Intimate partner violence and initiation of smoking and drinking: A population-based study of women in Yokohama, Japan

Tobacco use, trauma exposure and PTSD: a systematic review

Tobacco use remains one of the most significant preventable public health problems globally and is increasingly concentrated among vulnerable groups, including those with trauma exposure or diagnosed with PTSD. The goal of this systematic review was to update and extend previous reviews. Of the 7224 publications that met the initial criteria, 267 were included in the review. Summary topic areas include conceptual frameworks for the relation between trauma or PTSD and tobacco use; associations between trauma exposure or PTSD and tobacco use; number and type of trauma exposures and tobacco use; PTSD symptoms and tobacco use; Treatment-related studies; and the examination of causal relations. Evidence continues to indicate that individuals exposed to trauma or diagnosed with PTSD are more likely to use tobacco products, more nicotine dependent and less likely to abstain from tobacco even when provided evidence-based treatments than individuals without trauma. The most commonly cited causal association proposed was use of tobacco for self-regulation of negative affect associated with trauma. A small proportion of the studies addressed causality and mechanisms of action. Future work should incorporate methodological approaches and measures from which we can draw causal conclusions and mechanisms to support the development of viable therapeutic targets.

Intimate partner violence as a predictor of substance use outcomes among women: A systematic review

Although the correlation between experience of intimate partner violence (IPV) and substance use among women has been well-established, there is no consensus on whether or how IPV impacts subsequent substance use behaviors or treatment success. To identify research gaps and implications for substance use treatment, we conducted a systematic review to identify and examine evidence on IPV as a predictor of subsequent substance use behaviors, substance use disorders (SUD), and treatment outcomes among women. We included studies published between 2010 and 2020 that assessed IPV experiences as a predictor of subsequent substance use behaviors (i.e., use initiation, increased use), SUD diagnosis, or treatment outcomes (i.e., incomplete treatment, relapse) among women. From 576 unique records, we included 10 studies (4 longitudinal, 4 cross-sectional, 2 qualitative). Alcohol use and alcohol use disorder were the most commonly studied outcomes (n = 6); findings were mixed regarding the significance of IPV being associated with subsequent alcohol outcomes. Three studies examined illicit drug use, finding that physical and sexual IPV predicted crack/cocaine use and were associated with SUD diagnoses. Four studies examining SUD treatment outcomes found IPV to impede treatment engagement and completion, increasing the likelihood of relapse. To our knowledge, this is the first systematic review of the literature on IPV as a predictor of substance use behaviors and treatment outcomes among women. Findings highlight the need for diverse SUD treatment modalities to incorporate IPV screening and referral to appropriate services into their programming to improve SUD management and the overall health and wellbeing of women.

Profile of Women Seeking Treatment for Substance Use Disorder in Tertiary Care Government De-Addiction Centre

Background

There is an increasing trend among women using substance. However, very few women seek treatment for substance use disorder in Government de-addiction centre. There is limited literature available regarding the same.

Aim

To examine the profile of women seeking treatment for substance use disorder in Government De-addiction Centre, Bengaluru.

Methods

The study was retrospective in nature. All the female patients who sought in-patient treatment from centre for addiction medicine, NIMHANS, Bengaluru from Apr 2015- Sept 2016 were included in the study. Method of data collection: Content analysis was used to collect the secondary data from the hospital record. Descriptive statistics such as mean, frequency distribution was used for statistical analysis.

Results

Mean age of women who sought treatment for substance use disorder in the centre was 42 ±14 years. The mean age at initiation of alcohol was 27 ±9 years, alcohol dependence was 34 ±10.6 years. Majority (65%) belonged below poverty line. 59% were married and living with their spouse. 55% of them sought treatment either on their own or brought by family members, 38% referred by the psychiatrist. More than one-third (36%) had primary school education. Nearly one-third (27%) of them had repeated admissions more than once. More than one-third of them (34%) were homemakers, nearly one-fourth (24%) of them were lost their previous job, 6% of them students and professionals respectively.

