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.