Perceived Harms and Social Norms in the Use of Electronic Cigarettes and Smokeless Tobacco

Perceptions of harms and social norms influence the use of conventional tobacco cigarettes, but little research is available about their combined relationship with e-cigarette and smokeless tobacco use. We conducted a cross-sectional survey of 309 individuals from central Illinois. We explored (1) demographic predictors of perceived harms and social norms related to e-cigarette and smokeless tobacco use, and (2) whether perceived harms, social norms, or both were important predictors of e-cigarette and smokeless tobacco use. E-cigarette perceptions of harm were consistent across all demographic characteristics. Smokeless tobacco perceptions of harm were unrelated to age, race, and sex, but lower education and income were associated with lower perceived harm (p < .05). E-cigarette social norms were less favorable among non-whites (p < .05) but did not vary by other demographic characteristics. Only less education was associated with more favorable social norms of smokeless tobacco (p < .05). Higher perceived harms were related to lower use of e-cigarettes and smokeless tobacco (p < .05). Perceived social norms were not associated with product use. This study provides preliminary support for implementing broad-based health messaging efforts that focus more on the potential harms of e-cigarette and smokeless tobacco use than on social norms.     

Homelessness in Childhood and Adverse Childhood Experiences (ACEs)

Maternal and Child Health Journal - Objectives Research on adverse childhood experiences (ACEs) has provided a valuable framework for understanding associations between childhood maltreatment and...     

Health,Masculinity and Smokeless Tobacco Use Among College-Aged Men

Existing work on smokeless tobacco (SLT) often focuses on correlates and predictors of use, ignoring the social and cultural context surrounding initiation and continued use of SLT products. The current study takes a qualitative approach using guided focus groups to examine this unexplored context. The findings show that male SLT users gain social rewards from dipping with other men, and usage is initiated and continued in spite of known potential health consequences. For the men participating in this study SLT use was primarily initiated at social or athletic events with the encouragement of other men and continued for relational maintenance and bonding. Additionally, the men reported that the social rewards received from using SLT far outweighed any potential health consequences or negative social repercussions they might also experience. Implications for future research and health interventions targeting SLT use are discussed.     

Smokeless Tobacco Use Among Rural High School Students in Arkansas

This study determined the prevalence of smokeless tobacco use among high school students in selected rural communities in Arkansas, and identified factors associated with initiation and maintenance of use. A questionnaire was distributed to 1,237 students in 13 rural high schools in different educational service regions of Arkansas during spring 1985. Results indicated 34.5% of males and 2.5% of females reported regular use of smokeless tobacco. The factor contributing most to initiation of this practice was the influence of a parent who used smokeless tobacco products. Comparisons to other recent studies and implications for health educators are discussed.     

The Association between Adverse Childhood Experiences and Alcohol Use during Pregnancy in a Representative Sample of Adult Women

BackgroundThe impact of adverse childhood experiences (ACEs) on adult alcohol consumption is well-established, but little is known about the association with alcohol use during pregnancy.MethodsUsing data from the 2010 Nevada Behavioral Risk Factor Surveillance System, we assessed the relationship between ACEs and alcohol use during pregnancy in a representative sample of 1,987 adult women. An established ACEs scale was used to assess a range of childhood physical, emotional, and sexual abuse and household dysfunction (range, 0–8). Weighted logistic regression was used to assess the relationship between ACE scores and alcohol use during pregnancy after controlling for drinking before pregnancy and other covariates.ResultsSix percent of participants reported drinking alcohol during pregnancy. After controlling for race/ethnicity, age, employment status, smoking status, and prepregnancy alcohol use, increasing ACEs were positively associated with higher odds of alcohol use during pregnancy (1 ACE: adjusted odds ratio [AOR], 2.92; 95% CI, 1.08–7.87), (2–3 ACEs: AOR, 3.52; 95% CI, 1.46–8.48), and (≥4 ACEs: AOR, 4.79; 95% CI, 2.14–10.72). Prepregnancy drinking was also strongly associated with alcohol use during pregnancy (AOR, 11.95; 95% CI, 5.02–28.43).ConclusionsWe found evidence of a dose–response relationship between ACEs and alcohol use during pregnancy that remained even after controlling for prepregnancy drinking and other covariates. Screening women of childbearing age as well as pregnant women for ACEs may be an effective way to identify and address many of the emotional, behavioral, and physical sequelae of childhood adversity.     

