1. Bibliography 1.Mackenbach JP, Stirbu I, Roskam AJ, Schaap MM, Menvielle G, Leinsalu M, Kunst AE: Socioeconomic inequalities in health in 22 European countries. N Engl J Med 2008, 358:2468-248. 2.Dani JA, Harris RA: Nicotine addiction and comorbidity with alcohol abuse and mental illness. Nat Neurosci 2005, 8:1465-1470. 3.Hollon, S. D., Kendall, P. C.: Cognitive self-statements in depression: Development of an Automatic Thoughts Questionnaire. Cognitive Therapy and Research, 1980, 4: 383-395. Smoking prevalence, associated attitudes and comparison of negative automatic thoughts among high school students in Turkey Murat Acat 1, Çağdas Öykü Memiş 2, Muhammet Kamil Turan 3, Ali Ramazan Benli 4, Emre Taskin 3, Zehra Yasar 5, Seda Derici Memiş 2, Ümran Toru 6, Aylin Pihtili 7 1) Department of chest diseases, Karabük Üniversity, Faculty of Medicine, Karabük, Turkey, 2) Psychiatry, Karabük Üniversity, Faculty of Medicine, Karabük, Turkey 3) Medical biology and genetics, Karabük Üniversity, Faculty of Medicine, Karabük, Turkey, 4) Family Medicine, Karabük Üniversity, Faculty of Medicine, Karabük, Turkey 5) Department of chest diseases, Abant İzzet Baysal Universty, Faculty of Medicine, Bolu, Turkey, 6) Department of chest diseases, Dumlupinar University, Faculty of Medicine, Kütahya, Turkey 7) Department of pulmonary medicine, Haydarpasa Numune Training and Research Hospital, İstanbul, Turkey Introduction In European countries with the majority of adult smokers beginning to smoke before 18 years of age 1. Researches indicate that social stressors, negative affect, anxiety or depression are associated with increased prevalence of smoking in adolescents 2. The aim of this study is to determine the smoking prevalence and to find out whether spending more time on the internet or psychological characteristics like negative thoughts, the idea of failure at school affect smoking among adolescents. Methods Self-administered anonymous sociodemographic questionnaire and automatic thoughts questionnaire (ATQ) were conducted using a sample of students in grades 9 through 12 at eight different public senior high schools in Karabük, Turkey. The Automatic Thoughts Questionnaire (ATQ) developed to identify and measure the frequency of occurrence of automatic negative thoughts associated with depression 3. A descriptive analysis was made, and The Chi-square and The Mann-Whitney U test was used to compare the groups. Results From 463 participating students, aged 14-19 years (43.9% female, 56.1% male), 40 (8,7%) had tried it or former smokers and 48 (10,4%) were occasionally or daily smokers. Students with male gender (p<0,001), older age (Z=-5,356; p<0,001), those who drank alcohol before (p<0,001), scored higher on the ATQ (Z=-2,065; p=0,039), spent more time on the internet (Z=-3,021; p=0,003), and felt like failing at school (Z=-3,730; p<0,001), and a smoking mother (p<0,001), father (p=0,005), sibling (p=0,018), or close friend (p<0,001), had a higher frequency of smoking. Conclusions Most studies show an association between psychiatric disorders and smoking in adolescents. But there is not enough data on psychological basis of smoking behavior. In our study, we found correlation between smoking and negative automatic thoughts and the idea of failing at school in adolescents. In order to understand better, longitudinal studies required and future researches about smoking in adolescence can target more psychological basis of smoking behavior. Table #1 Sample characteristics by smoking status Smoking status NoYesP n%n% χ2 test Age (years) 14-1629194,8165,2p<0,001 17-1910276,13223,9 Gender Females19397,552,5p<0,001 Males21183,44216,6 Mother Smoker No32992,4277,6p<0,001 Yes8079,22120,8 Father Smoker No18094,2115,8p=0,005 Yes23186,23713,8 Sibling smoker No36291369p=0,018 Yes5281,31218,8 Close friend smoker No12298,421,6p<0,001 Yes28986,84413,2 Drink Alcohol No32795,9144,1p<0,001 Yes8070,23429,8 p<0.001 *, p=0,039 **. ATQ: Automatic Thoughts Questionnaire. Figure #1 The correlation graphs by smoking status * * **