Objective: Increased weight concern and dieting are associated with both depression and smoking among adolescents, particularly girls. This cross-sectional study examined the gender-specific role of weight concerns and dieting on the adolescent depression-smoking association.
Methods: Participants were 2051 adolescents (1056 boys and 995 girls) from seven high schools in the Netherlands who filled out questionnaires on smoking, depression, and weight constructs and of whom weight and height were measured.
Results: Logistic regression analyses showed that for girls, but not for boys, the depression-smoking association disappeared after controlling for weight concerns and dieting.
Conclusion: Our findings indicate that weight concerns and dieting are important factors to consider in the depression-smoking initiation relation for girls, but not for boys. This suggests that smoking prevention programs for depressed girls might be enhanced by challenging the idea of smoking as a diet strategy and incorporating a focus on healthy weight regulation. However, before setting up a prevention trial, future prospective studies should first examine why and how weight concerns and dieting are important factors in the depression-smoking initiation relation among girls, also in conjunction with other established risk factors such as parental and peer smoking.