Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA.
Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA.
Ann Epidemiol. 2019 Dec;40:13-20.e4. doi: 10.1016/j.annepidem.2019.10.003. Epub 2019 Oct 21.
The purpose of this study was to evaluate whether childhood maltreatment is associated with smoking behaviors and lifetime nicotine dependence and if associations are moderated by sex. We examined these associations among individuals who ever reported being regular smokers.
Using data from the National Longitudinal Study of Adolescent to Adult Health, we examined relationships between retrospectively self-reported child maltreatment (parent/caregiver-perpetrated emotional, physical, sexual abuse, and neglect; and non-parent/caregiver-perpetrated sexual abuse) and self-reported smoking behaviors among individuals with a history of regular smoking. Outcomes were any current smoking in early adulthood (mean age = 28 years), current smoking in adolescent study waves only, adulthood only, and adolescence and adulthood (n = 3581); and lifetime history of nicotine dependence (n = 3594) per the Fagerstrom scale.
Poly-maltreatment (aRR for 2+ vs. 0 exposures = 1.20, 95% CI: 1.08, 1.34) was associated with lifetime nicotine dependence; associations between nicotine dependence and neglect and non-parent/caregiver sexual abuse by force were only present in women. Neglect and non-parent/caregiver sexual abuse by nonphysical threat were associated with continued smoking, and an association between non-parent/caregiver sexual abuse by physical force and continued smoking was also noted in women only. Women who experienced poly-maltreatment were less likely to report current smoking in adolescence but not adulthood.
These data suggest in a nationally representative sample of ever regular smokers, child maltreatment is associated with outcomes that suggest an inability to quit smoking and some associations may vary by sex.
本研究旨在评估儿童期虐待是否与吸烟行为和终生尼古丁依赖有关,以及这些关联是否受性别影响。我们研究了曾经报告为经常吸烟者的个体中的这些关联。
利用国家青少年至成年健康纵向研究的数据,我们研究了回顾性自我报告的儿童虐待(父母/照顾者实施的情感、身体、性虐待和忽视;以及非父母/照顾者实施的性虐待)与有规律吸烟史个体的自我报告吸烟行为之间的关系。结局是青少年研究波中(平均年龄 28 岁)、青少年和成年期(n=3581)以及成年期(n=3594)的当前吸烟情况;以及根据 Fagerstrom 量表评估的终生尼古丁依赖史。
多型虐待(暴露 2+与 0 相比的校正相对危险度[aRR]为 1.20,95%可信区间:1.08,1.34)与终生尼古丁依赖有关;仅在女性中,尼古丁依赖与忽视和非父母/照顾者的强迫性性虐待之间存在关联。忽视和非父母/照顾者的非身体威胁性性虐待与持续吸烟有关,仅在女性中也注意到非父母/照顾者的身体强迫性性虐待与持续吸烟之间的关联。经历过多型虐待的女性更不可能在青少年期报告当前吸烟,但在成年期却不会。
这些数据表明,在一个具有全国代表性的经常吸烟的个体样本中,儿童虐待与提示无法戒烟的结局有关,并且一些关联可能因性别而异。