TY - JOUR AU - Yeoman, Kristin AU - Safranek, Thomas AU - Buss, Bryan AU - Cadwell, Betsy L. AU - Mannino, David PY - 2013 TI - Adverse Childhood Experiences and Adult Smoking, Nebraska, 2011 T2 - Preventing Chronic Disease JO - Prev Chronic Dis SP - E159 VL - 10 CY - Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA. N2 - INTRODUCTION Smoking is a public health risk; the prevalence of smoking among adults in Nebraska is 18.4%. Studies indicate that maltreatment of children alters their brain development, possibly increasing risk for tobacco use. Previous studies have documented associations between childhood maltreatment and adult health behaviors, demonstrating the influence of adverse experiences on tobacco use. We examined prevalence and associations between adverse childhood experiences and smoking among Nebraskans. METHODS We analyzed 2011 Nebraska Behavioral Risk Factor Surveillance System (Adverse Childhood Experience module) data, defining adverse childhood experience exposures as physical, sexual, and verbal abuse (ie, direct exposures), and household dysfunction associated with mental illness, substance abuse, divorce, domestic violence, and living with persons with incarceration histories (ie, environmental exposures). We estimated prevalence of exposures, taking into account the complex survey design. We used logistic regression with predicted margins to estimate adjusted relative risk for smoking by direct or environmental exposure. RESULTS Approximately 51% of Nebraskans experienced 1 or more adverse childhood events; 7% experienced 5 or more. Prevalence of environmental exposures (42%) was significantly higher than that of direct exposures (31%). Prevalence of individual exposures ranged from 6% (incarceration of a household member) to 25% (verbal abuse). Adjusted relative risks of smoking for direct and environmental exposures were 1.5 and 1.8, respectively. CONCLUSION We present a new method of evaluating adverse childhood experience data. Prevalence of adverse childhood experiences is high among Nebraskans, and these exposures are associated with smoking. State-specific strategies to monitor adverse events among children and provide interventions might help to decrease the smoking rate in this population. SN - 1545-1151 UR - http://dx.doi.org/10.5888/pcd10.130009 DO - 10.5888/pcd10.130009 ER -