title: Temporal association of onset of daily smoking with adolescent substance use and psychiatric morbidity.
abstract: OBJECTIVE
  The association between cigarette smoking and psychiatric disorders is well established for adult populations. However, only limited number of studies has investigated whether the young onset age of daily smoking (DS) among adolescents is associated with psychiatric morbidity and vice versa.
  
  
  METHODS
  Data from 508 adolescents admitted to psychiatric hospitalization were collected. Cox proportional hazard model were used to compare the initiation of DS between adolescents with and without substance use (SUD), and other psychiatric disorders.
  
  
  RESULTS
  Rates of DS were high in each diagnostic category. Boys started smoking at younger age (mean 12.4 years) than girls (13.0 years). Both boys and girls diagnosed with conduct or oppositional defiant disorders (COD) and also girls with SUD started daily smoking earlier as compared to those of same gender without these disorders.COD were found to be primary to the initiation of DS among boys. SUD, psychotic, and depressive disorders (DEP) were found to be secondary to DS among both genders.
  
  
  CONCLUSIONS
  DS in adolescence is related with later SUD. COD are associated with subsequent initiation of DS among boys. The temporal gap between smoking initiation and COD is shorter among girls. Gender difference plays a role in association of DS and DEP. Initiation of DS at very early age should alert health care professionals of development of later psychopathology, especially SUD.
authors: Department of Psychiatry, University of Oulu, Box 5000, FIN-90014, Finland. rilomaki@mail.student.oulu.fi
authors: Risto
authors: R
authors: Ilomäki
authors: Kaisa
authors: K
authors: Riala
authors: Helinä
authors: H
authors: Hakko
authors: Jaakko
authors: J
authors: Lappalainen
authors: Taru
authors: T
authors: Ollinen
authors: Pirkko
authors: P
authors: Räsänen
authors: Markku
authors: M
authors: Timonen
mesh_terms: D000293:Adolescent; D000367:Age Factors; D017668:Age of Onset; D000437:Alcoholism / Q000453:epidemiology; D001008:Anxiety Disorders / Q000453:epidemiology; D019958:Attention Deficit and Disruptive Behavior Disorders / Q000453:epidemiology; D015897:Comorbidity; D019955:Conduct Disorder / Q000453:epidemiology; D003866:Depressive Disorder / Q000453:epidemiology; D005260:Female; D005387:Finland; D006306:Health Surveys; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D011618:Psychotic Disorders / Q000453:epidemiology; D012737:Sex Factors; D012907:Smoking / Q000453:epidemiology*; D019966:Substance-Related Disorders / Q000453:epidemiology*