Prevention Science

, Volume 15, Issue 4, pp 506–515 | Cite as

Longitudinal Associations Between Smoking and Depressive Symptoms Among Adolescent Girls

  • Sarah J. BealEmail author
  • Sonya Negriff
  • Lorah D. Dorn
  • Stephanie Pabst
  • John Schulenberg


Adolescence is an important period for initiation of smoking and manifestation of depression, which are often comorbid. Researchers have examined associations between depressive symptoms and smoking to elucidate whether those with increased depressive symptoms smoke more to self-medicate, whether those who smoke experience increased subsequent depressive symptoms, or both. Collectively, there have been mixed findings; however, studies have been limited by (1) cross-sectional or short-term longitudinal data or (2) the use of methods that test associations, or only one direction in the associations, rather than a fully-reciprocal model to examine directionality. This study examined the associations between smoking and depressive symptoms in a sample of adolescent girls using latent dual change scores to model (1) the effect of smoking on change in depressive symptoms, and simultaneously (2) the effect of depressive symptoms on change in smoking across ages 11–20. Data were from a cohort-sequential prospective longitudinal study (N = 262). Girls were enrolled by age cohort (11, 13, 15, and 17 years) and were primarily White (61 %) or African American (31 %). Data were restructured by age. Every 6 months, girls reported depressive symptoms and cigarette use. Results indicated that controlling for sociodemographic characteristics, higher levels of smoking predicted a greater increase in depressive symptoms across adolescence. These findings suggest that a higher level of cigarette smoking does contribute to more depressive symptoms, which has implications for prevention of depression and for intervention and future research.


Smoking Depressive symptoms Adolescent Longitudinal Latent dual change score model 



This research was supported in part by grant number R01 DA 16402, National Institute of Drug Abuse, NIH, PI; Lorah D. Dorn, PhD and by USPHS grant #TR000077-04 from the National Center for Research Resources, NIH and by funds from the Bureau of Health Professions (BHPr), Health Resources and Services Administration (HRSA), Department of Health and Human Services (DHHS), under grant #T32HP10027. We also thank the editor and two reviewers who provided excellent feedback that contributed to the quality of this paper.


