Palestinian refugee children are prone to using energy drinks (EDs) and smoking tobacco because of their stressful lives. Limited
research has focused specifically on Palestinian adolescents in the context of depression and substance use. This study aims
to examine the effects of ED intake and tobacco smoking on the mental health of refugee children on the West Bank. A crosssectional
study was conducted in 2022 among 362 Palestinian refugee schoolchildren (aged 12–15) in 5 camps on the northern
West Bank. Data on ED and tobacco use were collected through structured interviews. Depression was assessed via the Birleson
Depression Self-Rating Scale for Children, psychosomatic symptoms were self-reported for the most recent 1-month period,
and waist circumference was measured. χ2 tests, Fisher exact test, and logistic regression analyses were performed to examine
associations between substance use, depression, and obesity. Among the 329 participants, 53.8% reported using ED, 22.8%
smoked waterpipe (WP), and 11.6% smoked cigarettes. Depression was noted in 28.9% of children. Logistic regression revealed
that depression was more prevalent among girls (OR = 2.7, 95% confidence interval (CI):1.57–4.98, P-value < .001) and was
associated with cigarette smoking (OR = 2.6, 95% CI: 1.15–5.98, P-value = .022) and ED intake (OR = 1.808, 95% CI: 1.04–3.17,
P-value = .038). No associations between WP use and electronic cigarette use were detected. The study revealed that depression
and risky behaviors were highly prevalent among Palestinian refugee children. ED and tobacco use were strongly associated with
depressive symptoms and psychosomatic complaints. These findings highlight the urgent need for early detection, culturally
tailored school-based interventions, and mental health support programs for refugee adolescents. Future research should explore
longitudinal effects and preventive strategies to reduce substance use and improve child mental health in conflict settings.

Title

Medicine

Publisher

pub med

Publisher Country

Palestine

Publication Type

Both (Printed and Online)

Volume

104

Year

2025

Pages

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