The mediating role of depressive symptoms in the relationship between adverse childhood experiences and smoking.

PURPOSE OF THE STUDY: Adverse childhood experiences (ACEs), including various types of abuse and other forms of household dysfunction (i.e. witnessing domestic violence, parental substance abuse, etc.), have been consistently linked to increased rates of health risk behaviors and negative health outcomes in adulthood. Using data from the 2010 Centers for Disease Control and Prevention's (CDC) annual, nationwide Behavioral Risk Factor Surveillance System (BRFSS) telephone survey, this study tested whether self-reported symptoms of depression mediate the significant relationship between the number of ACEs an individual reports (expressed as an "ACE score") and whether they are a current or past smoker.

METHODS

A path model was produced using multiple regression, and indirect effects were tested using bootstrapping of 2000 samples.

RESULTS

Results of analyses indicated that, among White, Asian, and Hispanic participants, self-reported depressive symptoms are indeed a significant, but only partial, mediator between participants' ACE score and their smoking status.

CONCLUSIONS

These results suggest that for smokers of White, Hispanic, and Asian ethnicity, screening for a history of ACEs and treatment for depressive symptoms may be indicated. However, while depressive symptoms may explain some of the associations between ACEs and smoking, these results suggest that other, unexamined factors also contribute to this pathway.