Researchers report a clear association between exposure to violence and adolescent tobacco use. Nicole Haderlein conducted the analysis as part of her master of public health thesis at Brown University, with Alexander Sokolovsky as senior author. Their work, published in Substance Use & Misuse, used data from the Youth Risk Behavior Surveillance System collected by the Centers for Disease Control.
The team examined bullying, cyberbullying, sexual violence and domestic violence, measuring each type separately and the combined effect when youth experienced multiple forms. They analyzed boys and girls across two time periods and measured past 30-day cigarette and e-cigarette use as outcomes.
Frequency data showed that about one in five youths reported bullying, roughly 15% reported cyberbullying, and about 5% reported sexual or domestic violence. Each form of violence was linked to higher past 30-day use of cigarettes and e-cigarettes. Sokolovsky noted a dose–response effect: the risk of tobacco use increased when young people were exposed to multiple types of violence.
The study also found sex differences in one period: in 2021 the association with recent cigarette use was stronger for boys than girls, but by 2023 no differences by sex were detected for either cigarette or e-cigarette use, suggesting the gap may be closing. The authors recommend that medical providers, teachers, school counselors and other care workers routinely assess students for violence exposure and tobacco risk, and that violence prevention and early intervention could serve as effective substance use prevention among adolescents.
Difficult words
- association — a connection or relationship between two things
- exposure — contact with something harmful or risky
- adolescent — a young person between childhood and adulthoodadolescents
- dose–response — greater exposure causing a larger effect or risk
- cyberbullying — using online messages to harm or harass someone
- surveillance — systematic collection and monitoring of information
- assess — to evaluate or measure a person's condition or risk
- intervention — action taken to prevent or reduce a problem
Tip: hover, focus or tap highlighted words in the article to see quick definitions while you read or listen.
Discussion questions
- How could schools and care workers use these findings to reduce tobacco use among students? Give examples.
- Why might the difference between boys and girls in 2021 have disappeared by 2023? What factors could explain that change?
- What are the benefits and possible challenges of routinely assessing students for violence exposure and tobacco risk in schools?
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