Cigarette Smoking as Sleep Aid: Self-Medication Practices in Adolescents

While smoking has been associated with alertness, it has also been reported as a stress relief and sleep aid. However, evidence on tobacco self-medication to improve sleep remains limited, particularly among adolescents. Therefore, the aim of this study was to explore the prevalence of tobacco self-medication in adolescents and analyze the association with sleep quality.

A cross-sectional descriptive study was conducted with 1,121 Spanish adolescents (mean age = 16.2 ± 0.7; 57.1% female) from public secondary schools. Participants completed assessments on their sleep quality and Cigarette Use. Analysis of variance and multinomial logistic regression analyses were conducted.

Among adolescents, 5.4% (n = 61) reported smoking cigarettes as a sleep aid in the past month, accounting for a third of those who had smoked in that timeframe (19.9%; n = 225). Adolescents smoking cigarettes for self-medication showed significantly higher cigarette consumption compared to those with past-month use only (mean diff. = 2.1; η² = .10) and longer regular use (mean diff. = 6.9 months; η² = .08). Self-medication was associated with poorer sleep quality, shorter sleep, longer sleep onset latency, and frequent nighttime awakenings. Adolescents experiencing poor sleep and frequent awakenings had twice the likelihood of using tobacco as a sleep aid in the past month (OR = 2.1 and OR = 2.2, respectively).

This study brings attention to adolescent self-medication practices and their associations with poor sleep outcomes. Findings underscore the need for further investigation into self-medication with implications for prevention strategies during adolescence.