TY - JOUR
T1 - Tobacco use behavior among adults exposed to cumulative adverse childhood experiences
T2 - A systematic review and meta analysis
AU - Abufarsakh, Bassema
AU - Okoli, Chizimuzo T.C.
AU - Darville, Audrey K.
AU - Williams, Lovoria B.
AU - Garcia, Antonio R.
AU - Martin, Catherine
N1 - Publisher Copyright:
© 2023 Elsevier Ltd
PY - 2024/5
Y1 - 2024/5
N2 - Background: Tobacco use remains one of the most used substances among adults globally and substantially impacts individuals and society. Adverse childhood experiences (ACEs) contribute to tobacco use. However, the association between cumulative ACEs and tobacco use behaviors (TUB) has not been established in the literature. In this review, we aimed to estimate the prevalence of ACEs among adult tobacco users and evaluated the relationship between cumulative ACEs and TUB. Methods: We identified original articles published before October 2022 by searching PubMed, CINAHL, and Psych INFO databases. Inclusion criteria were: English language, adults and used instruments assessing for cumulative ACEs defined as four or more ACEs. Results: Forty-two studies, totaling 674,087 participants; predominantly cohort and cross-sectional in study design (n = 33). Exposure to 4 ≥ ACEs was significantly associated with increasing the odds of current tobacco use (n = 35), ever or former tobacco use (n = 13), tobacco use initiation, (n = 3) nicotine dependence (n = 1), and ever using electronic cigarettes (n = 1). In the meta-analysis, as compared to those without ACEs, those with 4 ≥ ACEs were twice as likely to have ever used tobacco (OR = 2.16, 95 %CI:1.73–2.70) and approximately four times more likely to have used tobacco currently (OR = 3.73, 95 %CI:2.69–5.18). Conclusion: The cumulative ACEs exposure can increase the risk for TUB. However, the evidence is limited primarily to cigarette use. Ongoing research into the effects of cumulative ACEs on TUB is needed to integrate trauma-informed intervention in treating tobacco use and guide public health initiatives aimed to reduce the prevalence of ACEs and TUB among adults.
AB - Background: Tobacco use remains one of the most used substances among adults globally and substantially impacts individuals and society. Adverse childhood experiences (ACEs) contribute to tobacco use. However, the association between cumulative ACEs and tobacco use behaviors (TUB) has not been established in the literature. In this review, we aimed to estimate the prevalence of ACEs among adult tobacco users and evaluated the relationship between cumulative ACEs and TUB. Methods: We identified original articles published before October 2022 by searching PubMed, CINAHL, and Psych INFO databases. Inclusion criteria were: English language, adults and used instruments assessing for cumulative ACEs defined as four or more ACEs. Results: Forty-two studies, totaling 674,087 participants; predominantly cohort and cross-sectional in study design (n = 33). Exposure to 4 ≥ ACEs was significantly associated with increasing the odds of current tobacco use (n = 35), ever or former tobacco use (n = 13), tobacco use initiation, (n = 3) nicotine dependence (n = 1), and ever using electronic cigarettes (n = 1). In the meta-analysis, as compared to those without ACEs, those with 4 ≥ ACEs were twice as likely to have ever used tobacco (OR = 2.16, 95 %CI:1.73–2.70) and approximately four times more likely to have used tobacco currently (OR = 3.73, 95 %CI:2.69–5.18). Conclusion: The cumulative ACEs exposure can increase the risk for TUB. However, the evidence is limited primarily to cigarette use. Ongoing research into the effects of cumulative ACEs on TUB is needed to integrate trauma-informed intervention in treating tobacco use and guide public health initiatives aimed to reduce the prevalence of ACEs and TUB among adults.
KW - Adverse childhood experiences
KW - Electronic cigarettes
KW - Nicotine
KW - Smoking
KW - Tobacco use behavior
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U2 - 10.1016/j.addbeh.2023.107948
DO - 10.1016/j.addbeh.2023.107948
M3 - Review article
C2 - 38277993
AN - SCOPUS:85185185722
SN - 0306-4603
VL - 152
JO - Addictive Behaviors
JF - Addictive Behaviors
M1 - 107948
ER -