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Adverse Childhood Experiences and Use of Cigarettes and Smokeless Tobacco Products

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Abstract

Adverse childhood experiences (ACEs) have been linked to increased use of tobacco products later in life. However, studies to date have ignored smokeless tobacco products. To address this, data from the 2011 Behavioral Risk Factor Surveillance System, which interviewed adults 18 years and over (N = 102,716) were analyzed. Logistic regression models were fit to estimate odds ratios of ever smoking, current smoking and current smokeless tobacco use in relation to ACEs. Results showed that less than 4 % of respondents currently used smokeless tobacco products, while 44.95 and 18.57 % reported ever and current smoking, respectively. Physical abuse (OR 1.40; 95 % CI 1.14, 1.72), emotional abuse (OR 1.41; 95 % CI 1.19, 1.67), sexual abuse (OR 0.70; 95 % CI 0.51, 0.95), living with a drug user (OR 1.50; 95 % CI 1.17, 1.93), living with someone who was jailed (OR 1.50; 95 % CI 1.11, 2.02) and having parents who were separated or divorced (OR 1.31; 95 % CI 1.09, 1.57) were associated with smokeless tobacco use in unadjusted models. After accounting for confounders, physical abuse (OR 1.43; 95 % CI 1.16, 1.78), emotional abuse (OR 1.32; 95 % CI 1.10, 1.57), living with a problem drinker (OR 1.30; 95 % CI 1.08, 1.58), living with a drug user (OR 1.31; 95 % CI 1.00, 1.72) and living with adults who treated each other violently (OR 1.30; 95 % CI 1.05, 1.62) were associated with smokeless tobacco use. Living with someone who was mentally ill (OR 0.70; 95 % CI 0.53, 0.92) was associated with smokeless tobacco use after accounting for confounders and all ACEs. Results indicated that some childhood adversities are associated with use of smokeless tobacco products. Special attention is needed to prevent tobacco use of different types among those experiencing ACEs.

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Acknowledgments

We would like to thank Dr. Linda Bourque and Dr. Kagawa-Singer for their input on manuscript ideas.

Funding

This research was supported by grants from the National Institute of General Medical Sciences (NIGMS) (T32-GM084903) and by the California Center for Population Research at UCLA (CCPR), which receives core support (R24-HD041022) from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD).

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Correspondence to Héctor E. Alcalá.

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Alcalá, H.E., von Ehrenstein, O.S. & Tomiyama, A.J. Adverse Childhood Experiences and Use of Cigarettes and Smokeless Tobacco Products. J Community Health 41, 969–976 (2016). https://doi.org/10.1007/s10900-016-0179-5

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