Testing the reciprocal association between smoking and depressive symptoms from adolescence to adulthood: A longitudinal twin study

Depression screening outcomes among adolescents, young adults, and adults reporting past 30-day tobacco and cannabis use

BACKGROUND

Few studies examine the relationship between depression and use of specific tobacco and/or cannabis products among adolescents, young adults, and adults. We determined whether the odds of depression are greater among those who used specific tobacco and/or cannabis products and among co-users of tobacco and cannabis.

METHOD

Cross-sectional online survey of a national convenience sample of 13-40-year-olds (N = 6,038). The survey included depression screening and past 30-day use of specific tobacco and cannabis products (cigarettes; e-cigarettes, vaped cannabis, little cigars, cigarillos, cigars, hookah, chewing tobacco, smoked cannabis, edible cannabis, blunts). Analyses correspond to the total sample, and 13-17-, 18-24-, and 25-40-year-olds.

RESULTS

Among 5,281 individuals who responded to the depression screener and nine product use questions, 1,803 (34.1 %) reported co-use of at least one tobacco product and one cannabis product in the past 30 days. Past 30-day co-use was associated with higher likelihood of screening positive for depression compared to past 30-day use of tobacco-only (aOR = 1.32, 1.06-1.65; 0.006) or cannabis-only (aOR = 1.94, 1.28-2.94; <0.001). Screening positive for depression was more likely among those who reported past 30-day use of e-cigarettes (aOR = 1.56; 1.35-1.80; <0.001), cigarettes (aOR = 1.24, 1.04-1.48; 0.016), chewed tobacco (aOR = 1.91, 1.51-2.42; <0.001), and blunts (aOR = 1.22, 1.00-1.48; 0.053) compared to those who did not report past 30-day use of these products. Among the 2,223 individuals who screened positive for depression, the most used two-product combination was nicotine e-cigarettes and smoked cannabis (614 individuals, 27.6 %).

CONCLUSIONS

Screening positive for depression was more likely among past 30-day co-users versus past 30-day users of tobacco-only or cannabis-only. Findings suggest that prevention programs for depression and substance use address tobacco and cannabis co-use.

Investigating the Role of Anger and Cognitive Malfunction in Mental Health: A Cross-Sectional Exploration Paving the Way for a Subsequent Experiment

The functional outcomes associated with subjective well-being (SWB) and the detrimental aspects of psychological distress (PD) make it essential to explore contributing factors. The present study investigated a model about the existing gap in the determining role of trait anger (TA), state anger (SA), cognitive reappraisal (CR), rumination and cognitive failure (CF) as predictors of SWB and PD. The study contributes by exploring the interaction of dispositional, situation factors and emotional regulation strategies in shaping SWB and PD in the Indian Sample. A cross-sectional survey design was employed wherein 600 young adults aged 18-40 (Mage = 22.13, SDage = 4.06) were recruited from Uttar Pradesh, India using a multi-level cluster sampling method. The data were collected using questionnaires in the field setting during August-December 2021. Regression and path analysis revealed that the proposed predictors explained significant variance in SWB and PD, i.e., R2 = 0.24, F (5, 594) = 38.03, p < 0.01, Cohen f2 =0.31 and R2 = 0.35, F (5, 594) = 66.40, p < 0.01, Cohen f2 = 0.53, respectively. The models also fit well with the statistical indices. Except CR, all predictors emerged as significant risk factors. The findings suggest that the interventions to reduce PD and enhance SWB may consider inculcating CR and reducing higher levels of TA, SA, rumination and CF to enhance an individual's adaptive functioning. The findings pave the way for conducting a pre-planned experiment to study the outcomes of various levels of TA in regulating incidental anger (SA) employing CR and rumination.

Factors associated with psychological distress of workers in the Finnish Evangelical Lutheran Church

BACKGROUND

The work of church employees contains many elements causing symptoms of stress and anxiety. They can lead into psychological distress and possibly indicate the beginning of a more serious psychological state. Women seem to be more disposed to psychological stress than men. We investigated factors contributing to psychological distress among women and men in four professions of the Evangelical Lutheran Church of Finland (ELCF).

