Combination of depression and high sensitivity to advertising significantly increases risk that teenagers will smoke


Teenagers who have depression combined with a high receptivity to tobacco advertising are at increased risk to begin smoking, according to an article in the March issue of the Journal of Pediatric Psychology.

Although research has demonstrated the effects of a number of factors on adolescent smoking behavior (including exposure to smoking by family and friends, high receptivity to tobacco advertising, and positive attitudes and beliefs about smoking), the current study is one of the first to examine how a psychiatric condition - depression -- combines with these factors to influence the likelihood of smoking.

"This study demonstrates the complex interplay of factors that influence the initiation of smoking by youth and identifies subgroups of adolescents at especially high risk, such as those who are depressed and those with a high level of receptivity to tobacco advertising. These findings will be useful in targeting prevention messages," said Dr. Glen Hanson of the National Institutes of Health.

The senior author of the study, Dr. Janet Audrain, said, "Adolescents with elevated levels of depression may find the messages delivered by tobacco advertisements more appealing than adolescents without elevated levels of depression. Smoking prevention messages should educate youth about the tobacco industry's manipulation of youth that may be psychologically vulnerable to smoke, and dispel the myths about the benefits of smoking and the images that these advertisements portray (for example, that cigarette smoking is associated with happiness and good times)."

The investigators surveyed 1,123 high school freshmen as part of a longitudinal investigation of the biobehavioral predictors of adolescent smoking. Students completed a survey that assessed current smoking practices, exposure to other smokers including family and peers, and self-reported levels of depression and receptivity to tobacco advertising.

Whereas 60 percent of participants reported that they had never smoked, 40 percent reported having smoked at least one partial or whole cigarette. Across both groups, 34 percent had high receptivity to advertising shown by ability to name an often-advertised cigarette brand, describe a favorite tobacco ad, or report that they possessed or were willing to use a tobacco industry product.

Researchers found that more adolescents with high receptivity to tobacco advertising had smoked compared with those with low receptivity and that these results were further affected by depression.

"Among participants with clinically significant depression scores, the effects of tobacco advertising receptivity were heightened," said Kenneth P. Tercyak, Ph.D., lead author. "These adolescents may be less likely to successfully say 'no' when presented with the opportunity to receive and try promotional products and are more attracted to and influenced by the promises portrayed in tobacco ads."



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