Conclusion

The majority (68%) of women had diagnosis of alcohol dependence, nicotine (44%), benzodiazepine (14%), opioid dependence (11%), cannabis dependence (1.6%), less than 1% had other forms behavioural addictions.

[…] you feel there’s nowhere left to go: the barriers to support among women who experience substance use and domestic abuse in the UK

Purpose

Domestic abuse victimisation is a common experience among women with problematic substance use, but support provision for both issues is siloed within the UK. Research on the topic focuses on practitioner responses, dominating women’s voices within research, policy and practice. As such, knowledge about women’s experiences of help-seeking is missing. This study therefore aims to fill a gap in knowledge by exploring the lived experiences of supporting seeking among women impacted by domestic abuse and substance use.

Design/methodology/approach

Semi-structured interviews were conducted with 12 women who had a history of co-occurring problematic substance use and domestic abuse. Influenced by interpretive phenomenological analysis and feminist research praxis, the study explored how women with dual needs navigated support and help seeking and the barriers they faced.

Findings

The women reported the biggest barrier was the disconnect between substance use and domestic abuse support, including a gap in the communication of information. This resulted in them having to choose which of their needs to seek support for. None of the women received support for their combined experiences, and most of the women never received support for their domestic abuse experiences alone.

Originality/value

This is the first piece of research from the UK to explore, in-depth, women’s journey through support for their co-occurring substance use and domestic abuse victimisation. Previous research has not consulted with women to understand how they navigate the complex support systems available. This paper is, therefore, important, because it demonstrates the journeys to services these women take and the barriers they have to overcome.

Informal Control by Family and Risk Markers for Alcohol Abuse/Dependence in Seoul

Although previous research documents a reliable relationship between physical intimate partner violence (IPV) victimization and alcoholism, relatively little research has examined new theoretical constructs in IPV research that may increase risk for or help buffer women from alcohol abuse/dependence. The purpose of the present study was to examine informal social control of IPV by family members as a protective factor against and coercive control as a risk factor for alcohol abuse/dependence in a small population sample of married women in Seoul, South Korea. We hypothesized that (a) informal social control by family members would be negatively associated with victim alcohol abuse/dependence and (b) husband's coercive control would be positively associated with victim alcohol abuse/dependence. We measured alcohol abuse/dependence (CAGE scale), IPV and coercive control by husbands, and informal social control of IPV (ISC_IPV) by extended family members in a three-stage random cluster sample of 462 married women in Seoul, South Korea. Both random effects regression and zero-inflated Poisson regression models found that ISC_IPV by extended family members was associated with a significantly lower CAGE scores, and coercive control was associated with significantly higher CAGE scores. Interventions to boost ISC_IPV by extended family members may mitigate some of the risk of alcohol abuse/dependence by victims.

The role of smoking in the relationship between intimate partner violence and age at natural menopause: a mediation analysis

Background

Age at natural menopause (ANM) is considered as a biologic marker of health and ageing. The relationship between intimate partner violence (IPV) and ANM is currently unknown, and whether smoking plays a role in this relationship is unclear. The aim of this study was to examine the association between IPV and ANM and to quantify the effect mediated through smoking.

Methods

Data were drawn from the 1946–51 cohort of the Australian Longitudinal Study on Women’s Health, a prospective cohort study first conducted in 1996. History of IPV (yes or no) was self-reported at baseline. ANM was confirmed by at least 12 months of cessation of menses where this was not a result of medical interventions such as bilateral oophorectomy or hysterectomy and categorised as <45 (early menopause), 45–49, 50–51, 52–53, and ≥54 years. Regression models and mediation analyses based on the counterfactual framework were performed to examine the relationship between IPV and ANM and to quantify the proportion mediated through smoking (never, past, current <10, 10–19 and ≥20 cigarettes/day).

