Childhood sexual abuse and two stages of cigarette smoking in African-American and European-American young women |
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| Affiliation: | 1. Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA;2. Midwest Alcoholism Research Center, Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA;3. George Warren Brown School of Social Work, Washington University, St. Louis, MO, USA;4. University of Missouri-St. Louis College of Nursing, St. Louis, MO, USA;1. Division of Adolescent Medicine, University of California, San Francisco, San Francisco, CA, United States;2. Stanford Prevention Research Center in the Department of Medicine at Stanford University, Stanford, CA, United States;1. University of Southern California School of Social Work, 669 W. 34th Street, Suite 214, Los Angeles, CA 90089, United States;2. University of Miami, Department of Sociology, 5202 University Dr, Coral Gables, FL 33146, United States;1. Department of Preventive Medicine and Public Health, University of Kansas School of Medicine, Kansas City, KS, USA;2. College of Education, Department of Educational Psychology, University of Houston, Houston, TX, USA;3. Department of Behavioral Sciences and Health Education, Emory University School of Public Health, Atlanta, GA, USA;4. Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, MN, USA;5. Department of Health Behavior & Health Education, University of Michigan, School of Public Health, Ann Arbor, MI, USA;6. Department of Medicine and Center for Health Equity, University of Minnesota Medical School, Minneapolis, MN, USA;1. Tobacco Center of Regulatory Science (TCORS), School of Public Health, Georgia State University, Atlanta, GA, USA;2. Department of Health Policy and Behavioral Sciences, School of Public Health, Georgia State University, Atlanta, GA, USA;3. Department of Population Health Sciences, School of Public Health, Georgia State University, Atlanta, GA, USA;1. Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, 4502 East 41st Street, SAC 1G06, Tulsa, OK 74135, USA;2. Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, 801 NE 13th Street, CHB-309, Oklahoma City, OK 73104, USA |
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| Abstract: | ObjectiveThe aim of the current study was to determine whether the higher rates of childhood sexual abuse (CSA) but lower rates of cigarette smoking in African-American vs. European-American women can be explained in part by a lower magnitude of association between CSA and smoking in African-American women.MethodsData were drawn from a same-sex female twin study of substance use (n = 3521; 14.3% African-American). Cox proportional hazards regression analyses using CSA to predict smoking initiation and progression to regular smoking were conducted separately by race/ethnicity. Co-twin status on the smoking outcome was used to adjust for familial influences on smoking (which may overlap with family-level influences on CSA exposure).ResultsAfter adjusting for co-twin status, CSA was associated with smoking initiation in European Americans (hazard ratio (HR) = 1.43, 95% confidence intervals (CI): 1.26–1.62) and with smoking initiation ≤ 16 in African Americans (HR = 1.70, CI: 1.26–2.29). CSA was associated with regular smoking onset ≤ 15 in European Americans (HR = 1.63, CI: 1.21–2.18), with no change in HR after adjusting for co-twin status. In the African-American subsample, the HR for CSA was reduced to non-significance after adjusting for co-twin status (from HR = 3.30, CI: 1.23–8.89 to HR = 1.16, CI: 0.71–1.92 for regular smoking ≤ 15).ConclusionsCSA is associated with moderate elevation in risk for initiating smoking among African-American and European-American women. By contrast, CSA is associated with elevated risk for (adolescent onset) regular smoking only in European-American women. Furthermore, there is significant overlap between risk conferred by CSA and familial influences on regular smoking in African-American but not European-American women. |
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