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Background Suicidal behaviors are seriously social issues among adolescents in the world. Exposed to smoking and being bullied are risk factors of suicidal behaviors. The present study was aimed to examine the interaction of smoking and being bullied on suicidal behaviors among Chinese adolescents. Methods A total of 18,900 students were involved in the questionnaire study, in four cities of China from November 2017 to January 2018. Suicidal behaviors, smoking, and being bullied were measured by self-reported validated instruments. Chi-square tests and logistic regression were used to analyze the associations of suicidal ideation (SI)/suicidal plan (SP)/suicidal attempt (SA), smoking, and being bullied. Results The prevalence of smoking, being bullied, SI/SP/SA, were 3.1%, 20.6%, 26.4%, 13.2%, and 5.2% respectively. Interaction analysis indicated that being bullied was associated with a greater increase in the likelihood of suicidal behaviors for adolescents with smoking than for those without smoking. Conclusions These finding suggest that smoking exacerbates the association between being bullied and suicidal behaviors. Future research should explore how and why smoking appears to more bully-victims than for those without smoking and how to mitigate it.

Background: Global risks of suicidal behaviours (SB) and being bullied as well as their association among adolescents have been poorly understood. We aimed to determine the risks of suicidal ideation (SI), suicide planning (SP), suicide attempt (SA) and being bullied in adolescents and their related associations across gender, countries and different WHO regions. Methods: We examined data from the Global School-based Health Survey (GSHS), which recorded health behaviours among adolescents aged 12 to 15 years from 83 countries. We computed prevalence rates of SB and being bullied and their 95% confidence intervals (CIs). Multilevel models were employed to examine the association of being bullied with risks of SI, SP and SA. Results: The overall prevalence of SI was 16·5%, SP 16·5%, SA 16·4%, and being bullied 35·3%. The highest risks of SB and being bullied were in Africa (SI 19·9%, SP 23·2%, SA 20·8%, being bullied 48·0%). Compared to boys, girls had an increased risk for SI (18·2%) and SP (17·3%) but similar risk for SA (16·7%) and being bullied (33·3%). Being bullied was associated with SA (adjusted odds ratio ‒ aOR 2·14, 95%CI 2·06–2·23), more strongly than SI (1·83, 1·78–1·89) and SP (1·70, 1·65–1·76). The strongest association with SA was in the Western Pacific (2·68, 2·45–2·92) and with SI (2·04, 1·74–2·39) and SP (1·81, 1·68–1·95) were in Southeast Asia. There were no gender differences in aOR for SI and SP, but the aOR for SA among boys (2·28, 2·14–2·42) was significantly greater than among girls (2·04, 1·93–2·15), ratio of two odds ratios was 1.12 (P = 0.008). Interpretation: SB and being bullied were common among adolescents worldwide. The findings of gender differences in SB, being bullied and their association could inform the design of prevention programmes to reduce the risks of SI, SP and SA in adolescents worldwide. Keywords: Adolescent, Being bullied, Gender differences, Global health, Regional variation, Suicidal behaviours

The aim was to examine prospectively associations between bullying involvement at 14–15 years of age and self-reported general health and psychosocial adjustment in young adulthood, at 26–27 years of age. A large representative sample (N=2,464) was recruited and assessed in two counties in Mid-Norway in 1998 (T1) and 1999/2000 (T2) when the respondents had a mean age of 13.7 and 14.9, respectively, leading to classification as being bullied, bully-victim, being aggressive toward others or non-involved. Information about general health and psychosocial adjustment was gathered at a follow-up in 2012 (T4) (N=1,266) with a respondent mean age of 27.2. Logistic regression and ANOVA analyses showed that groups involved in bullying of any type in adolescence had increased risk for lower education as young adults compared to those non-involved. The group aggressive toward others also had a higher risk of being unemployed and receiving any kind of social help. Compared with the non-involved, those being bullied and bully-victims had increased risk of poor general health and high levels of pain. Bully-victims and those aggressive toward others during adolescence subsequently had increased risk of tobacco use and lower job functioning than non-involved. Further, those being bullied and aggressive toward others had increased risk of illegal drug use. Relations to live-in spouse/partner were poorer among those being bullied. Involvement in bullying, either as victim or perpetrator, has significant social costs even 12 years after the bullying experience. Accordingly, it will be important to provide early intervention for those involved in bullying in adolescence.

Background The aim is to examine associations between bullying involvement in adolescence and mental health problems in adulthood. Methods Information on bullying-involvement (being bullied, bully–victim, aggressive toward others) and non-involved was collected from 2464 adolescents in Mid-Norway at mean age 13.7 and again at mean age 14.9. Information about mental health problems and psychosocial functioning was collected about 12 years later at mean age 27.2 (n = 1266). Results All groups involved in bullying in young adolescence had adverse mental health outcomes in adulthood compared to non-involved. Those being bullied were affected especially regarding increased total sum of depressive symptoms and high levels of total, internalizing and critical symptoms, increased risk of having received help for mental health problems, and reduced functioning because of a psychiatric problem in adulthood. While those being aggressive toward others showed high levels of total and internalizing symptoms. Both those being bullied and bully–victims showed an increased risk of high levels of critical symptoms. Lastly, all groups involved in bullying on adolescence had increased risk of psychiatric hospitalization because of mental health problems. Conclusion Involvement in bullying in adolescence is associated with later mental health problems, possibly hindering development into independent adulthood.

The aim of this study was to examine the relationships between being bullied and aggressive behavior and self-reported mental health problems among young adolescents. A representative population sample of 2,464 young Norwegian adolescents (50.8% girls) aged 12–15 years was assessed. Being bullied was measured using three items concerning teasing, exclusion, and physical assault. Self-esteem was assessed by Harter’s self-perception profile for adolescents. Emotional and behavioral problems were measured by the Moods and Feelings Questionnaire (MFQ) and the youth self-report (YSR). Aggressive behavior was measured by four items from the YSR. One-tenth of the adolescents reported being bullied, and 5% reported having been aggressive toward others during the past 6 months. More of the students being bullied and students being aggressive toward others reported parental divorce, and they showed higher scores on all YSR subscales and on the MFQ questions, and lower scores on the global self-worth subscale (Harter) than students not being bullied or aggressive. A few differences emerged between the two groups being bullied or being aggressive toward others: those who were aggressive showed higher total YSR scores, higher aggression and delinquency scores, and lower social problems scores, and reported higher scores on the social acceptance subscale (Harter) than bullied students. However, because social problems were demonstrated in both the involved groups, interventions designed to improve social competence and interaction skills should be integrated in antibullying programs.