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Childhood abuse and risk of smoking onset
  1. H B Nichols1,
  2. B L Harlow2
  1. 1Department of Epidemiology, Harvard School of Public Health, Boston, USA
  2. 2Obstetrics and Gynecology Epidemiology Center, Brigham and Women’s Hospital/Harvard Medical School, Boston, USA
  1. Correspondence to:
 Dr B L Harlow
 Obstetrics and Gynecology Epidemiology Center, Brigham and Women’s Hospital, 221 Longwood Avenue, Boston, MA 02115, USA;


Study objective: To determine the association between childhood abuse and becoming a smoker.

Design: Retrospective cohort study.

Setting: Boston, Massachusetts.

Participants: 722 women aged 36–45 years who completed the baseline questionnaire for the Harvard study of moods and cycles and the survey of interpersonal relationships.

Main results: Women who experienced either physical or sexual abuse as a child were 40% more likely to begin smoking compared with women with no history of abuse (95% CI 1.0 to 2.0). Virtually all of this association was confined to sexual abuse (OR = 2.2, 95% CI 1.1 to 4.3) as compared with physical abuse (OR = 0.7, 95% CI 0.7 to 1.6). However, the joint effect of experiencing both physical and sexual abuse as a child led to a 3.5-fold increase in the likelihood of becoming a smoker (95% CI 1.3 to 9.4) compared with women who did not experience any childhood abuse after adjustment for religion, social class, and poverty.

Conclusions: Women who experience childhood abuse, even in the absence of depression, are at increased risk of becoming cigarette smokers.

  • child abuse
  • smoking

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  • Funding: supported by grants from the National Institutes of Health: R 01-MH50013 and R 01-MH577351.

  • Conflicts of interest: none declared.

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