title: Childhood sexual abuse and two stages of cigarette smoking in African-American and European-American young women.
abstract: The aim of the current study was to determine whether the higher rates of childhood sexual abuse (CSA) but lower rates of cigarette smoking in African-American vs. European-American women can be explained in part by a lower magnitude of association between CSA and smoking in African-American women.
  
  
  
  Data were drawn from a same-sex female twin study of substance use (n=3521; 14.3% African-American). Cox proportional hazards regression analyses using CSA to predict smoking initiation and progression to regular smoking were conducted separately by race/ethnicity. Co-twin status on the smoking outcome was used to adjust for familial influences on smoking (which may overlap with family-level influences on CSA exposure).
  
  
  
  After adjusting for co-twin status, CSA was associated with smoking initiation in European Americans (hazard ratio (HR)=1.43, 95% confidence intervals (CI): 1.26-1.62) and with smoking initiation ≤16 in African Americans (HR=1.70, CI: 1.26-2.29). CSA was associated with regular smoking onset ≤15 in European Americans (HR=1.63, CI: 1.21-2.18), with no change in HR after adjusting for co-twin status. In the African-American subsample, the HR for CSA was reduced to non-significance after adjusting for co-twin status (from HR=3.30, CI: 1.23-8.89 to HR=1.16, CI: 0.71-1.92 for regular smoking ≤15).
  
  
  
  CSA is associated with moderate elevation in risk for initiating smoking among African-American and European-American women. By contrast, CSA is associated with elevated risk for (adolescent onset) regular smoking only in European-American women. Furthermore, there is significant overlap between risk conferred by CSA and familial influences on regular smoking in African-American but not European-American women.
authors.affiliation: Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA; Midwest Alcoholism Research Center, Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA. Electronic address: carolyn.sartor@yale.edu.
authors.forename: Carolyn E
authors.initials: CE
authors.lastname: Sartor
authors.affiliation: Midwest Alcoholism Research Center, Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA.
authors.forename: Julia D
authors.initials: JD
authors.lastname: Grant
authors.affiliation: Midwest Alcoholism Research Center, Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA; George Warren Brown School of Social Work, Washington University, St. Louis, MO, USA.
authors.forename: Alexis E
authors.initials: AE
authors.lastname: Duncan
authors.affiliation: Midwest Alcoholism Research Center, Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA.
authors.forename: Vivia V
authors.initials: VV
authors.lastname: McCutcheon
authors.affiliation: Midwest Alcoholism Research Center, Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA.
authors.forename: Elliot C
authors.initials: EC
authors.lastname: Nelson
authors.affiliation: University of Missouri-St. Louis College of Nursing, St. Louis, MO, USA.
authors.forename: Wilma J
authors.initials: WJ
authors.lastname: Calvert
authors.affiliation: Midwest Alcoholism Research Center, Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA.
authors.forename: Pamela A F
authors.initials: PA
authors.lastname: Madden
authors.affiliation: Midwest Alcoholism Research Center, Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA.
authors.forename: Andrew C
authors.initials: AC
authors.lastname: Heath
authors.affiliation: Midwest Alcoholism Research Center, Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA.
authors.forename: Kathleen K
authors.initials: KK
authors.lastname: Bucholz
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology*; D001741:Black or African American / Q000523:psychology / Q000706:statistics & numerical data*; D002648:Child; D002650:Child Abuse, Sexual / Q000523:psychology / Q000706:statistics & numerical data*; D000073865:Cigarette Smoking / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008923:Missouri / Q000453:epidemiology; D016016:Proportional Hazards Models; D012307:Risk Factors; D014427:Twins / Q000523:psychology / Q000706:statistics & numerical data; D044465:White People / Q000523:psychology / Q000706:statistics & numerical data*
keywords: African Americans; Sexual abuse; Smoking; Women