Apples for Health- Teenage Smoking And Depression

Teenage Smoking And Depression

Two investigators at the University of Alabama at Birmingham have found a regulatory link between adolescent smoking and depression.

Psychologist Michael Windle -- who conducted the study with his wife, Rebecca Windle -- told United Press International that researchers have known of the association between depression and smoking for a long time. The question has always been, "What's the nature of the influence?" the professor said.

Windle told UPI that the study, published in the April issue of the Journal of Consulting and Clinical Psychology, is particularly important because it clearly demonstrates how cigarette smoking among the young is linked to feeling good or bad.

In the past, four alternative hypotheses have been posited to account for the linkage. (1) Self-selected depressives self-medicate with nicotine. (2) Smoking predisposes one to depression. (3) Smoking and depression may reinforce each other. (4) Both smoking and depression are caused by something else, such as kids hanging out with more deviant peers or coming from more troubled families.

Michael and Rebecca Windle adjusted for such variables as family history of smoking, which might suggest an individual susceptibility to nicotine addiction. They found that teenagers who were highly depressed when they started smoking increased their smoking substantially 18 months later. Kids who were not depressed did not.

And those who were smoking more at the beginning of the study also had increases in depression across time.

Specifically, youths who smoked 20 or more cigarettes every day for six months were likely to have more depressive symptoms for the year and a half they were followed than the teenagers who reported smoking less.

So what comes first, the chicken or the egg -- smoking or depression? Windle said the study did not find an answer to this age-old problem of cause vs. manifestation, but the research "most definitely" confirmed "the reciprocal, bi-directional effects model."

Smoking and depression are both influencing each other across time, he said, "which is what I'm describing as regulation. More than one variable has to be involved in regulation; otherwise it's just the system feeding back on itself."

The psychologist suggested how this "regulatory model," might work in high schools. Adolescents undergoing a lot of changes in their lives experience uncertainty and feelings of depression, he said. Nicotine via cigarettes is an easily available, sexually advertised substance that affects the pleasure center in the brain.

But to achieve that same good feeling over time, they have to smoke more. Only later do smokers reach saturation levels that work for them, but in adolescents "those addictive and dependent processes are not immediately established."

The problem is that if teenagers try to stop anywhere along the line, then the brain is deprived of an accustomed stimulant and feelings of depression return. That's why it's so hard for adults to quit smoking, he said.

Women have a harder time in breaking the addiction than men. Some have suggested a sex difference in the density of nicotine receptors in the brain. Others say that men hate to be controlled, even (or especially) by their own addictions, and therefore put more effort into quitting.

Windle posited another explanation.

He said that when individuals are feeling uncertain, it's more socially acceptable for males "to act out those emotions," including shows of anger and frustration.