Alexandra Budenz1, Amanda Klein2, Yvonne Prutzman1. 1. Tobacco Control Research Branch, Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD, USA. 2. Center for Chronic Disease Prevention and Control Prevention and Health Promotion Administration, Maryland Department of Health, Timonium, MD, USA.
Abstract
INTRODUCTION: Previous research has examined cigarette smoking in trauma exposed populations. However, the relationships between trauma exposure and use of other tobacco products (eg, cigars, e-cigarettes) and specific trauma exposure characteristics that may be associated with tobacco use are understudied. AIMS AND METHODS: Using the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions-III (N = 36 151 adults), we conducted weighted bivariate analyses of tobacco use among participants with no trauma exposure, trauma exposure, and trauma exposure with post-traumatic stress disorder (trauma + PTSD), stratified by tobacco product use. We also performed weighted logistic regressions testing relationships between trauma exposure and tobacco use, controlling for behavioral health (BH) conditions (mood, anxiety, substance use, personality disorders) and sociodemographics. RESULTS: Approximately 44% of participants had experienced trauma; 6% experienced trauma + PTSD. Trauma exposed participants had a higher prevalence of tobacco use (30%--46% vs. 22%) and poly-tobacco use (34%--35% vs. 28%) than unexposed participants. Cigarettes were the most used tobacco product; trauma + PTSD (19%), and trauma (15%) participants had a higher prevalence of e-cigarette use than unexposed participants (11%). Trauma exposure was associated with current tobacco use (AOR = 1.36 trauma + PTSD; 1.23 trauma) (but not former use), particularly among participants exposed to violence/abuse (AOR = 1.23). Personality and substance use disorders were strongly associated with current and former tobacco use. CONCLUSIONS: Trauma exposure, PTSD, and experiences of violence/abuse are associated with current tobacco use. BH conditions may also play a role in current and former tobacco use. Recognizing and addressing trauma exposure and BH conditions among tobacco users may improve cessation rates in these populations. IMPLICATIONS: This study contributes to research on tobacco use disparities in behavioral health populations by providing a comprehensive examination of tobacco use in trauma exposed individuals. Prior research has examined cigarette smoking, but not other tobacco product use in these populations. This study presents findings on multiple tobacco use behaviors (tobacco product, poly-tobacco use, cessation attempts) in trauma exposed populations and characteristics of trauma exposure (severity, type of traumatic event) associated with tobacco use. These findings underscore the importance of further examining the implications of trauma exposure for tobacco use and of screening and addressing trauma in cessation treatment. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco 2021.
INTRODUCTION: Previous research has examined cigarette smoking in trauma exposed populations. However, the relationships between trauma exposure and use of other tobacco products (eg, cigars, e-cigarettes) and specific trauma exposure characteristics that may be associated with tobacco use are understudied. AIMS AND METHODS: Using the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions-III (N = 36 151 adults), we conducted weighted bivariate analyses of tobacco use among participants with no trauma exposure, trauma exposure, and trauma exposure with post-traumatic stress disorder (trauma + PTSD), stratified by tobacco product use. We also performed weighted logistic regressions testing relationships between trauma exposure and tobacco use, controlling for behavioral health (BH) conditions (mood, anxiety, substance use, personality disorders) and sociodemographics. RESULTS: Approximately 44% of participants had experienced trauma; 6% experienced trauma + PTSD. Trauma exposed participants had a higher prevalence of tobacco use (30%--46% vs. 22%) and poly-tobacco use (34%--35% vs. 28%) than unexposed participants. Cigarettes were the most used tobacco product; trauma + PTSD (19%), and trauma (15%) participants had a higher prevalence of e-cigarette use than unexposed participants (11%). Trauma exposure was associated with current tobacco use (AOR = 1.36 trauma + PTSD; 1.23 trauma) (but not former use), particularly among participants exposed to violence/abuse (AOR = 1.23). Personality and substance use disorders were strongly associated with current and former tobacco use. CONCLUSIONS: Trauma exposure, PTSD, and experiences of violence/abuse are associated with current tobacco use. BH conditions may also play a role in current and former tobacco use. Recognizing and addressing trauma exposure and BH conditions among tobacco users may improve cessation rates in these populations. IMPLICATIONS: This study contributes to research on tobacco use disparities in behavioral health populations by providing a comprehensive examination of tobacco use in trauma exposed individuals. Prior research has examined cigarette smoking, but not other tobacco product use in these populations. This study presents findings on multiple tobacco use behaviors (tobacco product, poly-tobacco use, cessation attempts) in trauma exposed populations and characteristics of trauma exposure (severity, type of traumatic event) associated with tobacco use. These findings underscore the importance of further examining the implications of trauma exposure for tobacco use and of screening and addressing trauma in cessation treatment. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco 2021.
Authors: C Benjet; E Bromet; E G Karam; R C Kessler; K A McLaughlin; A M Ruscio; V Shahly; D J Stein; M Petukhova; E Hill; J Alonso; L Atwoli; B Bunting; R Bruffaerts; J M Caldas-de-Almeida; G de Girolamo; S Florescu; O Gureje; Y Huang; J P Lepine; N Kawakami; Viviane Kovess-Masfety; M E Medina-Mora; F Navarro-Mateu; M Piazza; J Posada-Villa; K M Scott; A Shalev; T Slade; M ten Have; Y Torres; M C Viana; Z Zarkov; K C Koenen Journal: Psychol Med Date: 2015-10-29 Impact factor: 7.723
Authors: Mary C Zanarini; Frances R Frankenburg; John Hennen; D Bradford Reich; Kenneth R Silk Journal: Am J Psychiatry Date: 2004-11 Impact factor: 18.112
Authors: Cassandra A Stanton; Diana R Keith; Diann E Gaalema; Janice Y Bunn; Nathan J Doogan; Ryan Redner; Allison N Kurti; Megan E Roberts; Stephen T Higgins Journal: Prev Med Date: 2016-04-15 Impact factor: 4.018
Authors: Michael J Zvolensky; Laura E Gibson; Anka A Vujanovic; Kristin Gregor; Amit Bernstein; Christopher Kahler; C W Legues; Richard A Brown; Matthew T Feldner Journal: Nicotine Tob Res Date: 2008-08 Impact factor: 4.244