{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T03:57:35Z","timestamp":1768795055183,"version":"3.49.0"},"reference-count":60,"publisher":"Walter de Gruyter GmbH","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,2,29]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"j_ijamh-2023-0197_abs_001\">\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Emerging evidence points to tobacco experimentation being associated with a vast array of mental disorders, particularly anxiety and depression. We aimed to assess the prevalence of tobacco experimentation, its predictive factors and its potential links with anxiety and depressive disorders among in school adolescents in a Tunisian delegation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_ijamh-2023-0197_abs_002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We carried out a cross sectional study among adolescents schooling in middle and high schools in the delegation of Nfidha, Sousse, Tunisia, during the period from January to March of the 2019\u20132020 school year using an anonymous questionnaire self-administered to a representative sample of 1,353 randomly selected pupils. Data were collected using the Arabic versions of the Beck Depression Inventory short form (13 items) and the Screen for Child Anxiety Related Disorders (SCARED-C) and a socio-demographic questionnaire with reference to the literature.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_ijamh-2023-0197_abs_003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Tobacco was experimented by (17.5\u202f%; CI 95\u202f%: 14.8\u201318.8\u202f%) of pupils. Almost three out of four pupils (73.2\u202f%; CI 95\u202f%: 70.8\u201375.6\u202f%) reported experiencing depressive symptoms and (65\u202f%; CI 95\u202f%: 62.5\u201367.5\u202f%) anxiety symptoms. Pupils who exhibited depressive disorder indicators were significantly more prone to experiment with tobacco (20.2 vs. 9.9\u202f%, p&lt;0.001; crude OR=2.301 CI 95\u202f%: 1.74\u20133.58). Similarly, the prevalence of tobacco experimentation was found to be higher among pupils who reported having experienced anxiety disorders (21.0 vs. 14.5\u202f%, p&lt;0.001; crude OR=1.56 CI 95\u202f%: 1.06\u20132.27). Being a male pupil (AOR=5.48 95\u202f% CI: 3.62\u20138.31), being be enrolled in a high school (AOR=2.86, 95\u202f% CI: 1.92\u20134.26), tobacco use by father and siblings (respectively AOR=1.76, 95\u202f% CI: 1.19\u20132.60; AOR=2.47, 95\u202f% CI: 1.52\u20134.02) and experiencing depressive disorders (AOR=2.69, 95\u202f% CI: 1.60\u20134.53) were the determinants of tobacco experimentation in the multivariate analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_ijamh-2023-0197_abs_004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Tobacco experimentation in adolescence has been shown to be significantly associated with anxiety and depression. National smoking prevention strategies should be reinforced with a focus on mental health disorders.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1515\/ijamh-2023-0197","type":"journal-article","created":{"date-parts":[[2024,2,27]],"date-time":"2024-02-27T23:50:22Z","timestamp":1709077822000},"page":"85-94","source":"Crossref","is-referenced-by-count":0,"title":["Association of tobacco experimentation with anxiety and depression: findings from a representative sample of Tunisian adolescents"],"prefix":"10.1515","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1300-8664","authenticated-orcid":false,"given":"Amel","family":"Amara","sequence":"first","affiliation":[{"name":"Department of Community and Family Medicine , Sousse , Tunisia"},{"name":"Research Laboratory LR12ES03 , Sousse , Tunisia"},{"name":"Faculty of Medicine of Sousse , University of Sousse , Sousse , Tunisia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nihel","family":"Omri","sequence":"additional","affiliation":[{"name":"Department of Community and Family Medicine , Sousse , Tunisia"},{"name":"Faculty of Medicine of Sousse , University of Sousse , Sousse , Tunisia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9363-4536","authenticated-orcid":false,"given":"Rania","family":"Bannour","sequence":"additional","affiliation":[{"name":"Department of Community and Family Medicine , Sousse , Tunisia"},{"name":"Research Laboratory LR12ES03 , Sousse , Tunisia"},{"name":"Faculty of Medicine of Sousse , University of Sousse , Sousse , Tunisia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manel","family":"Limam","sequence":"additional","affiliation":[{"name":"Department of Community and Family Medicine , Sousse , Tunisia"},{"name":"Research Laboratory LR12ES03 , Sousse , Tunisia"},{"name":"Faculty of Medicine of Sousse , University of Sousse , Sousse , Tunisia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Meriam","family":"El Ghardallou","sequence":"additional","affiliation":[{"name":"Department of Community and Family Medicine , Sousse , Tunisia"},{"name":"Research Laboratory LR12ES03 , Sousse , Tunisia"},{"name":"Faculty of Medicine of Sousse , University of Sousse , Sousse , Tunisia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Menel","family":"Mellouli","sequence":"additional","affiliation":[{"name":"Department of Community and Family Medicine , Sousse , Tunisia"},{"name":"Research Laboratory LR12ES03 , Sousse , Tunisia"},{"name":"Faculty of Medicine of Sousse , University of Sousse , Sousse , Tunisia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jihene","family":"Sahli","sequence":"additional","affiliation":[{"name":"Department of Community and Family Medicine , Sousse , Tunisia"},{"name":"Research Laboratory LR12ES03 , Sousse , Tunisia"},{"name":"Faculty of Medicine of Sousse , University of Sousse , Sousse , Tunisia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ali","family":"Mtiraoui","sequence":"additional","affiliation":[{"name":"Department of Community and Family Medicine , Sousse , Tunisia"},{"name":"Research Laboratory LR12ES03 , Sousse , Tunisia"},{"name":"Faculty of Medicine of Sousse , University of Sousse , Sousse , Tunisia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"374","published-online":{"date-parts":[[2024,2,28]]},"reference":[{"key":"2026011700054965943_j_ijamh-2023-0197_ref_001","doi-asserted-by":"crossref","unstructured":"Soleimani, MA, Sharif, SP, Bahrami, N, Yaghoobzadeh, A, Allen, KA, Mohammadi, S. The relationship between anxiety, depression and risk behaviors in adolescents. Int J Adolesc Med Health 2019 [cit\u00e9 1 ao\u00fbt 2023];31. Disponible sur: https:\/\/www.degruyter.com\/document\/doi\/10.1515\/ijamh-2016-0148\/html.","DOI":"10.1515\/ijamh-2016-0148"},{"key":"2026011700054965943_j_ijamh-2023-0197_ref_002","doi-asserted-by":"crossref","unstructured":"Sendi, I, Chouikh, A, Ammar, A, Bouafia, N. Depression in a sample of Tunisian adolescents: prevalence, associated factors and comorbidity with anxiety disorders. Int J Adolesc Med Health 2021;33:20180068. https:\/\/doi.org\/10.1515\/ijamh-2018-0068.","DOI":"10.1515\/ijamh-2018-0068"},{"key":"2026011700054965943_j_ijamh-2023-0197_ref_003","doi-asserted-by":"crossref","unstructured":"Zammit, N, Maatoug, J, Ghammam, R, Fredj, SB, Dhouib, W, Ayouni, I, et al.. Surveillance of tobacco use among young