METHODS

A link to an electronic survey was sent to the members of respective trade unions of four professions of the ELCF, and we got responses from pastors (n = 241), church musicians (n = 92), diaconal workers (n = 85) and youth workers (n = 56). Psychological distress was assessed using the Mental Health Inventory-5 (MHI-5; cut-off value ≤ 52 indicating severe distress). We used logistic regression to examine sociodemographic, health-related, and work-related factors that could potentially be associated with psychological distress.

RESULTS

We found severe psychological distress in all profession groups. Gender differences were scarce. Loneliness was the most important factor associated with psychological distress in both men and women (OR 14.01; 95% CI 2.68-73.25 and OR 7.84; 3.44-17.88, respectively), and among pastors and church musicians (OR 8.10; 2.83-23.16 and OR 24.36; 2.78-213.72, respectively). High mental strain of work was associated with distress in women (OR 2.45; 1.01-5.97). Good work satisfaction was a protective factor for men and women (OR 0.06; 95% CI 0.01-0.40 and OR 0.61; 0.18-0.40, respectively) and for pastors and church musicians (OR 0.22; 0.08-0.73 and OR 0.06; 0.01-0.43, respectively). For women, additional protective factors were being a pastor (OR 0.26; 0.07-0.95), or youth worker (OR 0.08; 0.01-0.48), and good self-reported health (OR 0.38; 0.18-0.82).

CONCLUSION

Even though we found some protective factors, the share of workers with severe distress was higher in all profession groups of the ELCF than in the general population. Loneliness was the strongest stressor among both genders and high mental strain among women. The result may reflect unconscious mental strain or subordination to the prevailing working conditions. More attention should be paid to the mental wellbeing and work conditions of church employees.

Underlying patterns of the co-occurrence of tobacco use and mental health among youth

We aimed to examine how bidirectional relationships between mental health problems and tobacco use are formed over time by types of tobacco use in recent samples of U.S. youth. Data were drawn from Waves 1-4 of the Population Assessment of Tobacco and Health Study (N = 10,082) and analyzed using cross-lagged panel models. A high level of internalizing problems at Wave 1 predicted conventional cigarette smoking (adjusted odds ratio [AOR] = 1.19, 95% CI = 1.06-1.34) and e-cigarette use (AOR = 1.25, 95% CI = 1.09-1.43) at Wave 2, but not vice versa. Both cigarette smoking and e-cigarette use at Wave 2 tended to persist into Wave 3, which, in turn, increased the risk of subsequent internalizing problems in late adolescence or young adulthood (Wave 4). The bidirectional relationship between tobacco use and internalizing problems seems to begin as a procession from internalizing problems to tobacco use, and then from persistent tobacco use to exacerbated internalizing problems over time.

Age of Smoking Initiation in Relation to Multiple Health Risk Factors among US Adult Smokers: National Health Interview Survey (NHIS) Data (2006-2018)

The adverse effects of multiple health risk factors have been well-documented; however, still understudied are the effects of early smoking in the context of multiple health risk factors. This study aimed to examine the role of early smoking initiation in relation to several health risk factors, including heavy drinking, physical inactivity, and obesity in later life among ever smokers in the USA. The National Health Interview Survey (NHIS) data from 2006 through 2018 were analyzed. The primary dependent variables were presence of three other risk factors: heavy drinking, physical inactivity, and obesity. The independent variable was the age of smoking initiation. Logit regression models were constructed to evaluate the association between smoking initiation and multiple health risk factors. All analyses were done in 2022. Among US adult smokers, 18.2% started smoking before age 15 (early initiators), 55.9% at ages 15-18 (middle initiators), and 25.9% at age 20 or later (late initiators). Compared to late smoking initiators, the odds of engaging in additional health risk factors increased by 37.3% among early initiators (OR = 1.373, 95% CI = 1.316, 1.432) and 7.7% among middle initiators (OR = 1.077, 95% CI= 1.041, 1.116). Additionally, current smoking was associated with higher odds (OR = 1.369, 95% CI = 1.322, 1.417) of having additional health risk factors compared to former smoking, with one exception: current smokers had lower odds of obesity (OR = 0.566, 95% CI = 0.537, 0.597). Tobacco control programs to prevent adolescents from initiating smoking may have the potential to prevent other health risk factors in adulthood.

