This study examines the relationship between depression, anxiety, and smoking in early adolescence. Studies have found evidence linking depression and anxiety to the initiation of smoking. The hypothesis is that individuals who smoke frequently display symptoms of depression, prompting the question of whether smoking causes depression. Initially, smoking may offer a calming effect and relieve anxiety. However, after the smoking session ends, the person's emotional state returns to its previous level of distress. Research has indicated that 15-year-olds without a smoking habit but with depression can accurately predict their future smoking habits about ten years later.
The objective of this study is to investigate the correlation between anxiety and depression in adolescents in Victoria, Australia. The research was conducted over a period of three years from August 1992 to July 1995. It involved an
...extensive examination of the health status of adolescents. The study followed a two-step approach, where 45 schools were chosen using stratified sampling, encompassing government, Catholic, and independent schools. The participants consisted of students aged 14 to 15 years old. In the second stage, data collection was performed by selecting a random intact class.
The second wave of the study occurred approximately six months later, involving the same group of participants who had progressed to grade 10. Additionally, a new class was randomly chosen from each school. The participants were informed about the study's focus on health-related matters and examination of various risky behaviors pertaining to health. Both verbal and written consent were required for participation. The questionnaire was administered periodically over a span of four years, starting in grade nine and ending in grade twelve, resulting in a total o
six waves.
The survey was conducted using twenty-nine laptops. If participants were unavailable, they were contacted by telephone to complete the questionnaire. To record daily tobacco consumption, a seven-day retrospective diary was utilized. Participants who did not smoke or were ex-smokers were not required to fill out the diary, minimizing unnecessary questions. The diary helped classify smoking habits based on frequency, resulting in distinct groups such as current daily smokers, current smokers, and ex-smokers.
The mental health status during each wave was assessed using a digital version of the revised Clinical Interview Schedule, which originally measured symptoms of anxiety and depression. The resulting form provided scores classified into 4 levels of psychiatric morbidity: Level 1 (0-5), Level 2 (6-11), Level 3 (12-17), and Level 4 (>18). The data was analyzed using the SAS and Strata programs. To ensure accurate representation, the assessments were weighted based on the inverse sampling fraction in each geographical area to minimize potential under-sampling.
The smoking incident rates were determined by dividing the number of cases by total person-years at risk. The remaining rates were calculated using midpoints between specific data points. Approximately 95.8% of the 2,032 students completed the questionnaire at least once. The response rates for each wave were as follows: Wave 1 - 86.6%, Wave 2 - 85.5%, Wave 3 - 83.6%, Wave 4 - 80.2%, Wave 5 - 77.6%, and Wave 6 -75.
The percentage of telephone interviews increased from 1% in Wave 1 to 22% in Wave 6. The gender ratio was around 47%.
The age of the students ranged from 14.5 years at Wave 1 to 17.4 years at Wave 6. This report specifically looks
at the data from 1688 participants (83%) who had data for at least two consecutive waves in the study. Out of these participants, there were 422 individuals who were identified as current smokers when they joined the study and 151 students who smoked daily. Students with smoker friends had a smoking risk that was 36 times higher than those without smoker friends. The behavior of friends greatly influences peer pressure.
The impact of peers, whether they are friends or co-workers, has an effect on individuals. Different factors such as friends/peers, being a former smoker, and parental smoking can forecast the start of smoking. In general, the analysis investigated the connection between smoking and future mental health issues by examining movements towards a high Clinical Interview Schedule status with scores of 12+. However, upon closer inspection, it was determined that neither the occurrence of smoking nor the progression to daily smoking indicated a subsequent transition to a high Clinical Interview Schedule status.
This study offers a more definitive risk profile for starting to smoke compared to previous studies. It indicates that trying smoking is a significant indicator of regular use, emphasizing the importance of studying early experimentation in order to develop effective preventive interventions. The study employed stratified random sampling, selecting 45 schools representing government, Catholic, and independent institutions. The participants were adolescents aged 14 to 15.
The population was divided into groups and a random sample was collected from each group. The results were adjusted based on the weights assigned to each group in order to estimate values for each area. Stratified sampling is used primarily to enhance the accuracy of sample statistics, gather enough
data for analyzing different subgroups, and accommodate diverse research methods and procedures within each group.
The results improve as more strata are used, but the cost increases with the number of strata. In my view, this article could have been more comprehensive by including participants from all age groups and not just teenagers from different schools. By incorporating individuals of different ages and ethnicities, the study could have provided further evidence on the correlation between smoking and depression or anxiety.
In my opinion, it is unfair to stigmatize smokers as depressed, and we should not criticize those who are dealing with depression for smoking. The decision to smoke or not ultimately rests on the individual. Teenagers' choice to smoke is heavily influenced by peer pressure. Nevertheless, I do recognize that quitting smoking can result in depression because of withdrawal symptoms. It would have been beneficial if this article had explored further the connection between smoking and anxiety or depression. The psychological evidence provided in the article was insufficient.
Conclusion: This study affirms that experimenting with smoking strongly predicts future smoking behavior, especially the adoption of smoking habits. Those who try smoking are 29 times more likely to become daily tobacco users within six months compared to non-smokers. Furthermore, there is a link between anxiety and depression and an increased susceptibility to peer pressure regarding smoking. Therefore, it is crucial to actively prioritize children's psychological well-being from an early age and address the adverse aspects of smoking as effective measures in preventing early tobacco use.