  1. Albers, A. B., & Biener, L. (2002). The role of smoking and rebelliousness in the development of depressive symptoms among a cohort of Massachusetts adolescents. Preventive Medicine, 34, 625–631. doi: 10.1006/pmed.2002.1029.CrossRefPubMedGoogle Scholar
  2. Angold, A., Costello, E. J., Erkanli, A., & Worthman, C. M. (1999). Pubertal changes in hormone levels and depression in girls. Psychological Medicine, 29, 1043–1053. doi: 10.1017/S0033291799008946.CrossRefPubMedGoogle Scholar
  3. Angold, A., Costello, E. J., & Worthman, C. (1998). Puberty and depression: The roles of age, pubertal status, and pubertal timing. Psychological Medicine, 28, 10.CrossRefGoogle Scholar
  4. Audrain-McGovern, J., Rodriguez, D., & Kassel, J. D. (2009). Adolescent smoking and depression: Evidence for self-medication and peer smoking mediation. Addiction, 104, 1743–1756. doi: 10.1111/j.1360-0443.2009.02617.x.PubMedCentralCrossRefPubMedGoogle Scholar
  5. Bachman, J. G., Johnston, L. D., O'Malley, P. M., & Schulenberg, J. (1996). Transitions in drug use during late adolescence and young adulthood. In J. A. Graber, J. Brooks-Gunn, & A. C. Petersen (Eds.), Transitions through adolescence: Interpersonal domains and context (pp. 111–140). Mahwah, NJ: Erlbaum.Google Scholar
  6. Beal, S. J., Dorn, L. D., Tissot, A., & Pabst, S. (2012). Modeling depressive symptoms in a jongitudinal study: What to do with an Aging Youth Sample Paper presented at the Biannual Conference of the Society for Research on Adolescence, Vancouver, BC Canada.Google Scholar
  7. Beck, A. T., Steer, R. A., & Brown, G. K. (1996). Manual for the Beck Depression Inventory-II (Second ed.). San Antonio, TX: Psychological Corporation.Google Scholar
  8. Chaiton, M., Cohen, J., O'Loughlin, J., & Rehm, J. (2010). Use of cigarettes to improve affect and depressive symptoms in a longitudinal study of adolescents. Addictive Behaviors, 35, 1054–1060. doi: 10.1016/j.addbeh.2010.07.002.CrossRefPubMedGoogle Scholar
  9. Chassin, L., Presson, C. C., Rose, J. S., & Sherman, S. J. (1996). The natural history of cigarette smoking from adolescence to adulthood: Demographic predictors of continuity and change. Health Psychology, 15, 478–484.CrossRefPubMedGoogle Scholar
  10. Dorn, L. D., Beal, S. J., Kalkwarf, H., Pabst, S., Noll, J. G., & Susman, E. J. (2013). Longitudinal impact of substance use and depressive symptoms on bone accrual among girls aged 11-19 years. Journal of Adolescent Health, 52(4), 393-399. doi:  10.1016/j.jadohealth.2012.10.005.Google Scholar
  11. Dorn, L. D., Negriff, S., Huang, B., Pabst, S., Hillman, J., Braverman, P., & Susman, E. J. (2009). Menstrual symptoms in adolescent girls: Association with smoking, depressive symptoms, and anxiety. Journal of Adolescent Health, 44(3), 237-243. doi:  10.1016/j.jadohealth.2008.07.018.Google Scholar
  12. Duncan, T. E., & Duncan, S. C. (2004). An introduction to latent growth curve modeling. Behavior Therapy, 35, 333–363. doi: 10.1016/s0005-7894(04)80042-x.CrossRefGoogle Scholar
  13. Fergusson, D. M., Goodwin, R. D., & Horwood, L. J. (2003). Major depression and cigarette smoking: Results of a 21-year longitudinal study. Psychological Medicine, 33, 1357–1367.CrossRefPubMedGoogle Scholar
  14. Ge, X., Best, K. M., Conger, R. D., & Simons, R. L. (1996). Parenting behaviors and the occurrence and co-occurrence of adolescent depressive symptoms and conduct problems. Developmental Psychology, 32, 717–731.CrossRefGoogle Scholar
  15. Ge, X., Brody, G. H., Conger, R. D., & Simons, R. L. (2006a). Pubertal maturation and African American children’s internalizing and externalizing symptoms. Journal of Youth and Adolescence, 35, 528–537. doi: 10.1007/s10964-006-9046-5.CrossRefGoogle Scholar
  16. Ge, X., Conger, R. D., & Elder, G. H. (2001). Pubertal transition, stressful life events and the emergence of gender differences in adolescent depressive symptoms. Developmental Psychology, 37, 404–417.CrossRefPubMedGoogle Scholar
