentage was higher than that in smokers (74.2%, 515/694) (χ(2) = 258.13, P < 0.05). College students who were females, at high-grade and with high parental educational level, high monthly household income, high living expenses per month in school and household registration in towns and places out of Guangdong province showed higher tobacco-related knowledge score (all P values <0.01).

CONCLUSIONThe awareness of tobacco-related knowledge was not high generally among college students in Guangzhou, but the awareness was significantly higher in non-smokers than that of smokers. The related factors which influenced the awareness rate of tobacco-related knowledge include sex, grade, place of household registration, parent's educational level and household income.

Adolescent ; Adult ; China ; epidemiology ; Female ; Health Knowledge, Attitudes, Practice ; Humans ; Male ; Smoking ; epidemiology ; Smoking Prevention ; Students ; psychology ; Surveys and Questionnaires ; Tobacco Smoke Pollution ; prevention & control ; Universities ; Young Adult

BACKGROUND: Suicidal behaviors are seriously social issues among adolescents in the world. Exposed to smoking and being bullied are risk factors of suicidal behaviors. The present study was aimed to examine the interaction of smoking and being bullied on suicidal behaviors among Chinese adolescents. METHODS: A total of 18,900 students were involved in the questionnaire study, in four cities of China from November 2017 to January 2018. Suicidal behaviors, smoking, and being bullied were measured by self-reported validated instruments. Chi-square tests and logistic regression were used to analyze the associations of suicidal ideation (SI)/suicidal plan (SP)/suicidal attempt (SA), smoking, and being bullied. RESULTS: The prevalence of smoking, being bullied, SI/SP/SA, were 3.1%, 20.6%, 26.4%, 13.2%, and 5.2% respectively. Interaction analysis indicated that being bullied was associated with a greater increase in the likelihood of suicidal behaviors for adolescents with smoking than for those without smoking. CONCLUSIONS These finding suggest that smoking exacerbates the association between being bullied and suicidal behaviors. Future research should explore how and why smoking appears to more bully-victims than for those without smoking and how to mitigate it.
Adolescent ; Adolescent Behavior/psychology* ; Bullying/psychology* ; Child ; China/epidemiology* ; Cross-Sectional Studies ; Humans ; Prevalence ; Smoking/psychology* ; Students/statistics & numerical data* ; Suicidal Ideation

OBJECTIVETo understand the prevalence of cigarette smoking among employed floating population in China and to provide evidence for developing prevention and control measures targeted at cigarette smoking among them.

METHODSOn the basis of the Disease Surveillance Points (DSPs)System and employed distribution among floating population, the China Non- communicable and Chronic Disease Risk Factor Surveillance in 2012 sampled from 170 DSPs, multi-stage stratified equal-sized cluster sampling method was used and stratified by six occupational groups. Cigarette smoking related information among the employed floating population was collected by face-to-face interviews. The analytical method accounted for the complex sampling design.

RESULTSThere were 48 699 subjects, aged 18-59 years old, eligible and included in this analysis among the surveyed employed floating population. Among them, the prevalence of current smoking was 32.5% (95%CI: 32.0%-33.0%). A significantly higher percentage of men 55.3% (95%CI:54.6%-56.0%)relative to women 1.9% (95% CI:1.7%-2.1%)reported current smoking(χ(2) = 2.6, P = 0.103 7). Among men, differences in current smoking rates remained similar across age groups (χ(2) = 2.6, P = 0.103 7), but the current smoking rate tended to be lower with higher education(χ(2) = 140.7, P < 0.000 1). The current smoking rate in men was the highest(58.6% , 95% CI:57.3%-60.0%)in the floating population working in the construction industry. The prevalent of daily cigarette smoking was 27.9% (95% CI: 27.4%-28.4%), with a significantly higher proportion among men 47.8% (95% CI:47.1%-48.5%) than among women 1.3% (95%CI:1.1%-1.4%). Among daily smokers, the mean number of cigarettes smoked was 15.6(95%CI:15.5-15.8)per day(men:15.7 per day; women: 10.3 per day). The number was higher in men 15.7(95% CI:15.6-15.9)than in women 10.3(95% CI:9.3-11.3). Among daily smoking men, the daily consumed cigarettes number increased with the age increased (t = 34.89, P < 0.000 1), whereas the daily consumed cigarettes number decreased with the increase of education level (t = -14.63, P < 0.000 1). The daily consumed cigarettes number in men was the highest (18.2, 95%CI:17.9-18.6)in the floating population working in the construction industry. There were 47.1% of the daily smokers who smoked more than 20 cigarettes per day in the floating population aged 18-59, with a higher percentage among men (47.6%) than women (21.9%). The percentage in men increased with age and education level and the heavy smoking rate was the highest in the construction industry (60.4%). Among current smokers, the percentage of attempting to quit was 10.3% (95%CI: 9.7%-10.8%). A higher proportion of women 14.8% (95% CI:11.1%-18.5%), compared to men 10.1% (95% CI:9.6%-10.7%), reported attempting to quit. The rate of attempting to quit among current smokers increased with age. No significant difference in prevalence of attempting to quit by education level or occupation was seen. The percent of successfully quitting smoking was 6.1% (95%CI:5.7%-6.5%). The proportion was higher in women 7.2% (95%CI:4.6%-9.8%)than in men 6.1% (95%CI:5.7%-6.5%). The percentage of quitting smoking successfully increased with age (χ(2) = 269.0, P < 0.000 1). The percent of people who exposed to secondhand smoking was 68.7% (95%CI: 68.1%-69.3%). The percent was higher among men 76.4% (95%CI:75.5%-77.3%) than in women 64.0% (95%CI:63.2%-64.9%).

CONCLUSIONSmoking was more common among men in the employed floating population aged 18-59 years old, especially in the construction industry. Low percent was seen among those who attempting to quit, and the ones who successfully quit were very few.

Adolescent ; Adult ; China ; epidemiology ; Employment ; statistics & numerical data ; Female ; Humans ; Male ; Middle Aged ; Prevalence ; Smoking ; epidemiology ; psychology ; Transients and Migrants ; psychology ; statistics & numerical data ; Young Adult