Tobacco smoking and health-related quality of life among university students: Mediating effect of depression.

Marija Milic,Darija Kisic Tepavcevic,Tatjana Gazibara,Aleksandra Popovic,Tatjana Pekmezovic,Hagai Levine,Karamchand Hukumchand Patil,Gorica Maric,Jasmina Stevanovic,Stanton A. Glantz

doi:10.1371/journal.pone.0227042

Marija Milic, Darija Kisic Tepavcevic + Show 8 more

Open Access

https://doi.org/10.1371/journal.pone.0227042

Copy DOI

Journal: PloS one	Publication Date: Jan 8, 2020
Citations: 37	License type: CC BY 4.0

Affiliation: Hebrew University of Jerusalem, University of Belgrade

Abstract

The aim of this study was to assess the association between cigarette smoking and health-related quality of life (HRQoL) among students in two different universities, and the potential mediating effect of depression. Participants were students who came for mandatory check-ups at Student Health Care Centers in two Universities in Serbia, differing by socio-politically and economically environments. Students completed socio-demographic questionnaire, Beck Depression Inventory (BDI) and the SF-36 questionnaire for assessment of HRQoL. In both populations, after adjustment for socio-demographic, behavioral and health factors, smoking was associated with poorer Mental Composite Score (MCS) and Physical Composite Score (PCS) (Belgrade 1,624 students: MCS β = 3.38, 95% confidence interval [CI] 1.31, 5.44, PCS β = 1.01, 95% CI -0.50, 2.52; Kosovska Mitrovica 514 students: MCS β = 5.06, 95% CI 1.74, 8.37, PCS β = 3.29, 95% CI 0.75, 5.83). After additional adjustment for BDI score, the observed associations were lost (Belgrade: MCS β = 1.12, 95% CI -0.57, 2.80, PCS β = -0.40, 95% CI -1.71, 0.92; Kosovska Mitrovica: MCS β = 0.77, 95% CI -2.06, 3.60, PCS β = 0.56, 95% CI -1.75, 2.87). Higher BDI score was associated with poorer PCS and MCS across all quintiles. The association of smoking with impairment of HRQoL among university students in two different settings was mediated by higher levels of depressive symptoms. These findings highlight the need for further research on the interaction between smoking, mental health and quality of life, with implications for prevention, diagnosis and treatment.

Highlights

Smoking and exposure to tobacco smoke are a major risk factor of morbidity and mortality worldwide [1]
Students who ever smoked had lower Mental Composite Score (MCS) compared to students who had never smoked in their lifetime in both student samples (Belgrade 67.3 ± 19.9 vs. 72.3 ± 17.8, p = 0.001; Kosovska Mitrovica 70.5 ± 19.7 vs. 77.6 ± 15.8, p = 0.001) and the some results was obtained for Physical Composite Score (PCS) (Belgrade 78.3 ± 14.7 vs. 80.6 ± 12.9, p = 0.004; Kosovska Mitrovica 77.6 ± 15.9 vs. 83.2 ± 12.2, p = 0.001)
Scores of healthrelated quality of life (HRQoL) related to mental health were lower compared with scores of domains related to physical health (Table 2)

Summary

Introduction

Smoking and exposure to tobacco smoke are a major risk factor of morbidity and mortality worldwide [1]. Evidence suggests that nearly 9 out of 10 current smokers initiated smoking. Tobacco smoking and depression among students distribute smoking cessation pharmacotherapy in Israel. This does not alter our adherence to PLOS ONE policies on sharing data and materials. Depression has been considered as a common mental health disorder among University students [4]. In this particular population, smoking has been reported as a predisposing factor for the development of depressive symptoms [5, 6]. A recent study found strong evidence to support a hypothesis that smoking could be a risk factor for development of depression for both lifetime smoking and smoking initiation [10]

Objectives

Methods

Results

Conclusion