Objectives. An association of smoking with depression and anxiety has
been documented in adult smokers. This study examines this association
in a representative group of teenage smokers. Methods. A two-stage cl
uster sample of secondary school students in Victoria, Australia, were
surveyed by using a computerized questionnaire, which included a 7-da
y retrospective diary for tobacco use and a structured psychiatric int
erview. Results. Subjects reporting high levels of depression and anxi
ety were twice as likely to be smokers after the potential confounders
of year level, sex, alcohol use, and parental smoking were controlled
for. Regular smokers were almost twice as likely as occasional smoker
s to report high levels of depression and anxiety. In a stratified ana
lysis, an association between regular smoking and psychiatric morbidit
y was found in girls of all ages but for boys only in the youngest gro
up. Conclusions. The cross-sectional association is consistent with th
e use of smoking by teenage girls as self-medication for depression an
d anxiety. Therefore, future health promotional campaigns might consid
er strategies that attend to perceived psychological benefits of smoki
ng.