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Early Trauma Encourages Smoking
> 2/22/2008 12:07:14 PM

A 2005 study demonstrated that smokers are twice as likely to develop post-traumatic stress disorder when exposed to harrowing life events. The authors suggested that this link exists because nicotine warps the dopaminergic pathway necessary to respond adaptively to trauma. A new study coming out next month in the Journal of Adolescent Health flips the order of causation without breaking the chain by showing that trauma can raise the risk of smoking.

Researchers from Duke Medical Center looked at the effects of pre-sixth grade physical and mental trauma. 15,000 subjects between the ages of 16 and 22 were asked about adolescent incidences of violence and abuse. Those who reported such an incident were approximately twice as likely to start smoking in the year following the trauma. Many of the subjects reported being aware of a connection and stated that smoking provided a way for them to deal with their stress.

The finding that smoking seems to cause maladaptive stress behavior and that stress seems to lead to smoking suggests that both are related to the same stress and reward mechanism. It is not yet clear whether both smoking and trauma alter a healthy mechanism rather than just correlate with an impaired mechanism. For example, it could be that poor parenting raises the risk of both maladaptive stress response and addiction. Many confounding factors, such as parental education level, were accounted for, but others may remain.

The establishment of a robust link between smoking and stress may save many lives. Not only can counselors more closely monitor smokers who have been subjected to trauma, but children who have been abused can be given preemptive therapy to dissuade them from taking up smoking when safer drugs, or just a shoulder to lean on, would better stabilize them.

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