Adverse Childhood Experiences and Youth Cigarette Use in 2013 and 2016: Emerging Disparities in the Context of Declining Smoking Rates.

Introduction: Cigarette use has dropped dramatically among youth since 2013, but smoking-related disparities persist. We examine who still smokes in the context of declining smoking rates. Using the Minnesota Student Survey (MSS), we examine adverse childhood experiences (ACEs) and cigarette use in 2013 and 2016. We assess how use rates changed, how ACEs relate to cigarette use, and the degree to which youth with ACEs comprise the current smoking population.

Methods: Data came from 2013 and 2016 MSS. We assessed past 30-day any and daily cigarette use statewide and among youth with no ACEs, high cumulative ACEs, and seven separate ACEs. We used descriptive statistics and multivariate logistic regression analyses.

Results: Cigarette use significantly declined for all groups from 2013 to 2016. Youth with no ACEs exhibited the highest percent decrease in any and daily use. Youth with ACEs were more likely to report any and daily use in 2013 and 2016, adjusting for demographics. Among youth with any 30-day use, the rate of ACEs increased from 2013 to 2016. Youth with ACEs disproportionately accounted for youth smoking populations in 2013 and 2016. For example, while 16% of all youth experienced parental incarceration, approximately 43% and 55% of youth with any and daily use experienced parental incarceration in 2016, respectively.

Conclusions: Cigarette use declined from 2013 to 2016 for all Minnesota youth, but the decline among youth with no ACEs was faster than among youth with ACEs. Youth with ACEs now account for an increasingly high percent of youth smokers.