Gender differences in the association between self-reported stress and cigarette smoking in Korean adolescents
Kisok Kim 1  
,   Hyejin Park 1
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College of Pharmacy, Keimyung University, Daegu, Republic of Korea
Kisok Kim   

College of Pharmacy, Keimyung University, Daegu 42601, Republic of Korea
Publication date: 2016-06-03
Tobacco Induced Diseases 2016;14(June):19
The aim of this study was to examine the relationship between stress and smoking among Korean adolescents, as well as the influence of gender on this relationship.

A cross-sectional study was conducted using data from 3930 adolescents aged 12–18 years, collected in the 2007–2012 Korea National Health and Nutrition Examination Surveys.

An increased level of self-reported stress was positively associated with increasing levels of smoking in both girls and boys (p for trend < 0.001). After adjusting for age, the odds ratios of smoking among girls and boys reporting very high levels of stress were 15.99 (95 % confidence interval (CI), 4.17–61.30) and 2.34 (95 % CI, 1.07–5.11), respectively, compared with those who reported low levels of stress.

This study found a statistically significant association between stress and smoking among Korean adolescents and this association was stronger in girls than boys. Further research is needed to understand more fully the link between stress and smoking in adolescents, with particular attention to sex differences.

World Health Organization. Tobacco Free Initiative. 2015. Accessed 16 Aug 2015.
U.S. Department of Health and Human Services. Preventing Tobacco Use Among Youth and Young Adults: A Report of the Surgeon General. 2012. Accessed 16 Aug 2015.
Korea Center for Disease Control and Prevention. The Tenth Korea Youth Risk Behavior Web-Based Survey 2014. 2015. Accessed 16 Jan 2016.
Fields S, Leraas K, Collins C, Reynolds B. Delay discounting as a mediator of the relationship between perceived stress and cigarette smoking status in adolescents. Behav Pharmacol. 2009;20:455–60.
Cui X, Rockett IR, Yang T, Cao R. Work stress, life stress, and smoking among rural-urban migrant workers in China. BMC Public Health. 2012;12:979.
Back SE, Waldrop AE, Saladin ME, Yeatts SD, Simpson A, McRae AL, et al. Effects of gender and cigarette smoking on reactivity to psychological and pharmacological stress provocation. Psychoneuroendocrinology. 2008;33:560–8.
Mitic WR, McGuire DP, Neumann B. Perceived stress and adolescents cigarette use. Psychol Rep. 1985;57:1043–8.
Dugan S, Lloyd B, Lucas K. Stress and coping as determinants of adolescent smoking behavior. J Applied Soc Psychol. 1999;29:870–88.
Statistics Korea. Youth statistics. 2014. Accessed 16 Aug 2015.
Yun BH, Choi YR, Choi YS, Cho S, Lee BS, Seo SK. Age at first delivery and osteoporosis risk in Korean postmenopausal women: The 2008–2011 Korea National Health and Nutrition Examination Survey (KNHANES). PLoS One. 2015;10:e0123665.
Biafora FA, Vega WA, Warheit GJ, Gil AG. Stressful life events and changes in substance use among multiracial/ethnic sample of adolescent boys. J Commun Psychol. 1994;22:296–311.
Guthrie BJ, Young AM, Boyd CJ, Kintner EK. Dealing with daily hassles: smoking and African-American adolescent girls. J Adolesc Health. 2001;29:109–15.
Finkelstein DM, Kubzansky LD, Goodman E. Social status, stress, and adolescent smoking. J Adolesc Health. 2006;39:678–85.
Voorhees CC, Schreiber GB, Schumann BC, Biro F, Crawford PB. Early predictors of daily smoking in young women: The national heart, lung, and blood institute growth and health study. Prevent Med. 2002;34:616–24.
Byrne DG, Byrne AE, Reinhart MI. Personality stress and the decision to commence cigarette smoking in adolescence. J Psychosom Res. 1995;39:53–62.
Byrne DG, Mazanov J. Adolescent stress and future smoking behaviour: A prospective investigation. J Psychosom Res. 2003;54:313–21.
Day NE, Wong MY, Bingham S, Khaw KT, Luben R, Michels KB, et al. Correlated measurement error--implications for nutritional epidemiology. Int J Epidemiol. 2004;33:1373–81.
Nielsen NR, Zhang ZF, Kristensen TS, Netterstrøm B, Schnohr P, Grønbaek M. Self reported stress and risk of breast cancer: prospective cohort study. BMJ. 2005;331:548.
Kwon JA, Park EC, Lee M, Yoo KB, Park S. Does stress increase the risk of atopic dermatitis in adolescents? results of the Korea Youth Risk Behavior Web-based Survey (KYRBWS-VI). PLoS One. 2013;8:e67890.
Ramage-Morin PL, Shields M, Martel L. Health-promoting factors and good health among Canadians in mid- to late life. Health Rep. 2010;21:45–53.
Perceived stress and smoking across 41 countries: A global perspective across Europe, Africa, Asia and the Americas
Brendon Stubbs, Nicola Veronese, Davy Vancampfort, A. Mathew Prina, Pao-Yen Lin, Ping-Tao Tseng, Evangelos Evangelou, Marco Solmi, Cristiano Kohler, André F. Carvalho, Ai Koyanagi
Scientific Reports
Perceived stress and poly-tobacco product use across adolescence: Patterns of association and gender differences
Adam M. Leventhal, Robert Urman, Jessica L. Barrington-Trimis, Nicholas I. Goldenson, Katia Gallegos, Chih Ping Chou, Kejia Wang, Kiros Berhane, Tess Boley Cruz, Mary Ann Pentz, Jennifer Unger, Rob S. McConnell
Journal of Psychiatric Research
Cigarette Smoking in South Korea: A Narrative Review
Rebekah Gunter, Edwin Szeto, Se-Hoon Jeong, Sooyeon Suh, Andrew Waters
Korean Journal of Family Medicine
Sex differences in the relationship among alcohol, smoking, and Helicobacter pylori infection in asymptomatic individuals
Wenzhi Wu, Marcis Leja, Vladislav Tsukanov, Zarrin Basharat, Dong Hua, Wandong Hong
Journal of International Medical Research