Gender Differences in the Association between Adverse Childhood Experiences and Cancer

ObjectivesAdverse childhood experiences (ACEs) have been linked to a variety of diseases in adulthood, including cancer. However, current research has yet to determine if all abuse types are associated with cancer and if women are more adversely impacted by ACEs than men.MethodsData from the 2011 Behavioral Risk Factor Surveillance System, a national survey of American adults 18 and older (N = 111,964) were analyzed. Logistic regression models were fit to estimate odds of ever being diagnosed with cancer after experiencing one or more of eight different ACEs, while adjusting for potential confounders. These analyses were then stratified by gender.ResultsAmong women, childhood experiences of physical abuse, sexual abuse, emotional abuse, living with someone who was mentally ill, living with a problem drinker, living with a drug user, and living in a household where adults treated each other violently were associated with higher odds of cancer. Among men, only emotional abuse was associated with higher odds of cancer.ConclusionsResults suggest that ACEs increase risk of cancer later in life. However, this impact occurs mostly among women. This finding may be because women experience many ACEs at higher rates than men and because women, via sexual abuse, can be exposed to cancer-causing viruses.     

Total Adverse Childhood Experiences and Preterm Birth: A Systematic Review

Maternal and Child Health Journal - Total adverse childhood experiences (ACEs) are gaining prominence as a risk factor for preterm birth (PTB). The emerging literature examining this relationship...     

Adverse Childhood Experiences and Obesity Among Young Children with Neurodevelopmental Delays

Maternal and Child Health Journal - Very little research has explored the complex relation between ACEs, poverty, and obesity in young children with neurodevelopmental delays. The purpose of this...     

Smokeless Tobacco and Cancer in Women

Smokeless tobacco, particularly snuff, is a recognized risk factor for cancer of the oral cavity. This conclusion rests in large part on epidemiologic studies of oral cancer in women, especially in the American South, where the oral cancer death rate in females has been high. The research focus on studies of women led to the identification of the hazards from smokeless tobacco use; the strategies used are broadly applicable to studies of the etiology of other cancers in both women and men. High levels of nitrosamines, which are potent carcinogens, are found in smokeless tobacco products. Steps should be taken to reverse the alarming increase in their use by men and boys. More research attention also should be directed to understanding new emerging trends in oral cancer mortality among women.     

Adverse Childhood Experiences and Pregnancy Intentions among Pregnant Women Seeking Prenatal Care

BackgroundThis study examined whether adverse childhood experiences (ACEs) are associated with increased risk of having an unwanted or mistimed pregnancy.MethodsWomen in two medical centers within an integrated health system were screened for ACEs during standard prenatal care (N = 745). Multinomial multivariable logistic regression analyses examined the associations of ACEs (count and type) with pregnancy intentions, adjusting for covariates.ResultsOverall, 58.3% of pregnant women reported no ACEs, 19.1% reported one ACE, and 22.7% reported two or more ACEs; 76.2% reported wanting to get pregnant, 18.5% reported wanting to get pregnant but not at this time (i.e., mistimed pregnancy), and 5.2% reported not wanting to get pregnant at all (i.e., unwanted pregnancy). Having two or more (vs. 0) ACEs was associated with higher odds of an unwanted pregnancy (odds ratio, 2.60; 95% confidence interval, 1.19–5.68). Further, childhood loss of parent (odds ratio, 2.20; 95% confidence interval, 1.03–4.71) and neglect (odds ratio, 5.67; 95% confidence interval, 1.72–18.72) were each associated with higher odds of an unwanted pregnancy in separate analyses. ACEs count and type were not significantly associated with having a mistimed pregnancy.ConclusionsAmong women screened for ACEs during standard prenatal care, ACEs were associated with increased odds of having an unwanted pregnancy, but not a mistimed pregnancy. Additional research is needed to better understand the mechanisms through which ACEs and other individual, social, and contextual factors impact pregnancy intentions to better support women and provide appropriate resources to help prevent unintended pregnancies.