Research suggests that there is a dose-response relationship between ACE score and cigarette smoking, such that as ACE score increases, so does smoking behavior, but little is known about what factors moderate this relationship. Therefore, the goal of this study was to examine demographic characteristics as potential moderators of relationship between Adverse Childhood Experiences (ACEs) and cigarette smoking. A secondary data analysis was conducted using the 2013 California Behavioral Risk Factor Surveillance System data. The sample included 2,604 U.S. adults (54.8% female; Age: M = 53.3, SD = 8.10; 83.6%; Caucasian, 6.4% Asian, 5.9% Black or African American, 3.1% American Indian or Alaska Native, and 0.6% other, and 0.2% Native Hawaiian or other Pacific Islander). We used multinomial logistic regression to test sex, race, socioeconomic status, and education as moderators of the relationship between ACE score and smoking. Sex, race, education, and income were significantly and independently associated with smoking outcomes. Men, individuals with lower income and education, and certain ethnic/racial groups reported greater odds of smoking. No interactions between ACE score and sex, race, education, or income significantly predicted smoking outcomes. ACEs were not significantly associated with smoking behavior. Results suggest that the relationship between ACEs and smoking later in life does not depend on basic demographic features. Knowing which populations are more vulnerable to smoking can help clinicians better assess and tailor interventions to meet the needs of their patients by using culturally sensitive interventions and obtaining resources to help improve treatment access, motivation, and success.
","abstract_html":"<p>Research suggests that there is a dose-response relationship between ACE score and cigarette smoking, such that as ACE score increases, so does smoking behavior, but little is known about what factors moderate this relationship. Therefore, the goal of this study was to examine demographic characteristics as potential moderators of relationship between Adverse Childhood Experiences (ACEs) and cigarette smoking. A secondary data analysis was conducted using the 2013 California Behavioral Risk Factor Surveillance System data. The sample included 2,604 U.S. adults (54.8% female; Age: M = 53.3, SD = 8.10; 83.6%; Caucasian, 6.4% Asian, 5.9% Black or African American, 3.1% American Indian or Alaska Native, and 0.6% other, and 0.2% Native Hawaiian or other Pacific Islander). We used multinomial logistic regression to test sex, race, socioeconomic status, and education as moderators of the relationship between ACE score and smoking. Sex, race, education, and income were significantly and independently associated with smoking outcomes. Men, individuals with lower income and education, and certain ethnic/racial groups reported greater odds of smoking. No interactions between ACE score and sex, race, education, or income significantly predicted smoking outcomes. ACEs were not significantly associated with smoking behavior. Results suggest that the relationship between ACEs and smoking later in life does not depend on basic demographic features. Knowing which populations are more vulnerable to smoking can help clinicians better assess and tailor interventions to meet the needs of their patients by using culturally sensitive interventions and obtaining resources to help improve treatment access, motivation, and success.</p>","abstract_has_math":false,"creators":["Cosanella, Taylor"],"institution":null,"degree_name":"Doctor of Psychology (PsyD)","degree_level":"Doctoral Project","degree_discipline":"Psychology","degree_department":null,"school":null,"contributors":["Holly E. R. Morrell","Cameron Neece"],"advisors":[],"committee_chairs":[],"committee_members":[],"year":2020,"date_issued":"2020-09-01T07:00:00Z","date_published":"2020-09-01T07:00:00Z","updated_at":"2026-07-24T02:53:37Z","subjects":["Demography, Population, and Ecology","Health Psychology","Adult Survivors of Child Adverse Events -- psychology; Behavioral Risk Factor Surveillance System; California -- epidemiology; Cigarette Smoking -- epidemiology; Cigarette Smoking -- psychology; Ethnic Groups; Female; Humans; Male; Middle Aged; Sex Factors; Socioenvironmental Therapy"],"languages":["English"],"rights":["This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights."],"rights_urls":[],"identifier_entries":[]},"links":{"outbound_url":"https://scholarsrepository.llu.edu/etd/1021","outbound_label":"Repository record","outbound_source":"dc:identifier"},"metadata_groups":[{"id":"people","label":"People","entries":[{"key":"dc:contributor","label":"Contributor","values":["Holly E. R. Morrell","Cameron Neece"]},{"key":"dc:creator","label":"Author","values":["Cosanella, Taylor"]}]},{"id":"academic_context","label":"Academic Context","entries":[{"key":"thesis:degree_discipline","label":"Discipline","values":["Psychology"]},{"key":"thesis:degree_level","label":"Degree Level","values":["Doctoral Project"]},{"key":"thesis:degree_name","label":"Degree Name","values":["Doctor of Psychology (PsyD)"]}]},{"id":"subjects_keywords","label":"Subjects and Keywords","entries":[{"key":"dc:subject","label":"Dc Subject","values":["Demography, Population, and Ecology","Health Psychology","Adult Survivors of Child Adverse Events -- psychology; Behavioral Risk Factor Surveillance System; California -- epidemiology; Cigarette Smoking -- epidemiology; Cigarette Smoking -- psychology; Ethnic Groups; Female; Humans; Male; Middle Aged; Sex Factors; Socioenvironmental Therapy"]}]},{"id":"language_rights","label":"Language and Rights","entries":[{"key":"dc:language","label":"Dc Language","values":["English"]},{"key":"dc:rights","label":"Dc Rights","values":["This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights."]