The role of smoking and rebelliousness in the development of depressive symptoms among a cohort of Massachusetts adolescents

Background. Recent studies have shown that smoking leads to depressive symptoms among adolescents, but the mechanisms underlying the relationship remain unclear. In this study, we focused on one possible mechanism, namely, the effect of rebelliousness. We examined the extent to which rebelliousness accounts for the relation between smoking and depression among adolescents in Massachusetts. Methods. Data were from a follow-up telephone survey of youth in Massachusetts. A subset of adolescents who were classified as not highly depressed at baseline in 1993 was used for the analyses (n=522). Logistic regression analyses were used to predict whether cigarette smoking increased the odds of developing high depressive symptoms 4 years later, while controlling for rebelliousness and other factors. Results. Ever smoking a cigarette at baseline had a statistically significant impact on high depressive symptoms at follow-up. Once rebelliousness was considered, the relationship between ever smoking and follow-up depressive symptoms became nonsignificant. Conclusions. The findings indicate that rebelliousness accounted for the relation between adolescent smoking and the emergence of depressive symptoms. Rebelliousness may provide a modifiable variable to be targeted to interrupt the linkage between adolescent smoking and depression. (C) 2002 American Health Foundation and Elsevier Science (USA).