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

Abstract

Adverse childhood experiences (ACEs), including various types of abuse and other forms of household dysfunction, 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. A path model was produced using multiple regression, and indirect effects were tested using bootstrapping of 2000 samples. 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. These results suggest that for individuals of White, Hispanic, and Asian ethnicity, screening for a history of ACEs and treatment for depressive symptoms could increase the efficacy of smoking prevention efforts among youth and smoking cessation programs among adults. However, while depressive symptoms may explain some of the association between ACEs and smoking, these results suggest that other, unexamined factors also contribute to this pathway.