Although it is commonly thought that teen depression can lead to cigarette smoking, it may actually be the opposite. So suggests a study reported in the October Pediatrics by Ohio researchers.

Elizabeth Goodman, M.D., an associate professor of pediatrics at Children’s Hospital Medical Center in Cincinnati, and her coworkers have found that nondepressed teens who smoke face about a four times greater risk of developing depression than do nonsmoking, nondepressed teens.

If cigarette smoking can indeed trigger depression in teens, it may be because nicotine alters serotonin or other brain neurotransmitters, Goodman speculated. Indeed, nerve receptors that control the release of the neurotransmitter acetylcholine are known to be stimulated by nicotine.

On a more positive front, a preliminary state analysis suggests that state tobacco policies may be helping reduce teen smoking.

Douglas Luke, Ph.D., and colleagues of the St. Louis University School of Public Health in Missouri compared two sets of data: the National Cancer Institute’s 1996 State Cancer Legislative Database—a measure of state cancer-related legislation—and the results of the Centers for Disease Control and Prevention’s Youth Smoking Behavior Survey. States with more extensive tobacco control policies, such as New York, Connecticut, California, and Rhode Island, had significantly lower youth smoking rates than states with fewer such policies, such as South Dakota, Wisconsin, and Kentucky, the investigators found.

More extensive tobacco-control policies involved the enforcement of smoking-age restrictions, photo ID requirements for purchase, and incrementally severe penalties for stores employees caught selling cigarettes to underage youths.