adolescents: trends and predictors across three years in Sousse, Tunisia. BMC Publ Health 2022;22:2022. https:\/\/doi.org\/10.1186\/s12889-022-14416-x.","DOI":"10.1186\/s12889-022-14416-x"},{"key":"2026011700054965943_j_ijamh-2023-0197_ref_004","doi-asserted-by":"crossref","unstructured":"Slomp, FM, Bara, TS, Picharski, GL, Cordeiro, ML. Association of cigarette smoking with anxiety, depression, and suicidal ideation among Brazilian adolescents. Neuropsychiatric Dis Treat 2019;15:2799\u2013808. https:\/\/doi.org\/10.2147\/ndt.s217069.","DOI":"10.2147\/NDT.S217069"},{"key":"2026011700054965943_j_ijamh-2023-0197_ref_005","doi-asserted-by":"crossref","unstructured":"Goldade, K, Choi, K, Bernat, DH, Klein, EG, Okuyemi, KS, Forster, J. Multilevel predictors of smoking initiation among adolescents: findings from the Minnesota Adolescent Community Cohort (MACC) study. Prev Med 2012;54:242\u20136. https:\/\/doi.org\/10.1016\/j.ypmed.2011.12.029.","DOI":"10.1016\/j.ypmed.2011.12.029"},{"key":"2026011700054965943_j_ijamh-2023-0197_ref_006","doi-asserted-by":"crossref","unstructured":"Talati, A, Wickramaratne, PJ, Keyes, KM, Hasin, DS, Levin, FR, Weissman, MM. Smoking and psychopathology increasingly associated in recent birth cohorts. Drug Alcohol Depend 2013;133:724\u201332. https:\/\/doi.org\/10.1016\/j.drugalcdep.2013.08.025.","DOI":"10.1016\/j.drugalcdep.2013.08.025"},{"key":"2026011700054965943_j_ijamh-2023-0197_ref_007","doi-asserted-by":"crossref","unstructured":"Bhandari, M. Anxiety and depression among adolescent students at higher secondary school. Bibechana 2017;14:103\u20139. https:\/\/doi.org\/10.3126\/bibechana.v14i0.16019.","DOI":"10.3126\/bibechana.v14i0.16019"},{"key":"2026011700054965943_j_ijamh-2023-0197_ref_008","unstructured":"Mental health of adolescents. Accessed February 13, 2024. https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/adolescent-mental-health."},{"key":"2026011700054965943_j_ijamh-2023-0197_ref_009","doi-asserted-by":"crossref","unstructured":"Taylor, S, Landry, CA, Rachor, GS, Paluszek, MM, Asmundson, GJG. Fear and avoidance of healthcare workers: an important, under-recognized form of stigmatization during the COVID-19 pandemic. J Anxiety Disord 2020;75:102289. https:\/\/doi.org\/10.1016\/j.janxdis.2020.102289.","DOI":"10.1016\/j.janxdis.2020.102289"},{"key":"2026011700054965943_j_ijamh-2023-0197_ref_010","unstructured":"Peltzer, K. Early smoking initiation and associated factors among in-school male and female adolescents in seven African countries. Afr Health Sci 2011 [cit\u00e9 31 juill 2023];11. Disponible sur: https:\/\/www.ajol.info\/index.php\/ahs\/article\/view\/73385."},{"key":"2026011700054965943_j_ijamh-2023-0197_ref_011","doi-asserted-by":"crossref","unstructured":"Morissette, SB, Tull, MT, Gulliver, SB, Kamholz, BW, Zimering, RT. Anxiety, anxiety disorders, tobacco use, and nicotine: a critical review of interrelationships. Psychol Bull 2007;133:245\u201372. https:\/\/doi.org\/10.1037\/0033-2909.133.2.245.","DOI":"10.1037\/0033-2909.133.2.245"},{"key":"2026011700054965943_j_ijamh-2023-0197_ref_012","doi-asserted-by":"crossref","unstructured":"Farrell, M, Howes, S, Taylor, C, Lewis, G, Jenkins, R, Bebbington, P, et al.. Substance misuse and psychiatric comorbidity: an overview of the OPCS national psychiatric morbidity survey. Addict Behav 1998;23:909\u201318. https:\/\/doi.org\/10.1016\/s0306-4603(98)00075-6.","DOI":"10.1016\/S0306-4603(98)00075-6"},{"key":"2026011700054965943_j_ijamh-2023-0197_ref_013","doi-asserted-by":"crossref","unstructured":"Fluharty, M, Taylor, AE, Grabski, M, Munaf\u00f2, MR. The association