Is mental health in childhood a major predictor of smoking in adolescence?

AIMS To test an extended version of Pomerleau's (1997) hypothesis that children with mental health problems are at higher risk of smoking in preadolescence and adolescence. DESIGN Information concerning mental health from 5 to 13 years, smoking at ages 11 and 15, and family disadvantage at age 7 was available for 773 children enrolled in a longitudinal study of children and adolescents. PARTICIPANTS Participants were enrolled into the Dunedin Multidisciplinary Health and Development Study, which is a longitudinal investigation of the health, development and behaviour of a large group of New Zealand children born between 1 April 1972 and 31 March 1973. MEASUREMENTS Assessment of mental health problems in childhood was based upon parent and teacher reports of behavioural and emotional problems. In pre-adolescence, mental health was assessed by self, parent and teacher report. Smoking was assessed by self-report. FINDINGS None of the potential risk factors of gender, childhood disadvantage or childhood mental health problems predicted onset of smoking in pre-adolescence. Daily smoking at age 15 was best predicted by smoking in preadolescence, being female and experiencing childhood disadvantage. Pre-adolescent mental health was only weakly predictive of later smoking and this association appeared to be confounded with background disadvantage. CONCLUSIONS We found little support for the extension of Pomerleau's (1997) hypothesis to childhood mental health. Our findings also run counter to recent suggestions for targeting smoking prevention at groups of children with mental health disorders.