Though smoking cessation is the best way to reduce premature death among individuals who have cardiovascular diseases (CVD), a substantial percentage of individuals with these conditions continue to smoke. Given that stressful environments are well-known predictors of smoking, we investigate life-course pathways from early-life adversities (low childhood SES, family instability, and abuse) to risk of recalcitrant smoking in midlife (smoking with CVD). Using longitudinal data from Midlife in the U.S., we found that for women, both low childhood SES and family instability independently increase the risk of recalcitrant smoking. By including midlife mediators, the effect of childhood SES reduced dramatically but the effect of family instability remained. For men, the effect of childhood SES remained even after adding mediators and the effect is stronger than adult SES. Our findings expand the current understanding of childhood as a critical period that contributes to the persistence of health-risk behaviors in later life.
Presented in Session 11. Demographic and Health Outcomes of Early Life Exposures