(Philadelphia, PA) Depressed adolescents who are highly receptive to tobacco advertising are most vulnerable to experiment with smoking, a study by researchers from the University of Pennsylvania School of Medicine and Georgetown University indicates. This finding, published in the March issue of the Journal of Pediatric Psychology, leads researchers to believe that tailoring prevention and intervention efforts to encompass tobacco advertising's effects and the role of depression could lead to a reduction in youth smoking.

Approximately 36 percent of all US adolescents are current smokers. The Centers for Disease Control and Prevention estimates that five million of today's adolescents will die prematurely from smoking-related illnesses, creating approximately $200 billion in future health care costs.

Why so many adolescents start and continue to smoke despite the associated health risks remains an important public health question. Previous research has shown that the nicotine contained in cigarettes is a psychostimulant and can ameliorate depressive symptoms by inducing feelings of euphoria and relaxation.

Senior author Janet Audrain, PhD, from the University of Pennsylvania Cancer Center and Department of Psychiatry, and researchers from Georgetown University are exploring the social, psychological and genetic factors that influence adolescents' decisions about smoking. Audrain's group surveyed over 1,100 ninth grade students. These students completed a survey that assessed current smoking practices, exposure to other smokers, levels of depression, and receptivity to tobacco advertising. Demographic data including age, gender, and race/ethnicity were also collected.

Sixty percent of the students reported that they were never smokers, i.e., "never tried or experimented with smoking, even a few puffs." Forty percent reported ever being smokers, i.e., "ever smoked at least a partial or whole cigarette." The data show that adolescents who are exposed to peer smoking are more likely to smoke themselves. Furthermore, adolescents who are highly receptive to tobacco advertising and have clinically significant symptoms of depression are also more likely to smoke than adolescents without these symptoms.

"It is critically important that adolescents, particularly those who grow up in households where one or more smokers are present, receive messages early in life about the hazards associated with smoking," said Kenneth P. Tercyak, PhD, study co-investigator and author. In tailoring these messages to adolescents, it is also important to consider their current psychological state.

The researchers suggest that anti-tobacco advertising campaigns designed to dispel myths about the benefits of smoking as portrayed in tobacco advertisements (i.e. ads that insinuate the smoking can be a key to happiness and social success) should incorporate messages about the possible relationship between depression and smoking. According to Audrain, such campaigns should also include messages about "how tobacco companies may be exploiting those who are psychologically vulnerable to smoke."

This research was funded by the National Cancer Institute and the National Institute on Drug Abuse and was conducted by the University of Pennsylvania/Georgetown University Transdisciplinary Tobacco Use Research Center.



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The Perelman School of Medicine has been ranked among the top five medical schools in the United States for the past 20 years, according to U.S. News & World Report's survey of research-oriented medical schools. The School is consistently among the nation's top recipients of funding from the National Institutes of Health, with $392 million awarded in the 2016 fiscal year.

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