Effect of adverse childhood experience on the health of current smokers : 2012 North Carolina Behavioral Risk Factor Surveillance System Survey

QUAM V' SCHS Studies A Publication of the State Center for Health Statistics 1908 Mail Service Center • Raleigh, NC 27699-1908 (919) 733-4728 • www.schs.state.nc.us/SCHS No. 168 May 2014 The Effect of Adverse Childhood Experiences on the Health of Current Smokers: 2012 North Carolina Behavioral Risk Factor Surveillance System Survey Harry W.B. Herrick, M.S.P.H., M.S.W., M.Ed. Anna E. Austin, M.P.H. Abstract Objective: Adverse childhood experiences (ACEs) are stressful or traumatic events experienced before age 18 such as physical abuse or witnessing domestic violence. Research has shown that nicotine addiction, as manifested in early initiation of smoking and heavy smoking, is strongly associated with an increase in the number of ACE exposures. The objective of this study was to measure the additional risk posed by ACE exposures on poor health outcomes among current smokers. A second objective was to highlight differences or similarities in the results of the state study on ACE, titled, “The Effect of Adverse Childhood Experiences on Health in Adulthood: 2012 North Carolina Behavioral Risk Factor Surveillance System Survey,” and the findings of this study. Methods: This study uses data from the 2012 North Carolina BRFSS Survey. From the population of all smokers, 1,846 respondents met the definition for study members, i.e., current smokers who completed some or all of the 1 1 ACE module questions. Following the methodology of the state study, three ACE study groups were constructed: 1) those who reported no ACEs; 2) those who reported one to two ACEs and 3) those who reported three to eight ACEs. These study groups were then compared with regard to the prevalence and risk (adjusted odds ratios) of chronic disease, self-perceived poor health and health risk behaviors. Results: Seventy-two percent of smokers reported at least one ACE. Both the prevalence and adjusted odds for HIV risk behavior, current asthma, chronic obstructive pulmonary disease (COPD), depression, disability and all four measures of perceived poor health, were significantly higher in the High ACE group (three or more ACEs), compared to the No ACE group. For the Low ACE group (one to two ACEs), only the prevalence and adjusted odds of HIV risk behavior was significantly higher as compared to the No ACE group. Conclusion: A key finding of this study is that only among smokers in the High ACE group did the results show significant worsening of health, as compared to smokers in the Low ACE group or the No ACE group. By comparison, findings from the state study revealed that individuals in both the Low and High ACE groups had significant excess risk for chronic disease, perceived poor health and health risk behaviors. nc department of health and human services STATE OF NORTH CAROLINA Department of Health and Human Services Division of Public Health North Carolina Public Health