  17. Ge, X., Lorenz, F. O., Conger, R. D., Elder, G. H., & Simons, R. L. (1994). Trajectories of stressful life events and depressive symptoms during adolescence. Developmental Psychology, 30, 17.CrossRefGoogle Scholar
  18. Ge, X., Natsuaki, M. N., & Conger, R. D. (2006b). Trajectories of depressive symptoms and stressful life events among male and female adolescents in divorced and nondivorced families. Developmental Psychology, 18, 253–273.Google Scholar
  19. Goodman, E., & Capitman, J. (2000). Depressive symptoms and cigarette smoking among teens. Pediatrics, 106, 748–755.CrossRefPubMedGoogle Scholar
  20. Graham, J. W., Flay, B. R., & Johnson, C. A. (1984). Reliability of self-report measures of drug use in prevention research: Evaluation of the Project SMART questionnaire via the test–retest reliability matrix. Journal of Drug Education, 14, 175–193. doi: 10.2190/cyv0-7dpb-djfa-ej5u.CrossRefPubMedGoogle Scholar
  21. Graham, J. W., Olchowski, A. E., & Gilreath, T. D. (2007). How many imputations are really needed? Some practical clarifications of multiple imputation theory. Prevention Science, 8, 206–213. doi: 10.1007/s11121-007-0070-9.CrossRefPubMedGoogle Scholar
  22. Hall, J. E. (1993). Female reproductive system: Physiology and pathophysiology. In United States Department of Health and Human Services (Ed.), Alcohol and the Endocrine System (pp. 117–138). Bethesda: National Institutes of Health. Vol. NIH Publication no. 93-3533.Google Scholar
  23. Hankin, B. L. (2006). Adolescent depression: Description, causes, and interventions. Epilepsy & Behavior, 8, 102–114. doi: 10.1016/j.yebeh.2005.10.012.CrossRefGoogle Scholar
  24. Hanna, E. Z., & Grant, B. F. (1999). Parallels to early onset alcohol use in the relationship of early onset smoking with drug use and DSM-IV drug and depressive disorders: Findings from the National Longitudinal Epidemiologic Survey. Alcoholism, Clinical and Experimental Research, 23, 513–522.PubMedGoogle Scholar
  25. Hollingshead, A. B. (1975). A four-factor classification of social status. New Haven, CT: Yale University.Google Scholar
  26. Hooshmand, S., Willoughby, T., & Good, M. (2012). Does the direction of effects in the association between depressive symptoms and health-risk behaviors differ by behavior? A longitudinal study across the high school years. The Journal of Adolescent Health, 50, 140–147. doi: 10.1016/j.jadohealth.2011.05.016.CrossRefPubMedGoogle Scholar
  27. Joffe, R. T. (1990). Perspective on the thyroid and depression. Canadian Journal of Psychiatry, 35, 754–758.Google Scholar
  28. Kim, M. J., Fleming, C. B., & Catalano, R. F. (2009). Individual and social influences on progression to daily smoking during adolescence. Pediatrics, 124, 895–902. doi: 10.1542/peds.2008-2015.PubMedCentralCrossRefPubMedGoogle Scholar
  29. Kovacs, M., Beck, A. T., Dadds, M. R., Sanders, M. R., Morrison, M., & Rebgetz, M. (1992). Child Depression Inventory. Childhood depression and conduct disorder: II. An analysis of family interaction patterns in the home. Journal of Abnormal Psychology, 101, 505–513.CrossRefGoogle Scholar
  30. Marmorstein, N. R., White, H., Tammy, C., Hipwell, A., Stouthamer-Loeber, M., & Loeber, R. (2010). Associations between first use of substances and change in internalizing symptoms among girls: Differences by symptom trajectory and substance use type. Journal of Clinical Child and Adolescent Psychology, 39, 545–558. doi: 10.1080/15374416.2010.486325.PubMedCentralCrossRefPubMedGoogle Scholar
  31. Martini, S., Wagner, F. A., & Anthony, J. C. (2002). The association of tobacco smoking and depression in adolescence: Evidence from the United States. Substance Use & Misuse, 37, 1853–1867. doi: 10.1081/ja-120014087.CrossRefGoogle Scholar
