Adverse childhood experiences (ACEs) can stay with us for life. New research published in BioMed Central’s open access journal Substance Abuse Treatment, Prevention, and Policy explains how these events can be tied up with adult smoking patterns, especially for women, and suggests that treatment and strategies to stop smoking need to take into account the psychological effects of childhood trauma.
ACEs can range from emotional, physical, and sexual abuse to neglect and household dysfunction and affect a large range of people. In one of the largest studies of ACEs survey over 60% of adults reported a history of at least one event. ACEs are thought to have a long term effect on the development of children and can lead to unhealthy coping behaviour later in life.
Since psychiatric disorders, including depression and anxiety, are known to increase the risk of smoking, researchers across the USA collaborated to investigate the effects of psychological distress on the relationship between ACE and current adult smoking. The ACE questionnaire was completed by over 7000 people, about half of whom were women.
Even after adjusting the data for factors known to affect a person’s propensity for smoking, such as their parents smoking during the subject’s childhood, and whether or not they had drunk alcohol in the previous month), women who had been physically or emotionally abused were 1.4 times more likely to smoke. Having had a parent in prison during childhood doubled chances of women smoking.
Psychological distress increases the chances that any person (male or female) will smoke. Dr Tara Strine, who led this study commented, “Since ACEs increase the risk of psychological distress for both men and women, it seemed intuitive that an individual experiencing an ACE will be more likely to be a tobacco cigarette smoker. However, in our study, ACEs only to increased the risk of smoking among women. Given this, men who have experienced childhood trauma may have different coping mechanisms than their female counterparts.”
Dr Strine continued, “Our results show that, among women, an underlying mechanism that links ACEs to adult smoking is psychological distress, particularly among those who have suffered emotional or physical abuse or physical neglect as a child. These findings suggest that current smoking cessation campaigns and strategies may benefit from understanding the potential relationship between childhood trauma and subsequent psychological distress on the role of smoking particularly in women.”
The mediating sex-specific effect of psychological distress on the relationship between adverse childhood experiences and current smoking among adults Tara W Strine, Valerie J Edwards, Shanta R Dube, Morton Wagenfeld, Satvinder Dhingra, Angela Witt Prehn, Sandra Rasmussen, Lela McKnight-Eily and Janet B Croft Substance Abuse Treatment, Prevention, and Policy (in press)