of cigarette smoking with depression and anxiety: a systematic review. Nicotine Tob Res 2017;19:3\u201313. https:\/\/doi.org\/10.1093\/ntr\/ntw140.","DOI":"10.1093\/ntr\/ntw140"},{"key":"2026011700054965943_j_ijamh-2023-0197_ref_014","doi-asserted-by":"crossref","unstructured":"Mykletun, A, Overland, S, Aar\u00f8, LE, Liab\u00f8, HM, Stewart, R. Smoking in relation to anxiety and depression: evidence from a large population survey: the HUNT study. Eur Psychiatry 2008;23:77\u201384. https:\/\/doi.org\/10.1016\/j.eurpsy.2007.10.005.","DOI":"10.1016\/j.eurpsy.2007.10.005"},{"key":"2026011700054965943_j_ijamh-2023-0197_ref_015","doi-asserted-by":"crossref","unstructured":"Ghali, H, Rejeb, OB, Fredj, SB, Kh\u00e9facha, S, Dhidah, L, Rejeb, MB, et al.. Smoking dependence and anxio-depressive disorders in Tunisian smokers attending the smoking cessation clinic in a university hospital. J Egypt Public Health Assoc 2019;94:9. https:\/\/doi.org\/10.1186\/s42506-019-0012-y.","DOI":"10.1186\/s42506-019-0012-y"},{"key":"2026011700054965943_j_ijamh-2023-0197_ref_016","doi-asserted-by":"crossref","unstructured":"Feldner, MT, Babson, KA, Zvolensky, MJ. Smoking, traumatic event exposure, and post-traumatic stress: a critical review of the empirical literature. Clin Psychol Rev 2007;27:14\u201345. https:\/\/doi.org\/10.1016\/j.cpr.2006.08.004.","DOI":"10.1016\/j.cpr.2006.08.004"},{"key":"2026011700054965943_j_ijamh-2023-0197_ref_017","unstructured":"Major depression and stages of smoking: a longitudinal investigation | depressive disorders | JAMA psychiatry | JAMA network [Internet]. [cit\u00e9 2 ao\u00fbt 2023]. Disponible sur: https:\/\/jamanetwork.com\/journals\/jamapsychiatry\/article-abstract\/190815."},{"key":"2026011700054965943_j_ijamh-2023-0197_ref_018","doi-asserted-by":"crossref","unstructured":"Glassman, AH. Cigarette smoking: implications for psychiatric illness. Am J Psychiatry 1993;150:546\u201353. https:\/\/doi.org\/10.1176\/ajp.150.4.546.","DOI":"10.1176\/ajp.150.4.546"},{"key":"2026011700054965943_j_ijamh-2023-0197_ref_019","doi-asserted-by":"crossref","unstructured":"Glassman, AH, Covey, LS, Stetner, F, Rivelli, S. Smoking cessation and the course of major depression: a follow-up study. Lancet 2001;357:1929\u201332. https:\/\/doi.org\/10.1016\/s0140-6736(00)05064-9.","DOI":"10.1016\/S0140-6736(00)05064-9"},{"key":"2026011700054965943_j_ijamh-2023-0197_ref_020","doi-asserted-by":"crossref","unstructured":"McKenzie, M, Olsson, CA, Jorm, AF, Romaniuk, H, Patton, GC. Association of adolescent symptoms of depression and anxiety with daily smoking and nicotine dependence in young adulthood: findings from a 10-year longitudinal study: teen depression and young adult smoking. Addiction 2010;105:1652\u20139. https:\/\/doi.org\/10.1111\/j.1360-0443.2010.03002.x.","DOI":"10.1111\/j.1360-0443.2010.03002.x"},{"key":"2026011700054965943_j_ijamh-2023-0197_ref_021","doi-asserted-by":"crossref","unstructured":"Chaiton, MO, Cohen, JE, O\u2019Loughlin, J, Rehm, J. A systematic review of longitudinal studies on the association between depression and smoking in adolescents. BMC Publ Health 2009;9:356. https:\/\/doi.org\/10.1186\/1471-2458-9-356.","DOI":"10.1186\/1471-2458-9-356"},{"key":"2026011700054965943_j_ijamh-2023-0197_ref_022","doi-asserted-by":"crossref","unstructured":"Munaf\u00f2, MR, Hitsman, B, Rende, R, Metcalfe, C, Niaura, R. Effects of progression to cigarette smoking on depressed mood in adolescents: evidence from the National Longitudinal Study of Adolescent Health. Addiction 