February 20, 2008(USA TODAY) -- Childhood abuse or physical violence in young adulthood greatly raises the odds of someone starting to smoke by their early 20s, a large study suggested Tuesday.
Smokers often find their habit relaxing, "and this may be how they cope with the trauma," says study leader Bernard Fuemmeler, a pediatric psychologist at Duke University Medical Center.
"Survivors of traumatic experiences will say they just want to get back to normal. But for some it's like having a broken leg -- you can't just go on and pretend it never happened," he says. "You need to get help or there will be bad effects."
Fuemmeler and co-author Miguel Roberts followed more than 15,000 young people from age 15 to about 22. They found a link between reports of childhood sexual or physical abuse and regular smoking that begins in the teen years.
Exposure to a physical assault in the past year -- either witnessing it or being a victim -- nearly doubled the odds of a young adult starting to smoke within a year.
And violence in any relationships -- pushing, slapping, kicking -- also raised the risk for becoming a smoker soon after.
The report will be published in the March issue of Journal of Adolescent Health.
Post-traumatic stress from violent incidents correlates with all kinds of addictions, such as drinking, drug abuse and gambling, says G. Alan Marlatt, a psychologist and director of the Addictive Behaviors Research Center at University of Washington in Seattle.
The study's results suggest that doctors need to pay more attention to teenagers and young adults who have had such traumas, says Walter Rosenfeld, a physician at Goryeb Children's Hospital in Morristown, N.J. It's normal for adolescents to experiment with smoking or drinking, he says, but if young people are experimenting and have had a lot of stress in their lives, they may need help.
There's other evidence that young people who become "light, social smokers" at college often develop into dedicated smokers within a few years, says Michael Resnick, director of the Healthy Youth Development Prevention Research Center at the University of Minnesota Medical Center in Minneapolis. "Traumatic experiences in adolescence bubble up in all kinds of ways, often self-destructive and health-jeopardizing," Resnick says.
More than 80% of smokers start before age 18, federal government data show. About 20% of adults smoke, down from 40% two decades ago, Marlatt says. But the rate among college students hasn't dropped that much, he says.
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