Depressed mood and the effect of two universal first grade preventive interventions on survival to the first tobacco cigarette smoked among urban youth.
BACKGROUND
As part of an evaluation of two first-grade, universal preventive interventions whose proximal targets were early learning and behavior, we investigated the influence of depressed mood, the interventions, and their interaction on survival to the first tobacco cigarette smoked through age 19. One intervention focused on improving teacher behavior management and instructional skills (Classroom-Centered, CC) as a means of improving student behavior and learning and the other on the family-school partnership (FSP). Variation in the relationship between depressed mood and first cigarette smoked by gender and grade was also examined.


METHODS
Self-reports of smoking behavior and depressed mood were collected on an annual basis from grade 6 through age 19. The present analyses were restricted to the 563 youth who had never smoked by grade 6, or 83% of the original sample of first grade participants. Discrete-time survival analysis was used to examine the effects of depressed mood and the interventions on survival to the first tobacco cigarette smoked.


RESULTS
Depressed mood was associated with reduced survival time to the first cigarette smoked (adjusted hazard ratio, aHR: 1.4; 95% CI: 1.1-1.9), whereas the CC intervention prolonged survival time (aHR: 0.8; 95% CI: 0.7-0.9). No significant variation in the effect of depressed mood on survival was found by gender or grade, nor was the effect of the CC intervention moderated by depressed mood.


CONCLUSIONS
Strategies to prevent tobacco cigarette smoking should include both a focus on depressed mood in adolescence as well as on early success in elementary school.
Wang
Yan
Y
Office of Policy and Planning, University of Maryland School of Medicine, 685 W. Baltimore St., HSF-1, Suite 618, Baltimore, MD 21201, USA.
Browne
Dorothy C
DC
Petras
Hanno
H
Stuart
Elizabeth A
EA
Wagner
Fernando A
FA
Lambert
Sharon F
SF
Kellam
Sheppard G
SG
Ialongo
Nicholas S
NS
D000293:Adolescent; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D003863:Depression / Q000150:complications / Q000453:epidemiology* / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D019964:Mood Disorders / Q000150:complications / Q000453:epidemiology / Q000523:psychology; D012309:Risk-Taking; D012907:Smoking / Q000453:epidemiology* / Q000523:psychology*; D000074606:Smoking Prevention; D012931:Social Environment; D013334:Students / Q000523:psychology*; D014504:Urban Health / Q000639:trends