title: Adolescent cigarette smoking and mental health symptoms.
abstract: OBJECTIVE
  Adolescent cigarette smoking has been reported to be associated with substance use and depression. Less is known about the association between smoking and other mental health symptoms, or the impact of mental health treatment on cigarette smoking and psychiatric morbidity including the substance use disorders. The purpose of this study is to examine the association among adolescent cigarette smoking, mental health symptoms including substance use disorders, and mental health treatment among adolescents treated at a large, hospital-based young adult clinic.
  
  
  METHODS
  Observational study of 486 adolescent patients presenting for routine medical care.
  
  
  RESULTS
  Participants were two-thirds female with an average age of 16.6 years and of diverse ethnic background; 129 (28.6%) reported ever-using tobacco products, and 68 (14%) were current smokers who had an average of 2 cigarettes per day. Current smoking was associated with significantly increased odds of having mental health symptoms and substance use disorders, even after controlling for age and previous mental health treatment, and in both boys and girls.
  
  
  CONCLUSIONS
  This study supports the increasing appreciation that adolescent tobacco use is clinically important, even at apparently low levels. Adolescent cigarette smoking is generally more common than alcohol and illicit drug use, and these results highlight its multifarious linkages with use of other substances and mental health symptoms. Thus, early identification and intervention of adolescent cigarette smoking may help not only to avert later daily smoking, but also may assist in identifying patients at increased risk for substance use and psychiatric problems.
authors.affiliation: Department of Psychiatry, Brigham and Women's Hospital, Boston, Massachusetts 02115, USA. gchang@partners.org
authors.forename: Grace
authors.initials: G
authors.lastname: Chang
authors.forename: Lon
authors.initials: L
authors.lastname: Sherritt
authors.forename: John R
authors.initials: JR
authors.lastname: Knight
mesh_terms: D000293:Adolescent; D015986:Confounding Factors, Epidemiologic; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D001523:Mental Disorders / Q000150:complications* / Q000209:etiology / Q000628:therapy; D017678:Sex Distribution; D012907:Smoking / Q000009:adverse effects*; D019966:Substance-Related Disorders / Q000150:complications* / Q000209:etiology / Q000628:therapy; D011795:Surveys and Questionnaires