Moderating effects of smoking and drinking on the relationship between biological rhythm and psychological health and gender differences among adolescents

Objectives To determine whether smoking and drinking moderate the correlation between biological rhythm and mental health and the role of gender differences in these moderating effects.Methods Adolescents from three cities, all twelve middle schools (N = 7,986), named Shenzhen, Nanchang and Shenyang in China, were asked to complete a standardized questionnaire including the details of biological rhythm, psychological health, and the status of smoking and drinking. The PROCESS program was used to analyze whether smoking and drinking moderated the relationship between biological rhythm and psychological health.Results The analyses revealed poorer psychological health and greater likelihood of smoking and drinking in participants with higher scores for biological rhythm disorder (P < 0.001). Specifically, smoking and drinking accelerated the relationship between biological rhythm and psychological health in the total sample (B = 0.05, P < 0.05; B = 0.06, P < 0.001) and only the subgroup of girls (B = 0.09, P < 0.05; B = 0.12, P < 0.001), respectively.Conclusions As the findings suggest, attention should be given to smoking, drinking and gender-specific approaches employed to alleviate the psychological disorders of adolescents with biological rhythm disorders.