  32. Maslowsky, J., & Schulenberg, J. E. (2013). Interaction matters: Quantifying conduct problem by depressive symptoms interaction and its association with adolescent alcohol, cigarette, and marijuana use in a national sample. Development and Psychopathology (in press).Google Scholar
  33. Mayhew, K. P., Flay, B. R., & Mott, J. A. (2000). Stages in the development of adolescent smoking. Drug and Alcohol Dependence, 59), S61–S81.CrossRefPubMedGoogle Scholar
  34. McArdle, J. J., & Hamagami, F. (2001). Latent difference score structural models for linear dynamic analyses with incomplete longitudinal data. In L. M. Collins & A. G. Sayer (Eds.), New methods for the analysis of change (pp. 139–175). New York: American Psychological Association.CrossRefGoogle Scholar
  35. McKenzie, M., Olsson, C. A., Jorm, A. F., Romaniuk, H., & Patton, G. C. (2010). Association of adolescent symptoms of depression and anxiety with daily smoking and nicotine dependence in young adulthood: Findings from a 10-year longitudinal study. Addiction, 105, 1652–1659. doi: 10.1111/j.1360-0443.2010.03002.x.CrossRefPubMedGoogle Scholar
  36. Moon, S., Mo, B., & Basham, R. (2010). Adolescent depression and future smoking behavior: A prospective study. Child and Adolescent Social Work Journal, 27, 405–422. doi: 10.1007/s10560-010-0212-y.CrossRefGoogle Scholar
  37. Munafò, M. R., Hitsman, B., Rende, R., Metcalfe, C., & Niaura, R. (2008). Effects of progression to cigarette smoking on depressed mood in adolescents: Evidence from the National Longitudinal Study of Adolescent Health. Addiction, 103, 162–171. doi: 10.1111/j.1360-0443.2007.02052.x.CrossRefPubMedGoogle Scholar
  38. Muthen, L. K., & Muthen, B. O. (1998–2012). Mplus (Fifth ed.). Los Angeles, CA: Muthen & Muthen.Google Scholar
  39. Negriff, S., Dorn, L. D., & Huang, B. (2010). Pubertal timing and smoking initiation in adolescent females: Differences by race. Nicotine & Tobacco Research, 12, 748–755. doi: 10.1093/ntr/ntq076.CrossRefGoogle Scholar
  40. Pomerleau, O. F., Turk, D. C., & Fertig, J. B. (1984). The effects of cigarette smoking on pain and anxiety. Addictive Behaviors, 9, 265–271.CrossRefPubMedGoogle Scholar
  41. Riggs, N. R., Chih-Ping, C., Chaoyang, L., & Pentz, M. A. (2007). Adolescent to emerging adulthood smoking trajectories: When do smoking trajectories diverge, and do they predict early adulthood nicotine dependence? Nicotine & Tobacco Research, 9, 1147–1154. doi: 10.1080/14622200701648359.CrossRefGoogle Scholar
  42. Rosenbaum, P. R., & Rubin, D. B. (1983). The central role of the propensity score in observational studies for causal effects. Biometrika, 70, 41–55. doi: 10.1093/biomet/70.1.41.CrossRefGoogle Scholar
  43. Schulenberg, J. E., & Maslowsky, J. (2009). Taking substance use and development seriously: Developmentally distal and proximal influences on adolescent drug use. Monographs of the Society for Research in Child Development, 74, 121–130.PubMedCentralCrossRefPubMedGoogle Scholar
  44. Stice, E., Presnell, K., & Bearman, S. K. (2001). Relation of early menarche to depression, eating disorders, substance abuse, and comorbid psychopathology among adolescent girls. Developmental Psychology, 37, 608–619.CrossRefPubMedGoogle Scholar
  45. Wu, L., & Anthony, J. C. (1999). Tobacco smoking and depressed mood in late childhood and early adolescence. American Journal of Public Health, 89, 1837.PubMedCentralCrossRefPubMedGoogle Scholar

Copyright information

© Society for Prevention Research 2013

Authors and Affiliations

  • Sarah J. Beal
    • 1
    Email author
  • Sonya Negriff
    • 2
  • Lorah D. Dorn
    • 3
  • Stephanie Pabst
    • 4
  • John Schulenberg
    • 5
  1. 1.Cincinnati Children’s Hospital and Medical CenterCincinnatiUSA
  2. 2.The University of Southern CaliforniaLos AngelesUSA
  3. 3.The Pennsylvania State University, 201 East Health and Human DevelopmentUniversity Park, PAUSA
  4. 4.Cincinnati Children’s Hospital Medical CenterCincinnatiUSA
  5. 5.University of MichiganMichiganUSA

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