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April 19, 2000

Smoking and Adverse Childhood Experiences

Author Affiliations

Phil B.FontanarosaMD, Deputy EditorIndividualAuthorStephen J.LurieMD, PhD, Fishbein FellowIndividualAuthor

JAMA. 2000;283(15):1958-1960. doi:10.1001/jama.283.15.1957

To the Editor: I disagree with the conclusion of Dr Anda and colleagues1 that " . . . nicotine provides pharmacological relief from the effects of adverse childhood experiences." Instead, their data clearly show that nicotine dependency is associated with heightened sadness and depression, just as we have shown that tobacco smoking leads to increased stress, with smokers being more stressed than nonsmokers.2 Anda et al showed that for every level of adverse childhood experience such as verbal or physical abuse and other stressful events, more smokers than nonsmokers reported depression or sadness during the previous year. Moreover, this was found among those who reported no severe adverse childhood experiences, just as it also occurred in those who had suffered many adverse childhood experiences. Thus, smoking provided an additional source of psychological distress, independent of the level of adverse childhood experience. Their data provide no evidence to support the notion that smoking helps control mood.