Childhood physical abuse linked to heavy cigarette use among teens who smoke

February 24, 2020

COLUMBUS, Ohio - Researchers have known that kids who are at high risk of being mistreated at home - who live in poverty or have parents who use drugs or have mental health problems - are more likely to start smoking. Because abused and neglected children are often unsupervised, these teens have easy access to cigarettes and other substances that they use to deal with anxiety and other trauma-related symptoms.

A new study shows that physical abuse of children in high-risk homes, especially when they're toddlers or teens, dramatically increases the odds that their adolescent experimentation with cigarettes will lead to a heavy smoking habit.

Neglect of very young children in the same high-risk population was linked to a gradual increase in cigarette use among teens who smoked.

The study examined data on children who were at high risk for abuse and neglect - either because they had been referred to a child protective service or lived in conditions associated with the likelihood of maltreatment, or both.

"I wanted to look at different types of maltreatment and whether they have an impact on cigarette smoking," said lead author Susan Yoon, assistant professor of social work at The Ohio State University. "There's also the impact of timing - it's not just maltreatment, yes or no. When did it happen, and does that matter with regard to outcomes?"

The study is published online in the journal Substance Use and Misuse.

Yoon noted that substance abuse research doesn't often take cigarette smoking into consideration despite its significant damaging effects on health.

"Adolescent cigarette smoking is a really serious social problem and public health concern. Brain development is not complete until late adolescence or during young adulthood, and cigarette smoking is associated with damage in brain development," Yoon said. "We also know that those who start smoking cigarettes during adolescence are more likely to continue smoking into adulthood."

Yoon and colleagues used data from the Longitudinal Studies of Child Abuse and Neglect, a consortium of studies across different regions of the United States targeting children who were identified as maltreated or at risk for maltreatment. This study used data on 903 adolescents who were assessed at age 12, 16 and 18.

A breakdown of different types of abuse and neglect experienced by the sample population during three different time periods (early childhood, school age and adolescence) confirmed how vulnerable these kids were. Almost a quarter had been neglected during early childhood and their school-age years, and 19 percent reported school-age physical abuse. Almost half lived in poverty and 58 percent lived in households in which family members smoked cigarettes.

Yoon used their responses about smoking between the ages of 12 and 18 to identify three patterns of cigarette use: stable low/no use (61 percent of respondents), gradually increasing use (30 percent) and sharply increasing cigarette use (9 percent).

"It was almost shocking how the pattern of cigarette use over time went up so drastically in the sharply increasing use class," Yoon said. "They were pretty similar to the others at age 12 - almost 80 percent didn't smoke. At age 16, we saw that almost 60 percent had used cigarettes more than 20 days in the past year and by 18, every single kid in this group reported heavy use of cigarettes."

A statistical analysis showed that adolescents who experienced early childhood physical abuse were 2.3 times more likely to be in the sharply increasing cigarette use group compared with the stable no/low group. Physical abuse during adolescence had an even stronger effect - this type of mistreatment at that point in life was linked to 3.7 times higher odds for sharply increased cigarette use.

Adolescents who had been neglected during early childhood were 1.89 times more likely to be in the gradually increasing cigarette use group than in the stable no/low use group. Neglect can include a lack of appropriate supervision and failure to meet kids' needs - ranging from food and clothing to medical needs and education.

About 40 percent of these smokers had reported using cigarettes at age 16, and by age 18, more than 80 percent were smokers, and about 40 percent had smoked on more than 20 days in the previous year.

The analysis also measured the potential effects of sexual abuse and emotional abuse on cigarette use, but neither was a predictor of an increase in smoking.

"The different types of maltreatment predicted different patterns of cigarette use, but the timing mattered as well. It was early childhood and adolescence that appear to be really sensitive periods in which maltreatment influences these outcomes," Yoon said.

The results suggest efforts to prevent smoking by teens at risk of maltreatment - and especially children experiencing physical abuse and neglect - should start before age 12, she said.

"If we intervene too late, it's likely they've already started using cigarettes and are in the process of using more cigarettes," Yoon said. "We know from our studies that these kids experiencing physical abuse and neglect are at much higher risk of showing this poor pattern of cigarette use over time. We should be targeting this high-risk group for cigarette use prevention and intervention."
-end-
This work was funded by The Ohio State University Institute for Population Research through a grant from the Eunice Kennedy Shriver National Institute of Child Health and Human Development.

Ohio State co-authors include Rebecca Dillard, Julianna Nemeth and Sarah Schoppe-Sullivan.

Contact: Susan Yoon, yoon.538@osu.edu; 614-292-3289

Written by Emily Caldwell, Caldwell.151@osu.edu; 614-292-8152

Ohio State University

Related Smoking Articles from Brightsurf:

Smoking rates falling in adults, but stroke survivors' smoking rates remain steady
While the rate of Americans who smoke tobacco has fallen steadily over the last two decades, the rate of stroke survivors who smoke has not changed significantly.

What is your risk from smoking? Your network knows!
A new study from researchers at Penn's Annenberg School for Communication found that most people, smokers and non-smokers alike, were nowhere near accurate in their answers to questions about smoking's health effects.

Want to quit smoking? Partner up
Kicking the habit works best in pairs. That's the main message of a study presented today at EuroPrevent 2019, a scientific congress of the European Society of Cardiology (ESC).

Smoking and mortality in Asia
In this analysis of data from 20 studies conducted in China, Japan, South Korea, Singapore, Taiwan and India with more than 1 million participants, deaths associated with smoking continued to increase among men in Asia grouped by the years in which they were born.

Predictors of successfully quitting smoking among smokers registered at the quit smoking clinic at a public hospital in northeastern Malaysia
In the current issue of Family Medicine and Community Health, Nur Izzati Mohammad et al. consider how cigarette smoking is one of the risk factors leading to noncommunicable diseases such as cardiovascular and respiratory system diseases and cancer.

Restaurant and bar smoking bans do reduce smoking, especially among the highly educated
Smoking risk drops significantly in college graduates when they live near areas that have completely banned smoking in bars and restaurants, according to a new study in the American Journal of Epidemiology.

How the UK smoking ban increased wellbeing
Married women with children reported the largest increase in well-being following the smoking bans in the UK in 2006 and 2007 but there was no comparable increase for married men with children.

Smoking study personalizes treatment
A simple blood test is allowing Vanderbilt University Medical Center (VUMC) researchers to determine which patients should be prescribed varenicline (Chantix) to stop smoking and which patients could do just as well, and avoid side effects, by using a nicotine patch.

A biophysical smoking gun
While much about Alzheimer's disease remains a mystery, scientists do know that part of the disease's progression involves a normal protein called tau, aggregating to form ropelike inclusions within brain cells that eventually strangle the neurons.

A case where smoking helped
A mutation in the hemoglobin of a young woman in Germany was found to cause her mild anemia.

Read More: Smoking News and Smoking Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.