Informing integrated interventions for trauma and smoking: The role of gender from childhood to adulthood
Kristman-Valente, Allison N.
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Integrated interventions for trauma and substance use often overlook smoking despite evidence that interpersonal traumas and smoking are related. When integrated treatments are specifically designed to address smoking and trauma they are based upon primarily male samples with combat related stressors and it remains unclear if these interventions will be as effective with women who experience differing forms of trauma and have different risk factors for smoking. This dissertation examined the life course and potentially, gendered relationship between child maltreatment, partner violence victimization and smoking behavior across four developmental periods (childhood, adolescence, young adulthood and adulthood) by capitalizing on existing longitudinal data from the Seattle Social Development Project, a 30-year prospective cohort study. Chapter 1 investigated whether a commonly used measure of partner violence, the Conflict Tactics Scale, is consistent in its measurement of victimization across gender and time. Chapter 2 explored gender similarities and differences in the relationship between partner violence and smoking behavior in young adulthood and adulthood (ages 24 to 33). Chapter 3 examined the influence of child maltreatment on smoking onset, adolescent smoking duration and becoming a high-risk smoker in young adulthood in the context of other risk factors among those people who have ever smoked and whether this differs for men and women. Findings suggest that these two issues are consistently related from childhood to adulthood, for both men and women, and remain significant even after controlling for important risk factors. Directional findings support a bidirectional relationship where interpersonal traumas influence a wide array of smoking behaviors (onset, adolescent duration, smoking type and high risk smoking in young adulthood and adulthood ) and smoking in young adulthood uniquely increases the risk for later interpersonal victimization in adulthood. The strong connection between interpersonal traumas, a prominent theme in the lives of women, and the identification of gender-specific risk factors for smoking underscore the need for considering gender in future integrated intervention development. Collectively, findings provide information of use to those designing gender-informed primary and secondary prevention efforts which ultimately will contribute to reducing the large public health burdens of both smoking and interpersonal violence.