Depressive symptoms and smoking among Hong Kong Chinese adolescents.
OBJECTIVE
To examine associations among depressive symptoms, smoking, smoking trajectories and quitting smoking in Hong Kong.


METHODS
Prospective longitudinal design, with wave 1 at baseline (T1) and wave 2 (T2) 12 months later.


METHODS
Form 1 (equivalent to 7th grade in the United States) students, mean age = 12.7 years, n = 1894.


METHODS
Self-reported smoking status, attempts to quit and depressive symptoms.


RESULTS
At both waves, current as well as ex-smokers had higher depressive symptoms than never smokers. T1 smoking predicted T2 depressive symptoms among those with low baseline depressive symptoms. Depressive symptoms at T1 predicted smoking at T2 among non-smokers at T1. Trajectories were defined by separating participants who were never smokers at both waves ('non-smokers'), those who smoked at both waves ('persistent smokers'), those who smoked at one time but were not smoking at either wave ('past smokers), and those who had never smoked at T1 but reported smoking a year later ('new smokers'). Persistent, past and new smokers had higher depressive symptoms at both waves than non-smokers. Smokers who reported not wanting or trying to quit and those who had been unsuccessful at quitting had higher depressive symptoms at T2 than those who successfully quit.


CONCLUSIONS
Our results suggest that depressive symptoms promote tobacco use in Asian adolescents by making it more likely that an adolescent will begin smoking and less likely that she or he will quit. These findings elucidate risk factors in Hong Kong for two important public health concerns for adolescents: smoking and depression.
Lam
T H
TH
Department of Community Medicine, The University of Hong Kong, China.
Stewart
Sunita M
SM
Ho
Sai Yin
SY
Lai
Man Kin
MK
Mak
Kwok Hang
KH
Chau
Ka Vai
KV
Rao
Uma
U
Salili
Farideh
F
D000293:Adolescent; D002648:Child; D003866:Depressive Disorder / Q000453:epidemiology / Q000523:psychology*; D005260:Female; D006723:Hong Kong / Q000453:epidemiology; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D011446:Prospective Studies; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology / Q000523:psychology*; D016540:Smoking Cessation / Q000523:psychology*