2008;103:162\u201371. https:\/\/doi.org\/10.1111\/j.1360-0443.2007.02052.x.","DOI":"10.1111\/j.1360-0443.2007.02052.x"},{"key":"2026011700054965943_j_ijamh-2023-0197_ref_023","doi-asserted-by":"crossref","unstructured":"Taylor, AE, Fluharty, ME, Bj\u00f8rngaard, JH, Gabrielsen, ME, Skorpen, F, Marioni, RE, et al.. Investigating the possible causal association of smoking with depression and anxiety using Mendelian randomisation meta-analysis: the CARTA consortium. BMJ Open 2014;4:e006141. https:\/\/doi.org\/10.1136\/bmjopen-2014-006141.","DOI":"10.1136\/jech-2014-204726.94"},{"key":"2026011700054965943_j_ijamh-2023-0197_ref_024","doi-asserted-by":"crossref","unstructured":"Pengpid, S, Peltzer, K. Prevalence and associated factors of psychological distress among a national sample of in-school adolescents in Morocco. BMC Psychiatr 2020;20:475. https:\/\/doi.org\/10.1186\/s12888-020-02888-3.","DOI":"10.1186\/s12888-020-02888-3"},{"key":"2026011700054965943_j_ijamh-2023-0197_ref_025","doi-asserted-by":"crossref","unstructured":"El Achhab, Y, El Ammari, A, El Kazdouh, H, Najdi, A, Berraho, M, Tachfouti, N, et al.. Health risk behaviours amongst school adolescents: protocol for a mixed methods study. BMC Publ Health 2016;16:1209. https:\/\/doi.org\/10.1186\/s12889-016-3873-4.","DOI":"10.1186\/s12889-016-3873-4"},{"key":"2026011700054965943_j_ijamh-2023-0197_ref_026","unstructured":"GLANZ, Karen, RIMER, Barbara K, et VISWANATH, Kasisomayajula. (ed.). Health behavior: Theory, research, and practice. John Wiley & Sons, 2015."},{"key":"2026011700054965943_j_ijamh-2023-0197_ref_027","doi-asserted-by":"crossref","unstructured":"Fakhfakh, R, Jaidane, I, Hsairi, M, Ben Hamida, AM. Les facteurs de risque et de protection de l\u2019initiation \u00e0 la cigarette chez les adolescents tunisiens. Revue d\u2019\u00c9pid\u00e9miologie et de Sant\u00e9 Publique, 2015, vol. 63, no 6, p. 369\u2013379. https:\/\/doi.org\/10.1016\/j.respe.2015.09.005.","DOI":"10.1016\/j.respe.2015.09.005"},{"key":"2026011700054965943_j_ijamh-2023-0197_ref_028","doi-asserted-by":"crossref","unstructured":"Ayedi, Y, Harizi, C, Skhiri, A, Fakhfakh, R. Linking global youth tobacco survey (GYTS) data to the WHO framework convention on tobacco control (FCTC): the case for Tunisia. Tob Induc Dis 2022;20:07. https:\/\/doi.org\/10.18332\/tid\/143994.","DOI":"10.18332\/tid\/143994"},{"key":"2026011700054965943_j_ijamh-2023-0197_ref_029","doi-asserted-by":"crossref","unstructured":"Ayed, HB, Yaich, S, Hmida, MB, Jemaa, MB, Trigui, M, Karray, R, et al.. Prevalence and factors associated with smoking among Tunisian secondary school-adolescents. Int J Adolesc Med Health 2021;33:379\u201387. https:\/\/doi.org\/10.1515\/ijamh-2019-0088.","DOI":"10.1515\/ijamh-2019-0088"},{"key":"2026011700054965943_j_ijamh-2023-0197_ref_030","unstructured":"1680a2c810.pdf [Internet]. [cit\u00e9 13 ao\u00fbt 2022]. Disponible sur: https:\/\/rm.coe.int\/p-pg-mednet-2021-8-medspad-guidelines-2020-2021-fr\/1680a2c810."},{"key":"2026011700054965943_j_ijamh-2023-0197_ref_031","unstructured":"16808cbf44.pdf [Internet]. [cit\u00e9 6 ao\u00fbt 2022]. Disponible sur: https:\/\/rm.coe.int\/2017-ppg-med-41-medspad-tunisia-report-fra\/16808cbf44."},{"key":"2026011700054965943_j_ijamh-2023-0197_ref_032","doi-asserted-by":"crossref","unstructured":"Beck, AT, Beck, RW. Screening depressed patients in family practice. A rapid technic. Postgrad Med 1972;52:81\u20135. https:\/\/doi.org\/10.1080\/00325481.1972.11713319.","DOI":"10.1080\/00325481.1972.11713319"},{"key":"2026011700054965943_j_ijamh-2023-0197_ref_033","unstructured":"An Arabic validation of a depression inventory \u2013 Julia West 1985 [Internet]. [cit\u00e9 17 juill 2023]. Disponible sur: https:\/\/journals.sagepub.com\/doi\/10.1177\/002076408503100406."