Results

Of 6138 women in the study with natural menopause, 932 (15%) reported a history of IPV and 429 (7.0%) had an early ANM (before age 45 years). Women with IPV were more likely to smoke and be heavy smokers (Odds Ratio: 2.77, 95% CI 2.19–3.51). Women with IPV were also at increased risk of early menopause (ANM <45 years) (Relative Risk Ratio: 1.36, 95% CI 1.03–1.80) after accounting for education level, income difficulties, age at menarche, parity, body mass index, and perceived stress, compared to the reference group (women without IPV and ANM at 50–51 years). This relationship was attenuated after adjusting for smoking (Relative Risk Ratio: 1.20, 95% CI 0.90–1.59). Mediation analysis showed that cigarette smoking explained 36.7% of the association between IPV and early menopause (ANM <45 vs. ≥45 years).

Conclusion

Cigarette smoking substantially mediated the relationship between IPV and early menopause. Findings suggest that as part of addressing the impact of IPV, timely interventions that result in cessation of smoking will partly mitigate the increased risk of early menopause.

Electronic supplementary material

The online version of this article (10.1186/s40695-017-0031-9) contains supplementary material, which is available to authorized users.

Stressful and Traumatic Experiences among Women with Alcohol Use Disorders in India

AIM

The aim of the present study was to examine lifetime stressful and traumatic experiences among women with alcohol use disorders (AUDs).

METHODS

The sample comprised of two groups: a clinical group of 35 women with a diagnosis of AUD and a comparison group of 60 women drawn from the community. After screening out, the participants were administered Life Stressor Checklist-Revised.

RESULTS

On an average, clinical group was exposed to 7.57 (standard deviation [SD] = 4.14) stressful events and comparison group was exposed to 4.03 (SD = 2.80) stressful events across the lifespan (t = 4.976; P < 0.001). Clinical group reported a high number of childhood abuse and interpersonal traumas across lifespan than comparison group. The relationship between adverse life experiences and alcohol abuse among women was bidirectional.

CONCLUSION

Understanding the nature and experiences of trauma in this group has implications for planning gender-sensitive treatment programs for women seeking help for AUDs in India.

Risk Factors for Smoking in Rural Women: The Role of Gender-Based Sexual and Intimate Partner Violence

BACKGROUND

Women living in Ohio Appalachia experience cervical cancer at disproportionately high rates. Intimate partner and sexual gender-based violence (GBV) and smoking are independent risk factors for cervical cancer and interact to heighten risk. Appalachian women smoke at higher rates than other Ohio women, but little is known about GBV exposure in the region. The purpose of this study was to establish prevalence of women's exposure to GBV in Ohio Appalachia and examine the association between GBV and smoking among women in the region.

METHODS

A two-phase address-based random sampling approach was used in three purposefully selected Ohio Appalachian counties to identify women to complete an interviewer administered cross-sectional survey (n = 398). The primary exposure variable was GBV Index Score, a 4 level indices representing increasing exposure to eight abuse types. Correlation analysis and logistic regression were used to examine smoking correlations and risk.

RESULTS

Almost 57% of women in the three selected Ohio Appalachian counties experienced GBV, with rate increasing to 77.5% among current smokers. The distribution of the GBV Exposure Index Score was significantly different across smoking status (p < = 0.0001), with exposure of GBV increasing when moving from never, to former, to current smokers. When controlling for depression, age, and adult socioeconomic position, GBV Exposure Index was significantly associated with current smoking behavior (OR:1.62, 95% CI [1.21-2.17]).

DISCUSSION

Professionals working to reduce disparate disease burden among women in Ohio Appalachia should consider the role GBV plays in health behavior and behavioral change interventions, including smoking and smoking cessation.

The Relationship between Interpersonal Violence Victimization and Smoking Behavior across Time and by Gender

The current study examined relationships between interpersonal violence victimization and smoking from childhood to adulthood. Data were from a community-based longitudinal study (N = 808) spanning ages 10 - 33. Cross-lag path analysis was used to model concurrent, directional, and reciprocal effects. Results indicate that childhood physical abuse predicted smoking and partner violence in young adulthood; partner violence and smoking were reciprocally related in the transition from young-adulthood to adulthood. Gender differences in this relationship were not detected. Social work prevention efforts focused on interpersonal violence and interventions targeting smoking cessation may be critical factors for reducing both issues.