Psychological Distress in the Republic of Serbia, the Association of Social Characteristics and Substance Use on a National Representative Sample of Serbia

This study examined the association between social characteristics, substance use, and psychological distress in a national representative sample of adults in Serbia. It was a secondary analysis of the National Survey on Lifestyles in Serbia: Substance Abuse and Gambling 2018. The study included a total of 2000 participants aged 18 to 65 from the general population in Serbia. Psychological distress was examined using the Kessler 6 questionnaire. There were a total of 945 male participants (47.3%) and 1055 (52.8%) female participants. The average age was 37.83 ± 13.61 years. The prevalence of a high risk of psychological distress was 5.2% (103/2000), while the prevalence of moderate risk of psychological distress was 15.2% (303/2000). Multivariate logistic regression analysis showed that being male, having poor self-rated health, having poor subjective financial status, binge drinking in the past year, and lifetime use of any illicit drug were associated with a higher likelihood of having a high risk of psychological distress. One in six adults in Serbia has a high risk of psychological distress, while one in twenty has a moderate risk. The findings of this study urge targeted actions to protect and improve the health of people in psychological distress and drug and alcohol users.

Longitudinal association between cardiovascular risk factors and depression in young people: a systematic review and meta-analysis of cohort studies

BACKGROUND

Depression is a common and serious mental illness that begins early in life. An association between cardiovascular disease (CVD) and subsequent depression is clear in adults. We examined associations between individual CVD risk factors and depression in young people.

METHODS

We searched MEDLINE, EMBASE, and PsycINFO databases from inception to 1 January 2020. We extracted data from cohort studies assessing the longitudinal association between CVD risk factors [body mass index (BMI), smoking, systolic blood pressure (SBP), total cholesterol, high-density lipoprotein] and depression, measured using a validated tool in individuals with mean age of 24 years or younger. Random effect meta-analysis was used to combine effect estimates from individual studies, including odds ratio (OR) for depression and standardised mean difference for depressive symptoms.

RESULTS

Based on meta-analysis of seven studies, comprising 15 753 participants, high BMI was associated with subsequent depression [pooled OR 1.61; 95% confidence interval (CI) 1.21-2.14; I2 = 31%]. Based on meta-analysis of eight studies, comprising 30 539 participants, smoking was associated with subsequent depression (pooled OR 1.73; 95% CI 1.36-2.20; I2 = 74%). Low, but not high, SBP was associated with an increased risk of depression (pooled OR 3.32; 95% CI 1.68-6.55; I2 = 0%), although this was based on a small pooled high-risk sample of 893 participants. Generalisability may be limited as most studies were based in North America or Europe.

CONCLUSIONS

Targeting childhood/adolescent smoking and obesity may be important for the prevention of both CVD and depression across the lifespan. Further research on other CVD risk factors including blood pressure and cholesterol in young people is required.

The dose-effect relationships of cigarette and alcohol consumption with depressive symptoms: a multiple-center, cross-sectional study in 5965 Chinese middle-aged and elderly men

BACKGROUND

Although association of depressive symptoms with cigarette or alcohol is well documented, the dose-response relationship between them is rarely studied. This study aims to evaluate dose-response relationships of cigarette and alcohol consumption with depressive symptoms in Chinese middle-aged and elderly men, providing evidence to guide cigarette and alcohol control.

METHODS

This multiple-center, cross-sectional study including 5965 Chinese men aged 40-79 years was conducted in 2013-2016 in China. Depressive symptoms were evaluated by Beck Depression Inventory-Short Form. History of cigarette smoking and alcohol drinking were collected with a structured questionnaire. Prevalence of depressive symptoms was compared depending on cigarette and alcohol consumption. Adjusted odds ratios (OR) and 95% confidence interval (CI) were estimated by binary logistic regression. Interpolation analysis was applied to test dose-effect relationships.

