Using a classification tree modeling approach to predict cigarette use among adolescents in the United States

Exposure to Violence Variety as a Risk Factor for Cigarette Smoking: Relevance of Sensation-Seeking and Impulsivity as Mediators

BACKGROUND

Prior research has indicated that exposure to violence is a risk factor associated with cigarette smoking. However, the relevance of variety of exposure for predicting this outcome has remained underexplored. This is problematic, as increased variety of exposure may represent a measure of severity of trauma exposure with less recall bias than other measures. Further, related constructs of sensation-seeking and impulsivity have yet to be investigated as mediators of this relationship. It is predicted that increased variety of exposure to violence results in dysfunctional variation in these constructs, leading to increased daily cigarette use.

METHODS

The present study utilizes data from the first three waves of the Pathways to Desistance study to examine these relationships. Generalized structural equation modeling is used to identify direct and indirect effects of interest. A bootstrap resampling process was used to compute normalized standard errors so that indirect effects were not biased.

RESULTS

Results indicated that lifetime exposure to violence variety prior to baseline predicted increased daily cigarette use at follow-up. Neither sensation-seeking nor impulsivity were significant mediators when both constructs were included in the model, but impulsivity emerged as a significant mediator when separate mediation models were estimated for each construct.

CONCLUSIONS

The findings indicate the potential utility of screening for variety of exposure to violence to determine adolescents who may be at-risk for high frequency cigarette smoking. Programming focused on impulsivity may play a role in addressing cigarette smoking issues stemming from exposure to violence.