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Bidirectional Associations Between Depressive Symptoms and Cigarette Use During Young Adulthood: a Survival Analysis
Jacob E Thomas1, Keryn E Pasch1, C Nathan Marti1
1Department of Kinesiology and Health Education, University of Texas at Austin, Austin, TX, United States.
Summary
Depression increases the risk of starting smoking, and smoking increases the risk of developing depression in young adults. This bidirectional relationship highlights the need for integrated mental health and smoking cessation interventions.
Area of Science:
- Public Health
- Mental Health Research
- Addiction Science
Background:
- Young adulthood is a critical period for the onset of mental health conditions and tobacco use.
- Previous research indicates a link between smoking and depression, but the temporal sequence is not well understood.
Purpose of the Study:
- To investigate the bidirectional relationship between cigarette use and depressive symptoms in young adults aged 18-30.
- To determine if depressive symptoms precede smoking initiation and if smoking precedes the onset of depressive symptoms.
Main Methods:
- Analysis of longitudinal data from 4,232 young adults across eight waves (2014-2019).
- Utilized survival analysis with multiple Cox regression, adjusting for demographic factors.
- Two models examined depressive symptoms influencing cigarette initiation and cigarette use influencing new depressive symptoms.
Main Results:
- 48.9% of participants developed new depressive symptoms, and 7.6% initiated cigarette use over the study period.
- Clinically significant depressive symptoms were associated with a 67% increased risk of cigarette initiation (HR=1.67, p<.001).
- Cigarette use was associated with a 17% increased risk of new depressive symptoms (HR=1.17, p=.017).
Conclusions:
- Evidence supports a bidirectional association between cigarette use and depressive symptoms in young adults.
- Interventions should address both mental health and smoking cessation concurrently.
- Targeted resources are needed for young adults experiencing depression and those who use cigarettes.
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