Adverse Childhood Experiences and Adult Smoking, Nebraska, 2011

Abstract

IntroductionSmoking is a public health risk; the prevalence of smoking among adults in Nebraska is 18.4%. Studies indicate that maltreatment of children alters their brain development, possibly increasing risk for tobacco use. Previous studies have documented associations between childhood maltreatment and adult health behaviors, demonstrating the influence of adverse experiences on tobacco use. We examined prevalence and associations between adverse childhood experiences and smoking among Nebraskans.MethodsWe analyzed 2011 Nebraska Behavioral Risk Factor Surveillance System (Adverse Childhood Experience module) data, defining adverse childhood experience exposures as physical, sexual, and verbal abuse (ie, direct exposures), and household dysfunction associated with mental illness, substance abuse, divorce, domestic violence, and living with persons with incarceration histories (ie, environmental exposures). We estimated prevalence of exposures, taking into account the complex survey design. We used logistic regression with predicted margins to estimate adjusted relative risk for smoking by direct or environmental exposure.ResultsApproximately 51% of Nebraskans experienced 1 or more adverse childhood events; 7% experienced 5 or more. Prevalence of environmental exposures (42%) was significantly higher than that of direct exposures (31%). Prevalence of individual exposures ranged from 6% (incarceration of a household member) to 25% (verbal abuse). Adjusted relative risks of smoking for direct and environmental exposures were 1.5 and 1.8, respectively.ConclusionWe present a new method of evaluating adverse childhood experience data. Prevalence of adverse childhood experiences is high among Nebraskans, and these exposures are associated with smoking. State-specific strategies to monitor adverse events among children and provide interventions might help to decrease the smoking rate in this population.

Adult Cancer Risk Behaviors Associated with Adverse Childhood Experiences in a Low Income Population in the Southeastern United States

“…19–24,31,36 However, our study extends the populations covered in previous work, with a cohort composition of Southern Blacks and Whites of similar (typically low) income and education and highlights that childhood experiences can have marked affect the underserved and vulnerable.…”

“…20, 33 Individual reports have shown a four- to 12-fold increased risk of alcoholism, drug abuse, depression, and suicide attempts among people who had experienced four or more categories of adverse childhood exposures, compared with those who had experienced none, as well as increases in poorer health behaviors, including a 1.5- to four-fold increase in smoking and 1.4- to 1.6-fold increase in physical inactivity and severe obesity. 19,29,34–36 …”

The Relationship of Adverse Childhood Events to Smoking, Overweight, Obesity and Binge Drinking Among Women in Hawaii

“…In a study of individuals with no significant psychopathology, a 4-fold magnitude of association was found between early childhood trauma and cigarette smoking in adulthood [26]. These overall results have also been demonstrated in studies nationwide using the BRFSS data [3–6]…”

“…Previous studies have found ACEs associated with smoking in adulthood [1–3]. In an assessment of a large HMO clinical database, the presence of 4+ ACEs was linked to over twice the likelihood of smoking in adulthood [1].…”

Adverse Childhood Events are Related to the Prevalence of Asthma and Chronic Obstructive Pulmonary Disorder Among Adult Women in Hawaii

“…Among youths (age 12–17 years), Hawaii ranks 2 nd in smoking prevalence [11]. The presence of ACEs is associated with greater smoking prevalence [12, 13] and may account, at least in part, for the rate of asthma and COPD in Hawaii. Other poor health factors (e.g.…”