Cigarette smoking, major depression, and other psychiatric disorders among adolescents

J Am Acad Child Adolesc Psychiatry. 1996 Dec;35(12):1602-10. doi: 10.1097/00004583-199612000-00011.


Objective: To examine cross-sectionally and prospectively relationships of cigarette smoking with major depressive disorder (MDD), controlling for comorbidity in a community sample of adolescents.

Method: A representative sample of 1,709 adolescents (aged 14 through 18 years) was assessed by using semistructured diagnostic interviews on two occasions, approximately 1 year apart. Logistic regression analyses were used to examine cross-sectionally and prospectively the relationships between smoking and each psychiatric disorder, while statistically controlling for the other disorders.

Results: Cross-sectional analyses revealed significant relationships of drug abuse/dependence and disruptive behavior disorders with adolescent smoking, even after the co-occurrence of all other disorders was controlled. Prospectively, smoking was found to increase the risk of developing an episode of MDD and drug abuse/dependence, after adjusting for other disorders. Finally, only lifetime prevalence of MDD remained a significant predictor of smoking onset, after controlling for other disorders. Gender did not moderate any of the relationships between psychopathology and smoking.

Conclusions: The results suggest important relationships between cigarette smoking and psychiatric disorders among adolescents, particularly with regard to MDD, drug abuse/dependence, and disruptive behavior disorders. These findings have important clinical implications, both for psychiatric care and for smoking prevention and cessation efforts with adolescents.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Cross-Sectional Studies
  • Depressive Disorder / complications*
  • Female
  • Humans
  • Logistic Models
  • Male
  • Mental Disorders / complications
  • Oregon / epidemiology
  • Prospective Studies
  • Risk Factors
  • Smoking / epidemiology*