Original articleChild Abuse and Smoking Among Young Women: The Importance of Severity, Accumulation, and Timing
Section snippets
Study population
The Nurses Health Study (NHS) II is an ongoing prospective study. A total of 116,608 female registered nurses between the ages of 25 and 42 years at the initiation of the study in 1989 completed a mailed questionnaire on their medical history and lifestyle. Follow-up questionnaires, mailed every 2 years to the entire cohort, updated information on the occurrence of diseases and health-related behaviors including smoking status. Detailed information on this study can be obtained online [13].
A
Results
Sample characteristics are shown in Table 1, Table 2. Notably, 4.8% of women reported having started smoking before they reached age 15, and 23.0% reported smoking between the ages of 15 and 19.
Discussion
Our findings support a consistent relation between several characteristics of childhood and adolescent abuse (timing, accumulation, and severity) and smoking behavior among adolescent girls. Exposure to physical and/or sexual abuse during childhood increased risk of smoking initiation prior to 14 years of age. A strong and graded association was found between severity of childhood physical abuse and risk for early smoking initiation. Moreover, smoking during ages 15 to 19 was more strongly
Conclusion
The developmental timing, cumulative type, and severity of abuse are important risk factors for smoking initiation during adolescence. Our finding that the children with a caring family member were less likely to start smoking in early childhood suggests that there are mechanisms to improve coping with social adversities. Future research to understand the processes by which children overcome social adversities is important to the development of effective interventions. Identifying and
Acknowledgments
During preparation of this manuscript, Dr. Jun and Dr. Wright were supported by a grant from the NIH/NHLBI (HL64108-04; Wright, PI).
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