Intimate partner violence-related experiences and mental health among college students in Japan, Singapore, South Korea and Taiwan

BACKGROUND

Intimate partner violence (IPV) is a significant public health threat that contributes to a wide range of mental and physical health problems for victims.

AIMS

The purpose of this study was to examine IPV-related experiences and mental health outcomes among college students in Japan, Singapore, South Korea and Taiwan.

METHODS

The data were obtained from the Inter-University Consortium for Political and Social Research (ICPSR), the International Dating Violence Study (IDVS) 2001-2006 (ICPSR 29583; N = 981; Japan n = 207; Singapore n = 260; South Korea n = 256; Taiwan n = 258).

RESULTS

Co-experience of physical IPV victimization and perpetration was associated with borderline personality traits and posttraumatic stress disorder (PTSD), but not with depression. Childhood sexual abuse, gender hostility and violence socialization were significant predictors of borderline personality traits, depression and PTSD. While country and gender variations in mental health are noted, there are two specific populations that may need special attention for mental health interventions: Taiwanese women especially for borderline personality traits and PTSD, and Japanese men especially for depression.

CONCLUSION

IPV victimization and perpetration, childhood sexual abuse, gender hostility and violence socialization have a significant impact on the mental health of college students in Japan, Singapore, South Korea and Taiwan. Since IPV and mental health are significant public health issues, research on IPV and mental health consequences of IPV victimization and perpetration in these countries should be further expanded in order to better understand the interventions that will be effective in treating victims, perpetrators and victim/perpetrators of IPV.

Cross-cultural measurement equivalence of the Japanese version of Revised Conflict Tactics Scales Short Form among Japanese men and women

AIM

The Revised Conflict Tactics Scales Short Form (CTS2SF) is an instrument used to measure intimate partner violence (IPV) perpetration and victimization over the past 12 months.

METHODS

The CTS2SF was translated into Japanese, and the reliability (internal consistency and 4-week test-retest reliability) and the concurrent and factor-based validity were examined using two waves of Internet surveys over an interval of 4 weeks. Participants of the survey were 393 Japanese men and women who were registrants of an Internet survey company.

RESULTS

Cronbach's α was greater than 0.5 for most scales, while it was low (α = 0.18) for sexual coercion by partner. The test-retest reliability of the binary variable for the presence or absence of IPV was high (Yule's Q, 0.79-1.00), and moderate between the scores (Spearman's rank correlation, 0.38:0.70). Concordance with the Buss-Perry Aggression Questionnaire, Violence Against Women Screen, and Kessler 6 generally indicated good concurrent validity. The results of the exploratory factor analysis confirmed the three-factor structure of the Japanese version of the CTS2SF.

CONCLUSION

Although the internal consistency reliability was limited for some sub-scales, its moderate internal consistency and test-retest reliability and good factor-based validity highlighted the benefit of using the Japanese version of the CTS2SF in a large-scale community survey where a shorter scale is required to assess IPV.

Worksite safety climate, smoking, and the use of protective equipment by blue-collar building workers enrolled in the MassBUILT smoking cessation trial

OBJECTIVE

To assess potential contributors to high injury rates and smoking prevalence among construction workers, we investigated the association of safety climate with personal protective equipment use, and smoking behaviors.

METHODS

Logistic regression models estimated risk ratios for personal protective equipment use and smoking using data from participants in MassBUILT smoking cessation intervention (n = 1725).

