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Numerous longitudinal studies have reported that depressive symptoms in childhood and adolescence are associated with increased risk of smoking initiation or progression to tobacco dependence.2 ,17 ,19 ,4648 At the same time, smoking cessation appears to be associated with an acute increase in depressive symptoms among a subgroup of smokers, and these individuals have poor smoking cessation outcomes.18 Taken together, this suggests that people experiencing depressive symptoms may smoke (or relapse to smoking) in an attempt to self-medicate these symptoms

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