Adverse Childhood Experiences and Cigarette Smoking: The 2009 Arkansas and Louisiana Behavioral Risk Factor Surveillance Systems

Introduction: Adverse childhood experiences (ACEs) such as neglect, verbal, sexual, and physical abuse, household dysfunction, and other childhood stressors are associated with a range of negative health outcomes and risk behaviors. Although there is evidence that ACEs are related to an increased risk for cigarette smoking, additional studies in more diverse samples are needed. Methods: Adults taking part in the 2009 Arkansas (n = 3,125) and Louisiana (n = 7,152) Behavioral Risk Factor Surveillance Systems were surveyed regarding their smoking history and exposure to 11 ACEs. Multivariable logistic regression was used to examine independent associations between individual and total number of ACEs and both lifetime and current smoking adjusting for sociodemographic characteristics. Results: Exposure to each type of ACE was associated with a significantly increased risk for both lifetime (odds ratios [ORs]: 1.35-3.65) and current (ORs: 1.31-2.43) cigarette smoking among residents of both states. Total number of ACEs was also related to the odds of smoking in a generally graded fashion such that Arkansas residents reporting 5 or more ACEs were 3.97 (95% CI: 2.46-6.41) and 2.70 (95% CI: 1.64-4.43) times as likely as those reporting no ACEs to be lifetime and current smokers, respectively. Corresponding odds for those living in Louisiana were 3.06 (95% CI: 2.32-4.02) for lifetime smoking and 2.80 (95% CI: 2.07-3.77) for current smoking. Conclusions: ACEs are associated with an increased likelihood of cigarette smoking in adulthood among residents of Arkansas and Louisiana. Efforts to prevent abuse, neglect, and other ACE may include among their benefits reduced risk for later smoking-related illness.