Childhood abuse and risk of smoking onset

To determine the association between childhood abuse and becoming a smoker.

Retrospective cohort study.

Boston, Massachusetts.

722 women aged 36-45 years who completed the baseline questionnaire for the Harvard study of moods and cycles and the survey of interpersonal relationships.

Women who experienced either physical or sexual abuse as a child were 40% more likely to begin smoking compared with women with no history of abuse (95% CI 1.0 to 2.0). Virtually all of this association was confined to sexual abuse (OR = 2.2, 95% CI 1.1 to 4.3) as compared with physical abuse (OR = 0.7, 95% CI 0.7 to 1.6). However, the joint effect of experiencing both physical and sexual abuse as a child led to a 3.5-fold increase in the likelihood of becoming a smoker (95% CI 1.3 to 9.4) compared with women who did not experience any childhood abuse after adjustment for religion, social class, and poverty.

Women who experience childhood abuse, even in the absence of depression, are at increased risk of becoming cigarette smokers.