Anxiety and Depressive Disorders Are Associated with Smoking in Adolescents with Asthma |
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| Institution: | 1. Behavioural Science Institute (BSI), Faculty of Social Sciences, Radboud University Nijmegen, Nijmegen, The Netherlands;2. Care and Public Health Research (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands;1. Center for Alcohol and Addiction Studies, Brown University, School of Public Health, Providence, RI, USA;2. Department of Psychiatry, University of Pennsylvania, Perelman School of Medicine, PA, USA;3. Department of Preventive Medicine, University of Southern California, Keck School of Medicine, Los Angeles, CA, USA;1. Department for Health, University of Bath, BA2 7AY, UK;2. School of Management and UK Centre for Tobacco Control Studies, University of Stirling, Stirling FK9 4LA, UK;3. National Centre for Smoking Cessation and Training (NCSCT), University College London, 1-19 Torrington Place, London WC1E 7HB, UK;4. Cancer Research UK, Health Behaviour Research Centre, University College London, Gower Street, London WC1E 6BT, UK;5. Faculty of Medicine & Health Sciences, University of Nottingham, Nottingham City Hospital, Hucknall Road, Nottingham NG5 1PB, UK |
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| Abstract: | PurposeTo evaluate the association between mental health indicators (including meeting criteria for one or more DSM-IV Diagnostic and Statistical Manual of Mental Disorders—fourth edition] anxiety or depressive disorders) and susceptibility to smoking or current smoking among youth with asthma and to evaluate the impact of smoking on asthma symptoms and self-management.MethodsWe conducted telephone interviews with a population-based sample of 11- to 17-year-old youth and their parents (n = 769). Interview content included questions on smoking behaviors, asthma symptoms and treatment, externalizing behavior, and a structured psychiatric interview to assess DSM-IV anxiety and depressive disorders.ResultsFive percent of youth were smokers and 10.6% indicated that they were “susceptible to smoking.” Smoking was more common among youth with mental health disorders. Anxiety/depressive disorders were present in 14.5% of nonsmokers, 19.8% of susceptible nonsmokers, and 37.8% of smokers. After controlling for important covariates, youth with more than one anxiety and depressive disorder were at over twofold increased risk for being a smoker. Similarly, for each one-point increase in externalizing disorder symptoms, youth had a 10% increase in likelihood of being a smoker and a 4% increase in risk for “susceptibility to smoking.” Youth who were smokers reported more asthma symptoms, reduced functioning due to asthma, less use of controller medicines, and more use of rescue medications.ConclusionsComorbid mental health disorders are associated with increased risk of smoking in youth with asthma. Smoking is associated with increased asthma symptom burden and decreased controller medication use. Interventions for youth with asthma should consider screening for and targeting these behavioral concerns. |
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