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The mediating sex-specific effect of psychological distress on the relationship between adverse childhood experiences and current smoking among adults

Tara W Strine17*, Valerie J Edwards2, Shanta R Dube3, Morton Wagenfeld45, Satvinder Dhingra1, Angela Witt Prehn4, Sandra Rasmussen46, Lela McKnight-Eily2 and Janet B Croft2

Author Affiliations

1 Office of Public Health Preparedness and Response, Office of Science and Public Health Practice, Centers for Disease Control and Prevention, Atlanta, GA, USA

2 National Center for Chronic Disease Prevention and Health Promotion, Division of Adult and Community Health, Centers for Disease Control and Prevention, Atlanta, GA, USA

3 National Center for Chronic Disease Prevention and Health Promotion, Office of Smoking and Health, Atlanta, GA, USA

4 Walden University, Minneapolis, MN, USA

5 Western Michigan University, Kalamazoo, MI, USA

6 Williamsville Wellness, Hanover, VA, USA

7 Office of Surveillance, Epidemiology, and Laboratory Services, Centers for Disease Control and Prevention, 2500 Century Pkwy Mailstop E-97, Atlanta, GA, 30345, USA

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Substance Abuse Treatment, Prevention, and Policy 2012, 7:30  doi:10.1186/1747-597X-7-30

Published: 13 July 2012

Abstract

Background

Research suggests that ACEs have a long-term impact on the behavioral, emotional, and cognitive development of children. These disruptions can lead to adoption of unhealthy coping behaviors throughout the lifespan. The present study sought to examine psychological distress as a potential mediator of sex-specific associations between adverse childhood experiences (ACEs) and adult smoking.

Method

Data from 7,210 Kaiser-Permanente members in San Diego California collected between April and October 1997 were used.

Results

Among women, psychological distress mediated a significant portion of the association between ACEs and smoking (21% for emotional abuse, 16% for physical abuse, 15% for physical neglect, 10% for parental separation or divorce). Among men, the associations between ACEs and smoking were not significant.

Conclusions

These findings suggest that for women, current smoking cessation strategies may benefit from understanding the potential role of childhood trauma.

Keywords:
Smoking; Adverse childhood experiences; Pyschological distress; Mediation analysis