Journal of pediatric nursing · 2026
Cigarette smoking prevalence and its risk factors, including social anxiety and depression, among adolescents in Turkey: A school-based cross-sectional study.
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Kaçmaz Elif Ezgi, Gümüş Şekerci Yasemin
Аннотация
PURPOSE: This study aimed to determine the prevalence of smoking and levels of social anxiety and depression among adolescents and examine the risk factors that influence smoking.
METHODS: This cross-sectional study was conducted in Turkey in 2025 with 3636 adolescents aged 13-19 years. Data were collected using a Personal Information Form, the Social Anxiety Scale for Adolescents, and the Basic Depression Scale. Descriptive statistics, independent-samples t-tests, chi-square tests, and logistic regression analyses were used for the data analysis.
RESULTS: The prevalence of smoking in this study was 9.5%. Sex, grade level, having family members or friends who smoke, social anxiety, and depression were identified as significant smoking risk factors. Specifically, having peers who smoke increased the likelihood of adolescent smoking by 9.627 times, whereas having family members who smoke increased this likelihood by 1.412 times. Additionally, each one-unit increase in social anxiety score was associated with a 1.6% increase in the likelihood of smoking, whereas each one-unit increase in depression score was associated with a 5.2% increase.
CONCLUSION: The findings revealed that depression and social anxiety are critical psychological variables that must be considered when understanding cigarette smoking.
PRACTICAL IMPLICATIONS: School nurses can develop comprehensive approaches to reduce peer influence and strengthen psychosocial support systems in anti-smoking programs for adolescents. Additionally, they can facilitate the expansion of school-based mental health screenings.
METHODS: This cross-sectional study was conducted in Turkey in 2025 with 3636 adolescents aged 13-19 years. Data were collected using a Personal Information Form, the Social Anxiety Scale for Adolescents, and the Basic Depression Scale. Descriptive statistics, independent-samples t-tests, chi-square tests, and logistic regression analyses were used for the data analysis.
RESULTS: The prevalence of smoking in this study was 9.5%. Sex, grade level, having family members or friends who smoke, social anxiety, and depression were identified as significant smoking risk factors. Specifically, having peers who smoke increased the likelihood of adolescent smoking by 9.627 times, whereas having family members who smoke increased this likelihood by 1.412 times. Additionally, each one-unit increase in social anxiety score was associated with a 1.6% increase in the likelihood of smoking, whereas each one-unit increase in depression score was associated with a 5.2% increase.
CONCLUSION: The findings revealed that depression and social anxiety are critical psychological variables that must be considered when understanding cigarette smoking.
PRACTICAL IMPLICATIONS: School nurses can develop comprehensive approaches to reduce peer influence and strengthen psychosocial support systems in anti-smoking programs for adolescents. Additionally, they can facilitate the expansion of school-based mental health screenings.