RESULTS

Contractor safety climate was negatively associated with the use of dust masks (rate ratio [RR], 0.88; 95% confidence interval [CI], 0.83 to 0.94), respirators (RR, 0.82; 95% CI, 0.75 to 0.89), general equipment (RR, 0.98; 95% CI, 0.95 to 1.00), and fall protection (RR, 0.94; 95% CI, 0.91 to 0.98) and positively associated with current smoking (RR, 1.12; 95% CI, 1.01 to 1.25) but not smoking cessation. Coworker safety climate was negatively associated with the use of dust masks (RR, 0.87; 95% CI, 0.82 to 0.92), respirators (RR, 0.80; 95% CI, 0.74 to 0.87), general equipment (RR, 0.96; 95% CI, 0.94 to 0.98), fall (RR, 0.92; 95% CI, 0.89 to 0.96), and hearing protection (RR, 0.88; 95% CI, 0.83 to 0.93) but not smoking.

CONCLUSIONS

Worksite safety climate may be important for personal protective equipment use and smoking, but further research is needed.

Intimate partner violence and current tobacco smoking in low- to middle-income countries: Individual participant meta-analysis of 231,892 women of reproductive age

Research on the health impact of intimate partner violence (IPV) has primarily focused on gynaecological and sexual health outcomes or psychiatric disorders. Much less is known about the association between IPV and tobacco smoking among women of reproductive age in low- to middle-income countries. This study examines the association between exposure to IPV and current tobacco smoking among women of reproductive age from low- to middle-income countries. We used data from Demographic and Health Surveys from 29 countries (231,892 women, aged 15-49) to examine the association between exposure to IPV and current tobacco smoking. Data were pooled using random-effects meta-analysis. There was a significant association between IPV and current tobacco smoking (pooled adjusted odds ratio [OR] = 1.58; 95% CI: 1.38-1.79) after controlling for age, education, occupation, household wealth, religion and pregnancy status across countries. The association was moderately consistent across the 29 countries (I(2) = 55.3%, p < 0.0001). These findings suggest that exposure to IPV is associated with an increased likelihood of current tobacco smoking among women of reproductive age in low- to middle-income countries. Future research on the association between exposure to IPV and tobacco smoking in prospective cohort studies is warranted.

Intimate partner violence victimization and alcohol consumption in women: a systematic review and meta-analysis

AIMS

To examine the evidence of association between intimate partner physical or sexual violence (IPV) victimization and alcohol consumption in women.

METHODS

We conducted a systematic review and meta-analysis of cross-sectional and longitudinal studies released before 6 June 2013. Studies providing an estimate of association between violence and alcohol consumption or alcohol use disorders were eligible for inclusion. Quality was assessed and random effects meta-analyses used to generate pooled odds ratios (OR) where appropriate. Higgins I(2) where P<0.10 was taken to indicate heterogeneity.

RESULTS

Fifty-five studies providing 102 estimates of association met the inclusion criteria. Most estimates were not controlled for partner alcohol use and other key confounders. Seven longitudinal studies provided 12 estimates of the association between alcohol and subsequent IPV; nine of 12 estimates showed a direction of increased odds of subsequent IPV, pooled OR=1.27 [95% confidence interval (CI)=1.07-1.52], I(2) =0%, P=0.437. Nine longitudinal studies provided 15 estimates of association between IPV and subsequent alcohol use; 14 of 15 estimates showed a direction of increased odds of subsequent alcohol use, pooled OR=1.25 (95% CI 1.02-1.52), I(2)=0%, P=0.751. Cross-sectional studies showed an association between IPV and alcohol use, pooled OR=1.80, 95% CI 1.58-2.06, but with substantial heterogeneity, I(2)=60.8%, P<0.0001. Definition of alcohol use partly accounted for heterogeneity in cross-sectional estimates.

CONCLUSIONS

There is a clear positive association between alcohol use and intimate partner physical or sexual violence victimization among women, suggesting a need for programming and research that addresses this link. However, the temporal direction of the association remains unclear. Longitudinal studies with multiple waves of data collection are needed.

