To study the association between aspects of mental health and the family context with tobacco experimentation and consumption among Brazilian schoolchildren.

A cross-sectional study using data from the National Survey of Schoolchildren Health in Brazil conducted in 109,104 schoolchildren from the ninth year of elementary school on the day shift of public and private schools in all the capitals of the Brazilian states and the Federal District. Descriptive analysis of variables, bivariate and multivariate analyzes were performed with logistic regression estimates, adjusted for socioeconomic variables, obtaining OR and 95% CI.

Among the participants, 52.2% were female. It was verified that the experimentation of cigarette at least once in the life was informed by 20.9% of the students. Adolescents who experienced more often feelings of loneliness (OR: 2.07; 95% CI: 1.98–2.16), difficulty sleeping (OR: 2.37; 95% CI: 2.52–2.48) and lower social interaction (OR: 1.27; 95% CI: 1.26–1.32), were more likely to smoke, regardless of socioeconomic status. The schoolchildren of parents or caregivers (OR: 2.39; 95% CI: 2.29–2.49) who do not know what their children do in their free time (OR: 1.52; 95% CI: 1.46–1.59) were associated with more frequent cigarette smoking.

It was evidenced an association between the aspects of mental health and the family context with the experimentation and consumption of tobacco in adolescents enrolled in Brazil. These associations are independent of school type, sex and skin color. It is important that programs for the prevention of tobacco use in adolescence emphasize these findings.