Roya Kelishadi1, Amir Eslami Shahr Babaki2, Mostafa Qorbani3,4, Zeinab Ahadi5, Ramin Heshmat6, Mohammad Esmaeil Motlagh7, Gelayol Ardalan1, Asal Ataie-Jafari5, Hamid Asayesh8, Rasool Mohammadi9. 1. Pediatrics Department, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran. 2. Research Department, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. 3. Department of Community Medicine, Alborz University of Medical Sciences, Karaj, Iran. mqorbani1379@yahoo.com. 4. Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran. mqorbani1379@yahoo.com. 5. Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran. 6. Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran. rheshmat@tums.ac.ir. 7. Pediatrics Department, Ahvaz University of Medical Sciences, Ahvaz, Iran. 8. Department of Medical Emergencies, Qom University of Medical Sciences, Qom, Iran. 9. Department of Epidemiology, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Abstract
BACKGROUND: Mental health and smoking have been receiving increasing attention in adolescents all over the world. Although some studies have assessed the independent association of active/passive smoking with mental health, joint association of active and passive smoking with mental health remains unclear. PURPOSE: This study was designed to evaluate the joint association of smoking status (active and passive smoking) with psychiatric distress and violent behaviors in Iranian children and adolescents. METHOD: In this national survey, 13,486 students, aged 6-18 years, living in rural and urban areas of 30 provinces of Iran were selected via multistage, cluster sampling method. Psychiatric distress (including worthless, angriness, worrying, insomnia, confusion, depression, and anxiety), violence behaviors (including bullying, victim, and physical fight), and smoking status (nonsmoker, only passive smoker, only active smoker, and active and passive smoker) were assessed. The questionnaire was prepared based on the World Health Organization Global School-based Student Health Survey (WHO-GSHS). Data were analyzed by the Stata package. RESULTS: Psychiatric distress and violent behaviors had linearly positive association with smoking status (p trend < 0.001). Compared to "nonsmoker" group, participants who were exposed to passive smoking besides active tobacco use were at increased risk of having angriness (odds ratio (OR) 2.55, 95 % confidence interval (CI) 1.86-3.48), worrying (OR 1.66, 95 % CI 1.24-2.20), and anxiety (OR 1.99, 95 % CI 1.52-2.61) and victim (OR 1.77, 95 % CI 1.34-2.33) and bully behaviors (OR 3.08, 95 % CI 2.33-4.07). CONCLUSION: The current findings suggest that active and passive tobacco smoking has synergistic effect on psychiatric distress. Since majority of smokers with psychiatric distress do not receive mental health services or counseling on smoking, strategies to address mental health problems and smoking prevention should be included as a part of school health services.
BACKGROUND: Mental health and smoking have been receiving increasing attention in adolescents all over the world. Although some studies have assessed the independent association of active/passive smoking with mental health, joint association of active and passive smoking with mental health remains unclear. PURPOSE: This study was designed to evaluate the joint association of smoking status (active and passive smoking) with psychiatric distress and violent behaviors in Iranian children and adolescents. METHOD: In this national survey, 13,486 students, aged 6-18 years, living in rural and urban areas of 30 provinces of Iran were selected via multistage, cluster sampling method. Psychiatric distress (including worthless, angriness, worrying, insomnia, confusion, depression, and anxiety), violence behaviors (including bullying, victim, and physical fight), and smoking status (nonsmoker, only passive smoker, only active smoker, and active and passive smoker) were assessed. The questionnaire was prepared based on the World Health Organization Global School-based Student Health Survey (WHO-GSHS). Data were analyzed by the Stata package. RESULTS:Psychiatric distress and violent behaviors had linearly positive association with smoking status (p trend < 0.001). Compared to "nonsmoker" group, participants who were exposed to passive smoking besides active tobacco use were at increased risk of having angriness (odds ratio (OR) 2.55, 95 % confidence interval (CI) 1.86-3.48), worrying (OR 1.66, 95 % CI 1.24-2.20), and anxiety (OR 1.99, 95 % CI 1.52-2.61) and victim (OR 1.77, 95 % CI 1.34-2.33) and bully behaviors (OR 3.08, 95 % CI 2.33-4.07). CONCLUSION: The current findings suggest that active and passive tobacco smoking has synergistic effect on psychiatric distress. Since majority of smokers with psychiatric distress do not receive mental health services or counseling on smoking, strategies to address mental health problems and smoking prevention should be included as a part of school health services.
Authors: Frank C Bandiera; Alberto J Caban-Martinez; Kristopher L Arheart; Evelyn P Davila; Lora E Fleming; Noella A Dietz; John E Lewis; David Fabry; David J Lee Journal: Ann Behav Med Date: 2010-05
Authors: K A Perkins; J E Sexton; R L Stiller; C Fonte; A DiMarco; J Goettler; A Scierka Journal: Psychopharmacology (Berl) Date: 1994-01 Impact factor: 4.530
Authors: Mostafa Qorbani; Ramin Heshmat; Mohammad Reza Hashemi-Aghdam; Gita Shafiee; Mehdi Ebrahimi; Hanieh-Sadat Ejtahed; Mehdi Yaseri; Mohammad Esmaeil Motlagh; Roya Kelishadi Journal: BMC Public Health Date: 2022-03-29 Impact factor: 3.295