title: Increased Risk of Major Depression With Early Age of Exposure to Cigarettes.
abstract: This study examined the association between age of initiation of cigarette use and increased risk of lifetime major depressive episode.
  
  
  
  This study utilized publicly available data from the 2013 National Survey on Drug Use and Health involving a nationally representative sample of interviews of 55,160 randomly selected people aged ≥12 years. Analysis was conducted in 2016. Age of initiation of cigarette use was divided into four groups (≤12 years, 13-14 years, 15-18 years, and >18 years). Eligible participants included adults aged ≥18 years who had ever smoked a cigarette and had non-missing data for all analytic variables (n=23,906). Associations between lifetime major depressive episode and covariates were assessed using chi-square tests. Logistic regression was used to calculate crude ORs and AORs with 95% CIs.
  
  
  
  About half of participants reported starting cigarette use when they were aged 15-18 years. Compared with the group that initiated cigarette use at age ≤12 years, all other age groups were from 25% to almost 50% less likely to report a lifetime major depressive episode.
  
  
  
  Early age of onset of cigarette use is associated with increased likelihood of experiencing a lifetime major depressive episode. Further research is needed to elucidate the mechanisms driving this association.
authors.affiliation: Department of Internal Medicine, Saint Louis University School of Medicine, Saint Louis, Missouri. Electronic address: bdevkota@slu.edu.
authors.forename: Bishnu
authors.initials: B
authors.lastname: Devkota
authors.affiliation: Department of Family and Community Medicine, Saint Louis University School of Medicine, Saint Louis, Missouri.
authors.forename: Joanne
authors.initials: J
authors.lastname: Salas
authors.affiliation: Mercy Hospital, Saint Louis, Missouri.
authors.forename: Lauren
authors.initials: L
authors.lastname: Garfield
mesh_terms: D000293:Adolescent; D000367:Age Factors; D002648:Child; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology*; D062789:Tobacco Products; D014481:United States / Q000453:epidemiology; D055815:Young Adult