RESULTS

A parabolic-shaped relationship was observed between cigarette consumption and depressive symptoms. Compared to never smokers, 59.0% (OR = 1.59, 95% CI 1.30-1.94) and 29.0% (OR = 1.29, 95% CI 1.08-1.54) higher odds of depressive symptoms were observed in men smoking < 10 cigarettes/day and 10-20 cigarettes/day, whereas, similar odds of depressive symptoms among men smoking > 20 cigarettes/day (P = 0.092). An inverted J-shaped relationship was observed between alcohol consumption and depressive symptoms. Compared to never drinkers, a tendency of higher prevalence of depressive symptoms (OR = 1.16, 95% CI 0.99-1.36) was observed in men drinking < 140 g/week, and similar prevalence was observed in those drinking 140-280 g/week (P = 0.920), whereas, 29.4% (OR = 0.71, 95% CI 0.57-0.88) lower odds in men drinking > 280 g/week.

CONCLUSIONS

Associations of cigarette smoking and alcohol drinking with depressive symptoms differ with consumption in middle-aged and elderly men. Health-care providers should exercise great caution on depressive symptoms in conducting cigarette and alcohol control.

Investigating the reciprocal temporal relationships between tobacco consumption and psychological disorders for youth: an international review

OBJECTIVE

To investigate reciprocal temporal relationships between tobacco consumption and psychological disorders for youth.Design: Review DATA SOURCES: Five databases (PubMed, Embase, Scopus, CINAHL and PsycINFO) on 26 September 2019 and updated on 11 May 2021, indexing tobacco, mental illness and longitudinal.Study selection: Methods used consensus and multiple reviewers.

INTERVENTIONS

Cohort studies (n=49) examining tobacco and selected psychological disorders (depression, anxiety, bipolar, psychosis, borderline personality disorder) among youth, and systematic reviews (n=4) of these relationships met inclusion criteria.

PRIMARY AND SECONDARY OUTCOME MEASURES

Effect of tobacco on psychological disorders and effect of psychological disorders on tobacco.

DATA EXTRACTION AND SYNTHESIS

Independent extraction by the first author and checked by final author. Joanna Briggs Institute Critical Appraisal Tools were used for all studies.Included studies had moderate-to-high appraisal scores. We synthesised findings using vote counting for effect direction and descriptive data.

RESULTS

Fifty-three studies were included in the review. Thirteen of 15 studies showed a positive effect direction of tobacco on depression (p<0.001). Six of 12 studies showed a positive effect direction of depression on tobacco (p=0.016). Six of eight studies showed a positive effect direction of tobacco on anxiety (p=0.016). Eleven of 18 studies showed a positive effect direction of anxiety on tobacco (p=0.003). No effect between tobacco and bipolar, or tobacco and psychosis was found. No studies examined tobacco and borderline personality disorder.

CONCLUSIONS

Reciprocal relationships existed between tobacco and both depression and anxiety for youth, though causality is unconfirmed. No positive effect direction was found between tobacco and psychosis, perhaps because nicotine has conflicting effects on psychosis. For other relationships examined, evidence was weak because of low number of studies. More research to inform prevention and early intervention is needed.

PROSPERO REGISTRATION NUMBER

CRD42020150457.

Use of electronic vaping products and mental health among adolescent high school students in the United States: The moderating effect of sex

Although studies have investigated the association between conventional tobacco smoking and mental health outcomes among adolescents in the United States, few studies have examined the association between electronic vaping products (EVPs) and mental health among adolescents. This study aimed to investigate the cross-sectional association between EVPs use, symptoms of depression, and suicidal behaviors among adolescents. Data were pooled from the 2017 and 2019 Youth Risk Behavior Survey. An analytic sample of 14,285 adolescents (50.3% female) was analyzed using binary logistic regression. The outcome variables investigated were symptoms of depression, suicidal ideation, suicide plan, and suicide attempts, and the main explanatory variable was EVPs use. Of the 14,285 adolescents, 22.2%, 19.2%, and 58.8% were current, former and never users of EVPs, respectively. Controlling for other factors, current users of EVPs were significantly more likely to report having symptoms of depression (AOR = 1.82, 95% CI = 1.58-2.09), having suicidal ideation (AOR = 1.55, 95% CI = 1.30-1.86), making a suicide plan (AOR = 1.62, 95% CI = 1.34-1.97), or attempting suicide (AOR = 1.75, 95% CI = 1.41-2.18) when compared to never users of EVPs. Gender moderated the association between EVPs use, symptoms of depression, suicidal ideation, and suicide plan. Racial minority identity, sexual minority identity, sexual violence victimization, victim of school and cyberbullying, alcohol use, and cigarette smoking were all significantly associated with depression and suicidal behaviors. Study findings support the association between EVPs use and adolescent mental health. Future studies that employ longitudinal designs may offer more insight into the mechanisms underlying this association.

