Associations Between Adverse Childhood Experiences, Depressive Symptoms, and Nicotine Dependence Among Tobacco Users With Mental Illnesses

Background: Adverse childhood experiences (ACEs) are associated with both increased depressive symptomatology and nicotine dependence (ND) in the general population. However, the relationship between ACEs, depressive symptoms, and ND among people with mental illness (MI) remains unexplored. Aims: In this study, we examined (a) depressive symptoms mediating the relationship between ACEs and ND and (b) ND severity mediating the relationship between ACEs and depressive symptoms. Method: A cross-sectional design was used to recruit participants online and from community mental health settings. Data analysis was conducted using IBM SPSS version 29. Results: Responses from 194 individuals were included in the analysis. ND intensity mediated the relationship between ACEs and depressive symptom severity. The indirect variance of the effects of this mediation was 10.9%, 6.9%, and 10.6% among the total sample, females, and males, respectively. In addition, depressive symptoms mediated the relationship between ACEs and ND intensity, and the indirect variance of the effect of this mediation was 7.9%, 3.6%, and 8.8% in the total sample, females, and males, respectively. Conclusions: Among people living with MI, ND mediates the impact of ACEs on depression, with varying degrees of influence between genders. In addition, depressive symptoms mediate the effect of ACEs on ND intensity. Further research is needed to investigate effective depressive treatment modalities to be integrated into tobacco treatment plans among people living with MI. In addition, nurse clinicians should assess for childhood adversity and depressive symptoms among tobacco users while treating ND.