Examining the Relationship between Adverse Childhood Experiences and E-Cigarette Use during Young Adulthood: The Role of Impulsive Personality

Background and Purpose

E-cigarette use is quite common and has overtaken traditional cigarette use among American adolescents. Individuals who have experienced childhood maltreatment (CM) may be at particular risk for e-cigarette use, as past research has consistently demonstrated an increased risk for traditional cigarette use and nicotine dependence among individuals with a history of CM. Despite the high prevalence and potentially negative consequences associated with e-cigarette use, little is known about the relationship between CM and e-cigarette use, including why CM might increase an individual's risk for future e-cigarette use. Because maltreated children are more likely to develop impulsive personality traits associated with e-cigarette use, impulsivity needs to be explored as a potential link. The overall aims of the current study were to investigate the relationship between CM and e-cigarette use during the transition to adulthood and to examine the role of different impulsivity traits in linking this relationship.

Methods

We used a sample of young adults (N=208; ages 18–21) recruited through community advertisements. CM was measured using the Childhood Trauma Questionnaire (CTQ), which assessed five CM types: physical, emotional, and sexual abuse, and physical and emotional neglect. Impulsivity was measured by the short version of the Urgency, Premeditation, Perseverance, and Sensation Seeking (UPPS) Impulsive Behavior scale, which assessed four impulsivities: negative urgency (NU), premeditation, perseverance, and sensation seeking (SS). Finally, current and lifetime e-cigarette use were measured using standard epidemiological questions. Structural equation modeling (SEM) was used to examine the pathways from CM to current and lifetime e-cigarette use via impulsivity. First, we examined separate direct paths from CM to both lifetime and current e-cigarette use. Next, we examined separate indirect paths from CM to lifetime and current e-cigarette use, through the four dimensions of impulsivity.

Results

First, the SEM model directly linking CM to lifetime e-cigarette use showed a significant direct path (β = 0.19, p = 0.02). Second, the model indirectly linking CM to lifetime e-cigarette use via impulsivity showed a significant association between CM and NU (β = 0.40, p < 0.001). In this model, NU (β = 0.26, p = 0.04) and SS (β = 0.27, p = 0.004) were also significantly related to lifetime e-cigarette use. Lastly, the direct link between CM and lifetime e-cigarette use was non-significant in this model (β = 0.07, p = 0.48), as NU fully mediated the relationship (β = 0.11, p = 0.04). Third, the model indirectly linking CM to current e-cigarette use through impulsivity subscales showed a significant association between CM and NU (β = 0.40, p < 0.001); however, both CM and the four dimensions of impulsivity were not significantly related to current e-cigarette use.

Conclusions and Implications

The present study found that CM is linked to lifetime e-cigarette use and that NU played a significant mediating role. These results suggest that CM victims who have NU might be at increased risk of e-cigarette use. Thus, impulsive personality traits may be useful targets in the intervention and prevention of e-cigarette use among this population.