Dr. Philip Smith, a recent graduate of the PhD program in community health and health behavior (CHHB) at the University at Buffalo School of Public Health and Health Professions, has completed a series of studies that improve our understanding of the relationships between childhood maltreatment, psychological distress, nicotine dependence, and smoking cessation. The studies used data from the baseline (N = 1,000 adult smokers) and 14-month follow-up with 751 respondents in interviews of a national smoking survey.
In the first investigation, published online in the February issue of the American Journal of Public Health, smokers with psychological distress had the greatest concerns at baseline about the negative health effects of smoking, but were 50 percent less likely to achieve 30-day abstinence from all forms of tobacco by the second wave. This association was accounted for by both greater levels of nicotine dependence and greater levels of nicotine withdrawal severity.
The second investigation, published in Nicotine and Tobacco Research in July, focused on quit attempters. Childhood emotional, physical, and sexual abuse were associated with greater levels of nicotine withdrawal during the respondents’ most recent attempt. This association was only partially mediated by current psychological distress. Associations between childhood abuse and adult nicotine dependence were fully mediated by psychological distress.
The third investigation, published online on October 27 in Psychology of Addictive Behaviors, studied the associations between childhood maltreatment and the likelihood of smoking cessation. In stratified analyses, women smokers who had experienced either physical or emotional maltreatment as children were more motivated to quit smoking and had greater concerns about their smoking than women without these types of maltreatment. However, among quit attempters maltreatment was associated with 60 percent lower odds of achieving 30-day abstinence. This association with abstinence was no longer significant after accounting for current psychological distress. Associations between maltreatment and cessation were non-significant among men.
Dr. Smith comments, “These findings add to the growing body of research documenting the importance of early intervention and prevention for victims of childhood maltreatment. From a perspective of treatment for nicotine addiction, the findings suggest history of childhood maltreatment may be an important factor to consider, in addition to current mental illness/psychological distress. Victims of maltreatment are vulnerable to particular types of psychological distress, such as negative affect and stress. This may explain why associations between childhood maltreatment and smoking were stronger among women, who tend to be more likely than men to smoke in response to negative affect and stress.”
The Hardcore Smoking Survey was led by Dr. Gary Giovino, professor and chair in the department of CHHB at the UB School of Public Health and Health Professions. The study was funded by the Robert Wood Johnson Foundation and the American Legacy Foundation. Dr. Smith is now associate research scientist at Yale University School of Medicine’s Department of Psychiatry. Dr. Lynn Kozlowski (CHHB), Dr. Gregory Homish (CHHB), Ms. Megan Saddleson (CHHB PhD candidate), and Dr. Sherry McKee (Yale Psychiatry) were co-investigators on the studies.