Although smoking rates among the general population continue to decline, Duke researchers have identified risk factors that drive some young people to defy the trend and pick up the habit.
The study, which appears in the March issue of the Journal of Adolescent Health, found that adolescents who witnessed or were involved in a physical assault were twice as likely to begin smoking within a year of the incident. Additionally, those exposed to physical or sexual abuse in early childhood faced an increased risk of becoming a regular smoker at an earlier age than the national average.
"When people suffer a traumatic event, they can experience an emotional shock to the system," said Dr. Bernard Fuemmeler, assistant professor of community and family medicine and one of the study's lead researchers. "Sometimes people turn to substances like nicotine because they feel that it helps them cope."
The researchers examined data gathered by the National Longitudinal Study of Adolescent Health, a nationally representative sample of approximately 15,000 adolescents tracked from 1995 to 2002. Participants, who entered the study at an average age of 15.6 years old, were given a series of surveys which included questions about their exposure to traumatic events and smoking behaviors. Events classified as traumatic included unwanted sexual contact, physical assault and interpersonal violence among partners or friends.
A nicotine-dependence test was also administered, allowing Fuemmeler and his team to uncover a positive correlation between childhood trauma and smoking frequency.
"There is a great need to intervene early, especially among those who might be at high risk," he said. "If we know the warning signs of risky behaviors, like smoking, we may be able to prevent them."
Fuemmeler said the study was unique in that it examined the association between trauma and smoking risk in a national sample of adolescents. Other research had focused on clinical or high-risk populations, he added.
A separate study, published in the December issue of the Journal of Family Practice, found that adolescent brains are more susceptible to nicotine addiction than those of adults and that about 25 percent of young people who had tried their first and only cigarette within the past month exhibited symptoms associated with addiction.
"We have long assumed that kids got addicted because they were smoking five or 10 cigarettes a day," Dr. Joseph DiFranza, a family medicine and community health professor at the University of Massachusetts Medical School and the study's lead researcher, told The New York Times. "Now we know that they risk addiction after trying a cigarette just once."
Dr. Francis McClernon, assistant professor of medical psychiatry and a researcher on the Duke study, said his team's work could have implications for DiFranza's findings.
"If you think about kids who have some of these risk factors, like being abused or having a traumatic experience, it may be that the addiction process starts even quicker for them," McClernon said. "What [DiFranza] has shown is potentially being amplified by the things we're seeing."
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