Adolescent tobacco smoking and associated psychosocial health risk factors

Abstract

Objective To determine the relationship between tobacco smoking and psychosocial health risk factors in adolescents.Design An in-class survey of schoolchildren in the final grade of basic school and in all three grades of secondary school.Setting Four of the 11 secondary schools in Tartu, Estonia.Subjects 977 schoolchildren, ages ranging from 14 to 18.Main outcome measures A questionnaire was developed to explore various psychosocial aspects of tobacco smoking behaviour. The 21-item Beck Depression Inventory was used to measure depression.Results In the total sample, smokers accounted for 24.5% of the girls and 26.5% of the boys, of which 13% of the girls and 19% of the boys were daily smokers. Not enjoying time spent with parents (OR=0.6), skipping breakfast (OR=1.3), frequent headache (OR=1.3) and stomach-ache (OR=1.4), dislike of school (OR=0.7), using illicit drugs (OR=5.0) and having multiple sexual partners (OR=2.4) were all associated with daily smoking. Higher BDI scores were seen among adolescent smokers, particularly in girls and among pupils whose parents were non-smokers. The girls who smoked daily showed a higher risk of having suicidal thoughts (OR=2.4) compared with non-smokers.Conclusion Smoking by adolescents is an indicator of risk for depression, distress and risk-taking health-damaging behaviours.