}]},{"id":"identifiers","label":"Identifiers","entries":[{"key":"dc:identifier","label":"Identifier","values":["https://scholarsrepository.llu.edu/etd/1021"]}]},{"id":"additional","label":"Additional Metadata","entries":[{"key":"dc:description.abstract","label":"Abstract","values":["Research suggests that there is a dose-response relationship between ACE score and cigarette smoking, such that as ACE score increases, so does smoking behavior, but little is known about what factors moderate this relationship. Therefore, the goal of this study was to examine demographic characteristics as potential moderators of relationship between Adverse Childhood Experiences (ACEs) and cigarette smoking. A secondary data analysis was conducted using the 2013 California Behavioral Risk Factor Surveillance System data. The sample included 2,604 U.S. adults (54.8% female; Age: M = 53.3, SD = 8.10; 83.6%; Caucasian, 6.4% Asian, 5.9% Black or African American, 3.1% American Indian or Alaska Native, and 0.6% other, and 0.2% Native Hawaiian or other Pacific Islander). We used multinomial logistic regression to test sex, race, socioeconomic status, and education as moderators of the relationship between ACE score and smoking. Sex, race, education, and income were significantly and independently associated with smoking outcomes. Men, individuals with lower income and education, and certain ethnic/racial groups reported greater odds of smoking. No interactions between ACE score and sex, race, education, or income significantly predicted smoking outcomes. ACEs were not significantly associated with smoking behavior. Results suggest that the relationship between ACEs and smoking later in life does not depend on basic demographic features. Knowing which populations are more vulnerable to smoking can help clinicians better assess and tailor interventions to meet the needs of their patients by using culturally sensitive interventions and obtaining resources to help improve treatment access, motivation, and success.
"]},{"key":"dc:title","label":"Title","values":["Adverse Childhood Experiences and Cigarette Smoking: Demographic Moderators"]}]}],"canonical_facts":{"dc:contributor":["Holly E. R. Morrell","Cameron Neece"],"dc:creator":["Cosanella, Taylor"],"dc:description.abstract":["Research suggests that there is a dose-response relationship between ACE score and cigarette smoking, such that as ACE score increases, so does smoking behavior, but little is known about what factors moderate this relationship. Therefore, the goal of this study was to examine demographic characteristics as potential moderators of relationship between Adverse Childhood Experiences (ACEs) and cigarette smoking. A secondary data analysis was conducted using the 2013 California Behavioral Risk Factor Surveillance System data. The sample included 2,604 U.S. adults (54.8% female; Age: M = 53.3, SD = 8.10; 83.6%; Caucasian, 6.4% Asian, 5.9% Black or African American, 3.1% American Indian or Alaska Native, and 0.6% other, and 0.2% Native Hawaiian or other Pacific Islander). We used multinomial logistic regression to test sex, race, socioeconomic status, and education as moderators of the relationship between ACE score and smoking. Sex, race, education, and income were significantly and independently associated with smoking outcomes. Men, individuals with lower income and education, and certain ethnic/racial groups reported greater odds of smoking. No interactions between ACE score and sex, race, education, or income significantly predicted smoking outcomes. ACEs were not significantly associated with smoking behavior. Results suggest that the relationship between ACEs and smoking later in life does not depend on basic demographic features. Knowing which populations are more vulnerable to smoking can help clinicians better assess and tailor interventions to meet the needs of their patients by using culturally sensitive interventions and obtaining resources to help improve treatment access, motivation, and success.
"],"dc:identifier":["https://scholarsrepository.llu.edu/etd/1021"],"dc:language":["English"],"dc:rights":["This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights."],"dc:subject":["Demography, Population, and Ecology","Health Psychology","Adult Survivors of Child Adverse Events -- psychology; Behavioral Risk Factor Surveillance System; California -- epidemiology; Cigarette Smoking -- epidemiology; Cigarette Smoking -- psychology; Ethnic Groups; Female; Humans; Male; Middle Aged; Sex Factors; Socioenvironmental Therapy"],"dc:title":["Adverse Childhood Experiences and Cigarette Smoking: Demographic Moderators"],"thesis:degree_discipline":["Psychology"],"thesis:degree_level":["Doctoral Project"],"thesis:degree_name":["Doctor of Psychology (PsyD)"]},"updated_at":"2026-07-24T02:53:37Z"}