},{"key":"2026011700054965943_j_ijamh-2023-0197_ref_034","doi-asserted-by":"crossref","unstructured":"Dadfar, M, Kalibatseva, Z. Psychometric properties of the Persian version of the short Beck depression inventory with Iranian psychiatric outpatients. Scientifica 2016;2016:8196463. https:\/\/doi.org\/10.1155\/2016\/8196463.","DOI":"10.1155\/2016\/8196463"},{"key":"2026011700054965943_j_ijamh-2023-0197_ref_035","doi-asserted-by":"crossref","unstructured":"Behrens, B, Swetlitz, C, Pine, DS, Pagliaccio, D. The screen for child anxiety related emotional disorders (SCARED): informant discrepancy, measurement invariance, and test-retest reliability. Child Psychiatry Hum Dev 2019;50:473\u201382. https:\/\/doi.org\/10.1007\/s10578-018-0854-0.","DOI":"10.1007\/s10578-018-0854-0"},{"key":"2026011700054965943_j_ijamh-2023-0197_ref_036","doi-asserted-by":"crossref","unstructured":"Birmaher, B, Khetarpal, S, Brent, D, Cully, M, Balach, L, Kaufman, J, et al.. The screen for child anxiety related emotional disorders (SCARED): scale construction and psychometric characteristics. J Am Acad Child Adolesc Psychiatry 1997;36:545\u201353. https:\/\/doi.org\/10.1097\/00004583-199704000-00018.","DOI":"10.1097\/00004583-199704000-00018"},{"key":"2026011700054965943_j_ijamh-2023-0197_ref_037","doi-asserted-by":"crossref","unstructured":"Hariz, N, Bawab, S, Atwi, M, Tavitian, L, Zeinoun, P, Khani, M, et al.. Reliability and validity of the Arabic screen for child anxiety related emotional disorders (SCARED) in a clinical sample. Psychiatry Res 2013;209:222\u20138. https:\/\/doi.org\/10.1016\/j.psychres.2012.12.002.","DOI":"10.1016\/j.psychres.2012.12.002"},{"key":"2026011700054965943_j_ijamh-2023-0197_ref_038","doi-asserted-by":"crossref","unstructured":"Beal, AC, Ausiello, J, Perrin, JM. Social influences on health-risk behaviors among minority middle school students. J Adolesc Health 2001;28:474\u201380. https:\/\/doi.org\/10.1016\/s1054-139x(01)00194-x.","DOI":"10.1016\/S1054-139X(01)00194-X"},{"key":"2026011700054965943_j_ijamh-2023-0197_ref_039","unstructured":"Suicidal ideation and suicide attempts among Tunisian adolescents: prevalence and associated factors [Internet]. [cit\u00e9 29 juill 2023]. Disponible sur: https:\/\/www.panafrican-med-journal.com\/content\/article\/34\/105\/full\/."},{"key":"2026011700054965943_j_ijamh-2023-0197_ref_040","unstructured":"Enqu\u00eate MedSPAD en Tunisie. PDF free download [Internet]. [cit\u00e9 21 juill 2022]. Disponible sur: https:\/\/docplayer.fr\/24795864-Enquete-medspad-en-tunisie.html."},{"key":"2026011700054965943_j_ijamh-2023-0197_ref_041","unstructured":"eftxssw9.pdf [Internet]. [cit\u00e9 7 ao\u00fbt 2022]. Disponible sur: https:\/\/www.ofdt.fr\/BDD\/publications\/docs\/eftxssw9.pdf."},{"key":"2026011700054965943_j_ijamh-2023-0197_ref_042","unstructured":"Jesus, M, Braga, V, Lins, E, Jesus, R, Freitas, F, Silva, M, et al.. Factors associated with tobacco experimentation among adolescents students. J Nurs UFPE on line, 2020, vol. 14, p. e244043."