Human rights violations and smoking status among South African adults enrolled in the South Africa Stress and Health (SASH) study

Despite South Africa's history of violent political conflict, and the link between stressful experiences and smoking in the literature, no public health study has examined South Africans' experiences of human rights violations and smoking. Using data from participants in the nationally representative cross-sectional South Africa Stress and Health study (SASH), this analysis examined the association between respondent smoking status and both human rights violations experienced by the respondent and violations experienced by the respondents' close friends and family members. SAS-Callable SUDAAN was used to construct separate log-binomial models by political affiliation during apartheid (government or liberation supporters). In comparison to those who reported no violations, in adjusted analyses, government supporters who reported violations of themselves but not others (RR = 1.76, 95% CI: 1.25-2.46) had a significantly higher smoking prevalence. In comparison to liberation supporters who reported no violations, those who reported violations of self only (RR = 1.56, 95%CI: 1.07-2.29), close others only (RR = 1.97, 95%CI: 1.12-3.47), or violations of self and close others due to close others' political beliefs and the respondent's political beliefs (RR = 2.86, 95%CI: 1.70-4.82) had a significantly higher prevalence of smoking. The results of this analysis suggest that a relationship may exist between human rights violations and smoking among South Africa adults. Future research should use longitudinal data to assess causality, test the generalizability of these findings, and consider how to apply these findings to smoking cessation interventions.

Intimate partner violence victimization and cigarette smoking: a meta-analytic review

The current meta-analytic review represents the first comprehensive empirical evaluation of the strength of the relationship between intimate partner violence (IPV) victimization and cigarette smoking. Thirty-nine effect sizes, drawn from 31 peer-reviewed publications, determined the existence of a small to medium composite effect size for the victimization-smoking relationship (d = .41, 95% confidence interval = [.35, .47]). Results indicate that victims of IPV are at greater smoking risk than nonvictims. Subsequent moderator analyses indicated that the association between victimization and smoking is moderately stronger among pregnant compared to nonpregnant victims. The strength of the victimization-smoking relationship did not differ by relationship type or ethnicity. More research is needed on the smoking behavior of male victims, victims of psychological violence, and victims who identify as Latino/Latina. It would be useful for professionals working with IPV victims to assess for smoking and incorporate smoking prevention and cessation skills in intervention settings.

Ties between event times and jump times in the Cox model

Methods for dealing with tied event times in the Cox proportional hazards model are well developed. Also, the partial likelihood provides a natural way to handle covariates that change over time. However, ties between event times and the times that discrete time-varying covariates change have not been systematically studied in the literature. In this article, we discuss the default behavior of current software and propose some simple methods for dealing with such ties. A simulation study shows that the default behavior of current software can lead to biased estimates of the coefficient of a binary time-varying covariate and that two proposed methods (Random Jitter and Equally Weighted) reduce estimation bias. The proposed methods can be easily implemented with existing software. The methods are illustrated on the well-known Stanford heart transplant data and data from a study on intimate partner violence and smoking.

Intimate partner violence and cardiovascular risk in women: a population-based cohort study

BACKGROUND

A potential link between intimate partner violence (IPV) and cardiovascular disease (CVD) has been suggested, yet evidence is scarce. We assessed cardiovascular risk and incident prescription of cardiovascular medication by lifetime experiences of physical and/or sexual IPV and psychological IPV alone in women.

METHODS

A population-based cohort study of women aged 30-60 years was performed using cross-sectional data and clinical measurements from the Oslo Health Study (2000-2001) linked with prospective prescription records from the Norwegian Prescription Database (January 1, 2004 to December 31, 2009). We used age-standardized chi-square analyses to compare clinical characteristics by IPV cross-sectionally, and Cox proportional hazards regression to examine cardiovascular drug prescription prospectively.

