Childhood sexual abuse and two stages of cigarette smoking in African-American and European-American young women.
OBJECTIVE
The aim of the current study was to determine whether the higher rates of childhood sexual abuse (CSA) but lower rates of cigarette smoking in African-American vs. European-American women can be explained in part by a lower magnitude of association between CSA and smoking in African-American women.


METHODS
Data were drawn from a same-sex female twin study of substance use (n=3521; 14.3% African-American). Cox proportional hazards regression analyses using CSA to predict smoking initiation and progression to regular smoking were conducted separately by race/ethnicity. Co-twin status on the smoking outcome was used to adjust for familial influences on smoking (which may overlap with family-level influences on CSA exposure).


RESULTS
After adjusting for co-twin status, CSA was associated with smoking initiation in European Americans (hazard ratio (HR)=1.43, 95% confidence intervals (CI): 1.26-1.62) and with smoking initiation ≤16 in African Americans (HR=1.70, CI: 1.26-2.29). CSA was associated with regular smoking onset ≤15 in European Americans (HR=1.63, CI: 1.21-2.18), with no change in HR after adjusting for co-twin status. In the African-American subsample, the HR for CSA was reduced to non-significance after adjusting for co-twin status (from HR=3.30, CI: 1.23-8.89 to HR=1.16, CI: 0.71-1.92 for regular smoking ≤15).


CONCLUSIONS
CSA is associated with moderate elevation in risk for initiating smoking among African-American and European-American women. By contrast, CSA is associated with elevated risk for (adolescent onset) regular smoking only in European-American women. Furthermore, there is significant overlap between risk conferred by CSA and familial influences on regular smoking in African-American but not European-American women.
['Sartor|Carolyn E|CE|', 'Grant|Julia D|JD|', 'Duncan|Alexis E|AE|', 'McCutcheon|Vivia V|VV|', 'Nelson|Elliot C|EC|', 'Calvert|Wilma J|WJ|', 'Madden|Pamela A F|PA|', 'Heath|Andrew C|AC|', 'Bucholz|Kathleen K|KK|']
D000293:Adolescent D000294:Adolescent Behavior D001741:African Americans D002648:Child D002650:Child Abuse, Sexual D000073865:Cigarette Smoking D005260:Female D006801:Humans D008137:Longitudinal Studies D008923:Missouri D016016:Proportional Hazards Models D012307:Risk Factors D014427:Twins D044465:Whites
Sexual abuse Smoking Women African Americans