},{"key":"2026011700054965943_j_ijamh-2023-0197_ref_043","doi-asserted-by":"crossref","unstructured":"Freitas, EAO, Martins, MSAS, Espinosa, MM. Alcohol and tobacco experimentation among adolescents of the Midwest Region\/Brazil. Cien Saude Colet 2019;24:1347\u201357. https:\/\/doi.org\/10.1590\/1413-81232018244.15582017.","DOI":"10.1590\/1413-81232018244.15582017"},{"key":"2026011700054965943_j_ijamh-2023-0197_ref_044","doi-asserted-by":"crossref","unstructured":"Bonilha, AG, Ruffino-Netto, A, Sicchieri, MP, Achcar, JA, Rodrigues-J\u00fanior, AL, Baddini-Martinez, J. Correlates of experimentation with smoking and current cigarette consumption among adolescents. J Bras Pneumol 2014;40:634\u201342. https:\/\/doi.org\/10.1590\/s1806-37132014000600007.","DOI":"10.1590\/S1806-37132014000600007"},{"key":"2026011700054965943_j_ijamh-2023-0197_ref_045","doi-asserted-by":"crossref","unstructured":"Charfi, N, Turki, M, Smaoui, N, Ma\u00e2lej Bouali, M, Omri, S, Zouari, L, et al.. Alcohol use and associated environmental factors among middle and high school students in Sfax (Tunisia). Int J Ment Health Addiction 2020;18:658\u201373. https:\/\/doi.org\/10.1007\/s11469-018-9969-6.","DOI":"10.1007\/s11469-018-9969-6"},{"key":"2026011700054965943_j_ijamh-2023-0197_ref_046","doi-asserted-by":"crossref","unstructured":"Ansari-Moghaddam, A, Rakhshani, F, Shahraki-Sanavi, F, Mohammadi, M, Miri-Bonjar, M, Bakhshani, NM. Prevalence and patterns of tobacco, alcohol, and drug use among Iranian adolescents: a meta-analysis of 58 studies. Child Youth Serv Rev 2016;60:68\u201379. https:\/\/doi.org\/10.1016\/j.childyouth.2015.11.018.","DOI":"10.1016\/j.childyouth.2015.11.018"},{"key":"2026011700054965943_j_ijamh-2023-0197_ref_047","doi-asserted-by":"crossref","unstructured":"Al-Gelban, KS, Al-Amri, HS, Mostafa, OA. Prevalence of depression, anxiety and stress as measured by the depression, anxiety, and stress scale (DASS-42) among secondary school girls in Abha, Saudi Arabia. Sultan Qaboos Univ Med J 2009;9:140\u20137.","DOI":"10.18295\/2075-0528.2780"},{"key":"2026011700054965943_j_ijamh-2023-0197_ref_048","doi-asserted-by":"crossref","unstructured":"Jha, KK, Singh, SK, Nirala, SK, Kumar, C, Kumar, P, Aggrawal, N. Prevalence of depression among school-going adolescents in an urban area of Bihar, India. Indian J Psychol Med 2017;39:287\u201392. https:\/\/doi.org\/10.4103\/0253-7176.207326.","DOI":"10.4103\/0253-7176.207326"},{"key":"2026011700054965943_j_ijamh-2023-0197_ref_049","doi-asserted-by":"crossref","unstructured":"Rofo, S, Gelyana, L, Moramarco, S, Alhanabadi, LHH, Basa, FB, Dellagiulia, A, et al.. Prevalence and risk factors of posttraumatic stress symptoms among internally displaced christian couples in Erbil, Iraq. Front Public Health 2023;11:1129031. https:\/\/doi.org\/10.3389\/fpubh.2023.1129031.","DOI":"10.3389\/fpubh.2023.1129031"},{"key":"2026011700054965943_j_ijamh-2023-0197_ref_050","doi-asserted-by":"crossref","unstructured":"Dardas, LA, Silva, SG, Smoski, MJ, Noonan, D, Simmons, LA. Personal and perceived depression stigma among Arab adolescents: associations with depression severity and personal characteristics. Arch Psychiatr Nurs 2017;31:499\u2013506. https:\/\/doi.org\/10.1016\/j.apnu.2017.06.005.","DOI":"10.1016\/j.apnu.2017.06.005"},{"key":"2026011700054965943_j_ijamh-2023-0197_ref_051","doi-asserted-by":"crossref","unstructured":"Fatiregun, AA, Kumapayi, TE. Prevalence and correlates of depressive symptoms among in-school adolescents in a rural district in southwest Nigeria. J Adolesc 2014;37:197\u2013203. https:\/\/doi.org\/10.1016\/j.adolescence.2013.12.003.","DOI":"10.1016\/j.adolescence.2013.12.003"},{"key":"2026011700054965943_j_ijamh-2023-0197_ref_052","doi-asserted-by":"crossref","unstructured":"Fr\u00f6jd, SA, Nissinen, ES, Pelkonen, MUI, Marttunen, MJ, Koivisto, AM, Kaltiala-Heino, R. Depression and school performance in middle adolescent boys and girls. J Adolesc 2008;31:485\u201398. https:\/\/doi.org\/10.1016\/j.adolescence.2007.08.006.","DOI":"10.1016\/j.adolescence.2007.08.006"},{"key":"2026011700054965943_j_ijamh-2023-0197_ref_053","doi-asserted-by":"crossref","unstructured":"Bhattarai, D, Shrestha, N, Paudel, S. Prevalence