Adverse Childhood Experiences and Tobacco Use Among Latinx Parents in the United States

Introduction

Tobacco use is the leading cause of death among Latinx individuals in the United States. Research suggests that adverse childhood experiences (ACEs) predispose individuals to various long-term negative health and mental health outcomes including tobacco use. Noteworthily, Latinx individuals report experiencing ACEs at higher rates than individuals of other ethnic-racial backgrounds; a relationship that differs by whether individuals and their families were born in the United States or elsewhere. Furthermore, cultural protective factors, such as connections to their ethnic-racial group, have been found to serve as a buffer against nicotine consumption. Thus, in this study, we examine the effect of ACEs, ethnic-racial identity, and history of depression on Latinx parents’ tobacco use patterns. In addition, we examine these relationships among US-born and immigrant Latinx parents of varied countries of origin.

Method

Data for this study came from the National Epidemiological Survey on Alcohol and Related Conditions (NESARC-III) study. Our sample comprised 2,809 18- to 50-year-old Latinx adults who had a child (under 18 years of age) living with them in the household. We used multinomial logistic regression to examine associations with former or current tobacco use versus never smoking by ACEs, ethnic-racial identity, mental health, and by country of origin. The ACEs measure included six major categories experienced by respondents before age 18 (Neglect; Physical/psychological abuse; Witnessing domestic violence; Sexual abuse; Parental psychopathology; Other traumatic events).

Results

In this sample of Latinx parents (Mage = 33.5 years, 53.7% female), 75.6% reported never using tobacco, 7.4% reported former tobacco use, and 16.9% reported current tobacco use. The average number of ACEs reported was 0.96 (95% CI: 91.2, 1.02) and over half of the sample (59.6%) reported being first-generation immigrants. Results of a multinomial logistic regression analysis suggested differential associations between early and current stressful life experiences and tobacco use for the tobacco outcome. A greater number of ACEs, having experienced depression in the past year and having US-born parents increased the likelihood of respondents being current tobacco users relative to never users. We further found that individuals of Mexican or Central American heritage were less likely than those of Puerto Rican heritage to report being a current tobacco user relative to never having used tobacco. In addition to the effect of ACEs, greater levels of ethnic-racial identity increased the likelihood of respondents being a former tobacco user.

Implications

The well-being of Latinx children depends in large part on the well-being and health of the adults in their lives. Although the majority of this nationally representative sample of Latinx adults had never smoked, those who reported ACEs had increased tobacco use, whether current or former. Higher levels of ethnic-racial identity increased participants’ likelihood of having quit smoking. Considering the damaging health outcome of tobacco use on parents and the effects of secondhand smoke exposure on their children it is important to examine possible drivers of tobacco use and potential cultural protective factors that could prevent both Latinx parents and children from the short and long-term negative health effects of smoking.