Introduction: Smoking has been linked with depressive symptoms in adolescents, but data on secondhand smoking and depressive symptoms in low- and middle-income countries are scarce. Thus, this study analyzes the association between secondhand smoking and depressive symptoms among in-school adolescents from 22 low- and middle-income countries. Methods: Data from the 2003–2008 Global School-Based Student Health Survey were analyzed in June 2019. Data on past-week exposure to secondhand smoke and past-year depressive symptoms were collected. The association between secondhand smoke and depressive symptoms was studied using multivariable logistic regressions and meta-analyses. Results: The sample consisted of 37,505 adolescents aged 12–15 years who never smoked. The prevalence of depressive symptoms increased from 23.0% in adolescents with no secondhand smoking to 28.9% in those with secondhand smoking every day in the past week. After adjusting for sex, age, food insecurity, and country, there was a dose–response relationship between secondhand smoking and depressive symptoms in the overall sample (0 days: reference; 1–2 days: OR=1.06, 95% CI=0.95, 1.18; 3–6 days: OR=1.38, 95% CI=1.20, 1.58; 7 days: OR=1.63, 95% CI=1.44, 1.86). The country-wise analysis showed that secondhand smoking on at least 3 days (versus <3 days) in the past week was associated with a 1.48-fold increase in the odds of depressive symptoms (95% CI=1.39, 1.59), with a low level of between-country heterogeneity (I2=4.2%). Conclusions: There was a positive association between secondhand smoking and depressive symptoms among in-school adolescents from low- and middle-income countries. Further research should investigate causality and assess whether prevention of exposure to secondhand smoke can have a positive effect on the mental well-being of adolescents.
|Number of pages||9|
|Journal||American Journal of Preventive Medicine|
|Publication status||Published - 2020 May|
Bibliographical noteFunding Information:
This research was based on data from the Global School-Based Student Health Survey, which was made available for use by the Chronic Diseases and Health Promotion Department of the WHO and the U.S. Centers for Disease Control and Prevention. Ai Koyanagi's work is supported by the PI15/00862 project, integrated into the National R + D + I and funded by the ISCIII - General Branch Evaluation and Promotion of Health Research - and the European Regional Development Fund (ERDF-FEDER). LJ contributed to the design of the study, undertook the statistical analysis, managed the literature searches, wrote the first draft of the manuscript, and contributed to the correction of the manuscript. LS, SEJ, JMH, and JIS contributed to the design of the study and the correction of the manuscript. AK contributed to the design of the study, undertook the statistical analysis, and contributed to the correction of the manuscript. All authors contributed to and have approved the final manuscript. The data sets supporting the conclusions of this article are available at www.cdc.gov. No financial disclosures were reported by the authors of this paper.
Ai Koyanagi's work is supported by the PI15/00862 project, integrated into the National R + D + I and funded by the ISCIII - General Branch Evaluation and Promotion of Health Research - and the European Regional Development Fund (ERDF-FEDER).
© 2020 American Journal of Preventive Medicine
All Science Journal Classification (ASJC) codes
- Public Health, Environmental and Occupational Health