Abused children found to smoke more as teens and adults

Researchers have long suspected some kind of link between childhood abuse and smoking. But in an interesting twist, a new study from the University of Washington finds a connection not between whether or not an abused child will ever begin smoking, but to how much they smoke once they do start.

"In other words, people are as likely to smoke whether or not they were sexually or physically abused, but they're inclined to smoke more if they were abused and have a history of smoking," said Todd Herrenkohl, a professor in the UW School of Social Work.

The paper is published online in the Journal of Adolescent Health.

Herrenkohl and co-authors probed the Lehigh Longitudinal Study, which began in the mid-1970s. Participants were recruited from child welfare abuse and protective service programs, as well as day care programs, private nursery programs and Head Start classrooms in Eastern Pennsylvania.

UW researchers looked specifically for any connection between physical or sexual abuse and adolescent and adult smoking. They found that boys who had experienced either type of abuse and were smokers, smoked more than those who hadn't been abused as a child. For girls who smoked, only those who had been sexually abused smoked more as adolescents. That frequency of adolescent smoking by both girls and boys, in turn, led to increased smoking in adulthood, especially among women.

Lead author Allison Kristman-Valente, a doctoral candidate in social work, found the difference between boys and girls to be one that requires more study.

"There may be other factors at work that we need to disentangle," she said. "I think the big 'Aha' finding is the one on gender differences. Hopefully this will encourage other researchers to look at gender differences in smoking among teens and adults."

In the Lehigh study, slightly more than 50 percent of the participants said they had smoked in adolescence – that's about five times the national average for children ages 12-17. Fifty-seven percent of males and 44 percent of females reported smoking in adolescence. Researchers said they don't know why the rate of smoking was so high in this study. Herrenkohl theorizes that the reasons could have been socioeconomic, geographical, or the fact that participants in this study were already at relatively high risk.

When study participants were evaluated as adults, 49 percent reported smoking in the past year (at nearly equal rates for men and women).

Kristman-Valente said what is of great concern is the fact that so many women who were abused as children were smoking while raising children, and that women who smoke frequently also are less successful in smoking cessation programs.

Since tobacco use often begins in adolescence, researchers say it's important that public policies are in place to try to prevent kids from lighting up a cigarette in the first place.

"Early adversity can persist throughout a person's life, so early intervention or prevention of child abuse can potentially lead to long-term public health benefits," Kristman-Valente said. "I hope our findings encourage more focus on the connection between child maltreatment and smoking in particular. Not many people look at this consequence, even though smoking is the number one cause of preventable death in the U.S."