The genetic background of the associations between sense of coherence and mental health, self-esteem and personality

PURPOSE

Sense of coherence (SOC) represents coping and can be considered an essential component of mental health. SOC correlates with mental health and personality, but the background of these associations is poorly understood. We analyzed the role of genetic factors behind the associations of SOC with mental health, self-esteem and personality using genetic twin modeling and polygenic scores (PGS).

METHODS

Information on SOC (13-item Orientation of Life Questionnaire), four mental health indicators, self-esteem and personality (NEO Five Factor Inventory Questionnaire) was collected from 1295 Finnish twins at 20-27 years of age.

RESULTS

In men and women, SOC correlated negatively with depression, alexithymia, schizotypal personality and overall mental health problems and positively with self-esteem. For personality factors, neuroticism was associated with weaker SOC and extraversion, agreeableness and conscientiousness with stronger SOC. All these psychological traits were influenced by genetic factors with heritability estimates ranging from 19 to 66%. Genetic and environmental factors explained these associations, but the genetic correlations were generally stronger. The PGS of major depressive disorder was associated with weaker, and the PGS of general risk tolerance with stronger SOC in men, whereas in women the PGS of subjective well-being was associated with stronger SOC and the PGSs of depression and neuroticism with weaker SOC.

CONCLUSION

Our results indicate that a substantial proportion of genetic variation in SOC is shared with mental health, self-esteem and personality indicators. This suggests that the correlations between these traits reflect a common neurobiological background rather than merely the influence of external stressors.

Associations Between Smoking Status and Physical and Mental Health-Related Quality of Life Among Individuals With Mobility Impairments

BACKGROUND

In the general population, quitting smoking is associated with improved health-related quality of life (QoL), but this association has not been examined in smokers with chronic mobility impairments (MIs).

PURPOSE

We examined associations between smoking status and health-related QoL over 6 months, and whether relationships are moderated by depression and MI severity.

METHODS

This is a secondary analysis of a smoking cessation induction trial among smokers with MIs (n = 241, 56% female, 36% Black) assessed at baseline, and 4 and 6 months after. Participants were grouped into "Smokers" (smoking at 4 and 6 months), "Abstainers" (quit at 4 and 6 months), "Relapsers" (relapsed at 6 months), and "Late-quitters" (quit at 6 months). Physical and mental health-related QoL was assessed with the Short-Form Health Survey. Depression was defined as scores ≥10 on the Patient Health Questionnaire, and MI severity by the use of skilled care for personal needs. Data were analyzed with linear mixed models.

RESULTS

Aggregating across time, among nondepressed participants, compared with "Smokers," the "Abstainer," and "Late-quitter" groups improved their physical health scores. "Late-quitters" also improved compared with "Relapsers." Among the total sample, compared with "Smokers," "Abstainers" showed improvements in mental health scores overtime, whereas "Relapsers" improved their score at 4 months, and "Late-quitters" improved at 6 months.

CONCLUSIONS

Quitting smoking is associated with improvements in physical health-related QoL regardless of the severity of MI but only among those without depression at baseline. For mental health-related QoL, associations with quitting smoking were independent of baseline depression and severity of MI.