RESULTS

Our study included 5593 women without cardiovascular disease or drug use at baseline. Altogether 751 (13.4%) women disclosed IPV experiences: 415 (7.4%) physical and/or sexual IPV and 336 (6.0 %) psychological IPV alone. Cross-sectional analyses showed that women who reported physical and/or sexual IPV and psychological IPV alone were more often smokers compared with women who reported no IPV. Physical and/or sexual violence was associated with abdominal obesity, low high-density lipoprotein cholesterol, and elevated triglycerides. The prospective analysis showed that women who reported physical and/or sexual IPV were more likely to receive antihypertensive medication: incidence rate ratios adjusted for age were 1.27 (95% confidence interval 1.02-1.58) and 1.36 (CI 1.09-1.70) after additional adjustment for education and systolic and diastolic blood pressure, respectively. No significant differences were found for cardiovascular drugs overall or lipid modifying drugs.

CONCLUSIONS

Our findings indicate that clinicians should assess the cardiovascular risk of women with a history of physical and/or sexual IPV, and consider including CVD prevention measures as part of their follow-up.

Smoking and behavioral health of women

BACKGROUND

Using data from a study of reliability and validity of a screening tool for co-occurring substance abuse and mental health problems, our objective was to compare behavioral health issues of female smokers and nonsmokers and explore correlates of smoking.

METHODS

Using a convenience sample (n=1021), we recruited participants to complete an online survey conducted in substance abuse treatment, primary care, mental health services, senior, and public settings. The survey included demographic questions, smoking status, the co-occurring disorders screening tool, the Global Appraisal of Individual Needs-Short Screener (GAIN-SS) and the Postraumatic Stress Disorder Checklist (PCL)-Civilian.

RESULTS

One third of participants self-identified as smokers, and African American, American Indian, and bisexual women reported the highest rates of smoking. Seventy-two percent of women reported at least one mental health problem in the past year; 29% had a past year substance abuse problem, and 26% reported a past year co-occurring disorder of both. Smokers had significantly higher rates of posttraumatic stress disorder (PTSD), past year depression and anxiety, suicidality, past year substance abuse, and co-occurring disorders. Smokers also had significantly higher rates of lifetime intimate partner violence (IPV) and childhood abuse.

CONCLUSIONS

Smoking in women was associated with significantly higher rates of mental health and substance abuse problems. Substance abuse, being in a treatment setting, IPV, African American and mixed ethnicity, Medicaid insurance status, reduced income, and no home ownership were identified as predictors of smoking. Screening and evaluation of smoking status, mental health, substance use disorders, and the presence and impact of violence are essential for women's health.

The role of smoking expectancies in the relationship between PTSD symptoms and smoking behavior among women exposed to intimate partner violence

Intimate partner violence (IPV) is a public health problem associated with negative health consequences, including higher rates of tobacco smoking. Smoking expectancies are related to motivation to quit and relapse. IPV-exposed women endorse higher rates of PTSD symptoms, which are related to smoking and smoking expectancies. The present study sought to examine the relationship among smoking behavior, smoking expectancies, and PTSD symptoms among IPV-exposed women. Participants were 83 women who reported experiencing IPV within the last month, smoked an average of 12 cigarettes per day, and reported moderate levels of nicotine dependence (FTND mean=4.4). Participants completed baseline and follow-up interviews. Multiple regression analyses assessed the relationships among smoking expectancies and PTSD symptoms to cigarettes smoked per day and nicotine dependence. Findings demonstrated that Stimulation/State Enhancement expectancies were positively related to cigarettes per day, whereas PTSD arousal symptoms were negatively related to cigarettes per day, p's<.05. Neither smoking expectancies nor PTSD symptoms were significantly related to nicotine dependence. Supplemental analyses revealed that PTSD re-experiencing symptoms were negatively related and PTSD avoidance/numbing symptoms were positively related to Stimulation/State Enhancement expectancies, p's<.05. This study extends findings regarding the association between PTSD symptoms and smoking among an understudied population - IPV-exposed women. The relationship between PTSD symptoms and smoking differed across PTSD symptom clusters and expectancy scales, which may have implications for treatment development. The fact that expectancies and PTSD symptoms are related to smoking behavior among IPV-exposed women may be important for enhancing prevention and intervention efforts.