title: Adverse Childhood Experiences and Use of Cigarettes and Smokeless Tobacco Products.
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.
authors.affiliation: Department of Public Health Sciences, University of Virginia, Fontaine Research Park, 560 Ray C. Hunt Drive Room 2104, Charlottesville, VA, 22903, USA. hectorapm@ucla.edu.
authors.forename: Héctor E
authors.initials: HE
authors.lastname: Alcalá
authors.affiliation: Department of Community Health Sciences, Fielding School of Public Health, University of California Los Angeles , 650 Charles E. Young Drive South, Los Angeles, CA, 90095, USA.
authors.forename: Ondine S
authors.initials: OS
authors.lastname: von Ehrenstein
authors.affiliation: UCLA Department of Psychology, 1285 Franz Hall, Los Angeles, CA, 90095, USA.
authors.forename: A Janet
authors.initials: AJ
authors.lastname: Tomiyama
mesh_terms: D040343:Behavioral Risk Factor Surveillance System; D002648:Child; D002649:Child Abuse; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D012907:Smoking; D064424:Tobacco Use; D014030:Tobacco, Smokeless / Q000706:statistics & numerical data*
keywords: Adverse childhood experiences; Adversity; Child abuse; Cigarettes; Smokeless tobacco