Association of health-risk behaviors and depressive symptoms and anxiety symptoms: a school-based sample of Chinese adolescents

Background Depressive symptoms and anxiety symptoms of adolescents not only affect youth but also have wide-ranging impacts on the health of adults. The study was carried out to determine the epidemiological characteristics of depressive symptoms and anxiety symptoms and the associations between the two and health-risk behaviors in Chinese adolescents. Methods Participants were recruited from the junior and senior high schools in China. Data were collected by self-designed questionnaires. The questionnaires included questions about demographic characteristics, depressive symptom scales, anxiety symptom scales and nine categories of health-risk behaviors. Descriptive analysis and binary logistic regression were performed by SPSS 21.0 software. Results There were 4.4% of the participants with depressive symptoms. Approximately 32.0% of the participants had anxiety symptoms. Girls and general senior school students were risk factors for depressive symptoms and anxiety symptoms. Multiple health-risk behaviors were associated with depressive symptoms and anxiety symptoms in Chinese adolescents. Conclusion Depressive symptoms and anxiety symptoms were prevalent in Chinese adolescents. Their distribution was affected by certain health-risk behaviors. Multiple health-risk behaviors were associated with depressive symptoms and anxiety symptoms in Chinese adolescents.

Factors contributing to psychological distress in the working population, with a special reference to gender difference

Background

Psychological distress refers to non-specific symptoms of stress, anxiety and depression, and it is more common in women. Our aim was to investigate factors contributing to psychological distress in the working population, with a special reference to gender differences.

Methods

We used questionnaire data from the nationally representative Finnish Regional Health and Well-being Study (ATH) collected in the years 2012–2016 (target population participants aged 20 +, n = 96,668, response rate 53%), restricting the current analysis to those persons who were working full-time and under 65 of age (n = 34,468). Psychological distress was assessed using the Mental Health Inventory-5 (MHI-5) (cut-off value <=52). We studied the following factors potentially associated with psychological distress: sociodemographic factors, living alone, having children under18 years of age, lifestyle-related factors, social support, helping others outside of the home and work-related factors. We used logistic regression analysis to examine association between having work-family conflict with the likelihood for psychological distress. We first performed the models separately for men and women. Then interaction by gender was tested in the combined data for those independent variables where gender differences appeared probable in the analyses conducted separately for men and women.

Results

Women reported more psychological distress than men (11.0% vs. 8.8%, respectively, p < 0.0001). Loneliness, job dissatisfaction and family-work conflict were associated with the largest risk of psychological distress. Having children, active participation, being able to successfully combine work and family roles, and social support were found to be protective factors. A significant interaction with gender was found in only two variables: ignoring family due to being absorbed in one’s work was associated with distress in women (OR 1.30 (95% CI 1.00–1.70), and mental strain of work in men (OR 2.71 (95% CI 1.66–4.41).

Conclusions

Satisfying work, family life and being able to successfully combine the two are important sources of psychological well-being for both genders in the working population.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-021-10560-y.

Anxiety in social interactions and nicotine dependence in nicotine-dependent men: The role of metacognitions about smoking

Anxiety in social interactions is an important factor in cigarette use and nicotine dependence. Metacognitions about smoking have been found to predict smoking behavior and may help understand the relationship between anxiety in social interactions and nicotine dependence. In the current study, we evaluated the direct effect of anxiety in social interactions on nicotine dependence and its indirect effect through metacognitions (controlling for anhedonia and depression) in nicotine-dependent men (n = 388). Participants completed measures of anxiety in social interactions [the Social Interaction Anxiety Scale (SIAS)], anhedonia [the Snaith HamiltonPleasure Scale (SHAPS)], metacognitions about smoking [e.g., theMetacognitions aboutSmoking Questionnaire (MSQ)] nicotine dependence [the Fagerström Test for Nicotine Dependence (FTND)], and clinical factors related to smoking including depressive symptoms [e.g., the Beck Depression Inventory-II (BDI-II)]. As expected, after controlling for depressive symptoms and anhedonia, anxiety in social interactions indirectly affected nicotine dependence through negative metacognitions about smoking, but not positive metacognitions. These findings are discussed in relation to the metacognitive model of addictive behaviors.

Association of Tobacco Use and Exposure to Secondhand Smoke With Suicide Attempts Among Adolescents: Findings From 33 Countries

INTRODUCTION

There is evidence to suggest that tobacco use is associated with suicide attempts. However, it is unclear whether such an association can be extended to include secondhand smoke exposure. Using nationally representative data of school-attending adolescents from 33 countries, we examined the association of tobacco use and exposure to secondhand smoke with suicide attempts.