and factors associated with depression among higher secondary school adolescents of Pokhara Metropolitan, Nepal: a cross-sectional study. BMJ Open 2020;10:e044042. https:\/\/doi.org\/10.1136\/bmjopen-2020-044042.","DOI":"10.1136\/bmjopen-2020-044042"},{"key":"2026011700054965943_j_ijamh-2023-0197_ref_054","doi-asserted-by":"crossref","unstructured":"Escobedo, LG, Reddy, M, Giovino, GA. The relationship between and cigarette smoking in depressive symptoms US adolescents. Addiction 1998;93:433\u201340. https:\/\/doi.org\/10.1046\/j.1360-0443.1998.93343311.x.","DOI":"10.1046\/j.1360-0443.1998.93343311.x"},{"key":"2026011700054965943_j_ijamh-2023-0197_ref_055","unstructured":"Lakhdar, NEY, Lamri, D, Ouahidi, ML. Activit\u00e9 physique, d\u00e9pression, anxi\u00e9t\u00e9 et ob\u00e9sit\u00e9 chez les adolescents scolaris\u00e9s de B\u00e9ni Tadjit, Est du Maroc."},{"key":"2026011700054965943_j_ijamh-2023-0197_ref_056","doi-asserted-by":"crossref","unstructured":"Quello, SB, Brady, KT, Sonne, SC. Mood disorders and substance use disorder: a complex comorbidity. Sci Pract Perspect 2005;3:13\u201321. https:\/\/doi.org\/10.1151\/spp053113.","DOI":"10.1151\/spp053113"},{"key":"2026011700054965943_j_ijamh-2023-0197_ref_057","doi-asserted-by":"crossref","unstructured":"Zammit, N, Amara, A, Ghammam, R, Ben Fredj, S, Boujebha, S, Maatouk, A, et al.. Monitoring tobacco use among a sample of Tunisian high school pupils. Eur J Publ Health 2022;32:ckac131.570. https:\/\/doi.org\/10.1093\/eurpub\/ckac131.570.","DOI":"10.1093\/eurpub\/ckac131.570"},{"key":"2026011700054965943_j_ijamh-2023-0197_ref_058","doi-asserted-by":"crossref","unstructured":"Global Youth Tobacco Survey Collaborating Group. Differences in worldwide tobacco use by gender: findings from the global youth tobacco survey. J Sch Health 2003;73:207\u201315. https:\/\/doi.org\/10.1111\/j.1746-1561.2003.tb06562.x.","DOI":"10.1111\/j.1746-1561.2003.tb06562.x"},{"key":"2026011700054965943_j_ijamh-2023-0197_ref_059","unstructured":"The influence of peer behavior as a function of social and cultural closeness: a meta-analysis of normative influence on adolescent smoking initiation and continuation. PsycNET [Internet]. [cit\u00e9 6 ao\u00fbt 2022]. Disponible sur: https:\/\/psycnet.apa.org\/doiLanding?doi=10.1037%2Fbul0000113."},{"key":"2026011700054965943_j_ijamh-2023-0197_ref_060","doi-asserted-by":"crossref","unstructured":"Byeon, H. Association among smoking, depression, and anxiety: findings from a representative sample of Korean adolescents. PeerJ 2015;3:e1288. https:\/\/doi.org\/10.7717\/peerj.1288.","DOI":"10.7717\/peerj.1288"}],"container-title":["International Journal of Adolescent Medicine and Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.degruyterbrill.com\/document\/doi\/10.1515\/ijamh-2023-0197\/xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.degruyterbrill.com\/document\/doi\/10.1515\/ijamh-2023-0197\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,17]],"date-time":"2026-01-17T00:06:50Z","timestamp":1768608410000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.degruyterbrill.com\/document\/doi\/10.1515\/ijamh-2023-0197\/html"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,2,1]]},"references-count":60,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,2,28]]},"published-print":{"date-parts":[[2024,2,29]]}},"alternative-id":["10.1515\/ijamh-2023-0197"],"URL":"https:\/\/doi.org\/10.1515\/ijamh-2023-0197","relation":{},"ISSN":["2191-0278"],"issn-type":[{"value":"2191-0278","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,2,1]]}}}