 | The 131st Annual Meeting (November 15-19, 2003) of APHA |
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| The 131st Annual Meeting (November 15-19, 2003) of APHA |
Hee-Jin Jun, DS, Channing Laboratory, Harvard Medical School and Harvard School of Publich Health, Harvard University, 181 Longwood Ave., Boston, MA 02115, 617-525-2563, nhhjj@channing.harvard.edu, Reneé Boynton-Jarrett, SM, Department of Health and Social Behavior, Harvard School of Public Health, 677 Huntington Ave, Boston, MA 02115, Janet W. Rich-Edwards, Harvard Medical School and Harvard School of Public Health, Harvard Medical School, 126 Brookline Avenue, Suite 200, Boston, MA 02115, Frank Erwin Speizer, MD, Department of Medicine-Brigham and Women's Hospital, Harvard University, 181 Longwood Ave., Boston, MA 02115, and Rosalind J. Wright, MD, MPH, Channing Laboratory, Brigham & Women's Hospital, 181 Longwood Ave, Boston, MA 02115.
We examined the association between exposure to violence (ETV) during childhood and adolescence and age of smoking initiation in the Nurses°¯ Health Study II. ETV, ascertained through a standardized retrospective questionnaire mailed to 91,297 participants [73% response rate (n=66,519)], was categorized by severity and type of abuse (physical or sexual). An abbreviated physical/emotional abuse Childhood Trauma Questionnaire (CTQ) subscale was also used. Smoking onset was retrospectively reported in 1989. Logistic regression was used to predict smoking initiation at two age cutoffs (<15 and <20) adjusting for race/ethnicity. Among the respondents, 4.8% smoked before age 15; 18.3% smoked before age 20. During childhood and/or adolescence, 10.7% reported severe physical/emotional violence; 33.6% experienced some kind of sexual abuse. Compared to no ETV, women with exposure to severe violence were more likely to start smoking <20 (odds ratio [OR] 2.1, 95% CI 1.9-2.2 for physical/emotional violence; OR 1.8, 95% CI 1.7-1.9 for sexual violence). Women with highest-level exposure on the CTQ were more likely to start smoking compared to those with lowest-level exposure (OR 3.0, 95% CI 2.5-3.7 smoking onset <15;OR 2.1, 95% CI 1.9-2.3 for smoking onset <20). Women who had a family member make them "feel important" during childhood were less likely to initiate smoking <15 (OR 0.6, 95% CI 0.5-0.7), after controlling for parental smoking and race/ethnicity. Conclusions: ETV during childhood/adolescence is associated with earlier age of smoking onset. Efficacious smoking prevention programs may benefit from addressing such social stressors at multiple levels: individual, family, community, and society.
Learning Objectives:
Keywords: Adolescents, Smoking
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Channing Laboratory, Harvard Medical School Harvard School of Public Health
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.