METHODS

We used data from the Global School-based Student Health Survey, a cross-sectional survey conducted among adolescents 12-15 years of age. We used logistic regression to estimate the country-specific associations. We then conducted random effect meta-analyses to obtain overall and country-income level pooled estimates. Lastly, we used logistic regression analyses to investigate a dose-response association of cigarette smoking and exposure to secondhand smoke with suicide attempts.

RESULTS

A positive association between tobacco use and suicide attempts among adolescents was present regardless of country-income level (low income: odds ratio 4.98, 95% CI: 3.11-7.96; lower middle income: 3.47, 2.91-4.15; upper middle income: 3.09, 2.75-3.47; and high income: 3.18, 2.63-3.84) and gender (boys: 3.28, 2.86-3.76; girls: 3.86, 3.30-4.51). Exposure to secondhand smoke was associated with suicide attempts, albeit weakly, among girls only (1.26, 1.14-1.39; boys: 1.00, 0.87-1.15). There was some evidence that a dose-response association of cigarette smoking and exposure to secondhand smoke with suicide attempts may only exist among girls.

CONCLUSIONS

Adolescents who use tobacco, and adolescent girls exposed to secondhand smoke were found to be more likely to attempt suicide; however, future longitudinal studies are warranted to assess causality.

IMPLICATIONS

Our findings indicate that routine screening of adolescents for tobacco use should be implemented globally, especially when assessing suicidal behaviors and risk. Future longitudinal and intervention studies are warranted to assess causality and whether prevention efforts such as tobacco control interventions and programmes targeting tobacco use and exposure to secondhand smoke among adolescents could ultimately lead to a reduction in the occurrence of suicide attempts.

Is exposure to secondhand smoke associated with current depression (PHQ-8) among never-smokers? Results from a survey among German adults

Background

Findings on the association between exposure to secondhand smoke (SHS) and depression are contradictory. Comparability of existing research is limited due to varied methods and measures. This study examines the potential association between exposure to SHS and depression and a potential moderation by sex using representative data from Germany.

Methods

For our study, we used data from the German Health Update (GEDA) 2014/2015 on n = 10,274 never-smokers. We calculated a logistic regression model with an interaction term for potential sex-exposure interactions. We used the self-reported duration of exposure to predict current depression of any type as defined by the Patient Health Questionnaire PHQ-8 (score ≥ 10), accounting for a large number of confounders.

Results

In our sample, prevalence of depression was 8.8% in women and 5.3% in men. 90.4% were never or almost never exposed to SHS, while 7.1% were exposed < 1 h per day and around 2.5% reported being exposed for ≥1 h per day. While SHS exposure for < 1 h per day was not associated with current depression (OR = 1.54; 95%-CI: 0.93–1.61), SHS exposure for at least 1 h per day was associated with increased odds for current depression (OR = 1.59; 95%-CI: 1.08–2.35). No sex-specific differences were found.

Conclusions

Higher levels of SHS exposure are associated with current depression, although the nature and direction of the association are still unclear. We identified no differences in the association between men and women. More studies, particularly using longitudinal data, are needed to determine the nature of the association.

FinnTwin12 Cohort: An Updated Review

This review offers an update on research conducted with FinnTwin12 (FT12), the youngest of the three Finnish Twin Cohorts. FT12 was designed as a two-stage study. In the first stage, we conducted multiwave questionnaire research enrolling all eligible twins born in Finland during 1983-1987 along with their biological parents. In stage 2, we intensively studied a subset of these twins with in-school assessments at age 12 and semistructured poly-diagnostic interviews at age 14. At baseline, parents of intensively studied twins were administered the adult version of the interview. Laboratory studies with repeat interviews, neuropsychological tests, and collection of DNA were made of intensively studied twins during follow-up in early adulthood. The basic aim of the FT12 study design was to obtain information on individual, familial and school/neighborhood risks for substance use/abuse prior to the onset of regular tobacco and alcohol use and then track trajectories of use and abuse and their consequences into adulthood. But the longitudinal assessments were not narrowly limited to this basic aim, and with multiwave, multirater assessments from ages 11 to 12, the study has created a richly informative data set for analyses of gene-environment interactions of both candidate genes and genomewide measures with measured risk-relevant environments. Because 25 years have elapsed since the start of the study, we are planning a fifth-wave follow-up assessment.