Adolescent mental health predicts quitting smoking in adulthood: a longitudinal analysis.
OBJECTIVE
Several studies have reported an association between cigarette smoking and psychiatric illness. A common finding is that the prevalence of psychiatric illness among former smokers is much lower than among current smokers and is often similar to that among never-smokers. There are two alternative causal explanations for this association: either improved mental well-being results from smoking cessation; or those with poorer mental well-being are less successful at smoking cessation. The objective was to analyse a unique longitudinal data set to shed light on the direction of causality and to distinguish between these alternative explanations.


METHODS
Information on smoking status and indicators of poor mental well-being from childhood and adolescence was collected at age 18 in 1969 from 49 321 men at compulsory conscription for military service. Follow-up data on smoking status were collected among a random subset (n = 694) who participated in one or more annual national Swedish Surveys of Living Conditions in 1981-2001.


RESULTS
Approximately half of the smokers at age 18 in 1969 had quit by the time they were resurveyed (1981-2002). Those who had not quit and who reported smoking more than 10 cigarettes/day at age 18 (called persistent heavy smokers), were more likely to have had childhood and adolescent indicators of poor mental health measured at age 18 in 1969 than non-smokers or quitters.


CONCLUSIONS
Our findings indicate that men who would subsequently be successful at smoking cessation reported better mental health and a lower prevalence of childhood mental health indicators at age 18 than persistent heavy smokers.
Hemmingsson
Tomas
T
Division of Occupational Health, Department of Public Health Sciences, Karolinska Institute, Stockholm, Sweden. tomas.hemmingsson@ki.se
Kriebel
David
D
Tynelius
Per
P
Rasmussen
Finn
F
Lundberg
Ingvar
I
D000293:Adolescent; D000328:Adult; D006305:Health Status Indicators; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D008603:Mental Health; D008875:Middle Aged; D008889:Military Personnel; D015995:Prevalence; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology* / Q000523:psychology*; D016540:Smoking Cessation / Q000523:psychology / Q000706:statistics & numerical data*; D013548:Sweden / Q000453:epidemiology; D016896:Treatment Outcome