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<p>This study examined the association between adverse childhood experiences (ACEs), including discrimination due to sexual orientation and gender identity, and exposure to secondhand smoke (SHS).&#xa0;Using data from the 2018–2020 National Survey of Children’s Health (NSCH), logistic regression models calculated adjusted odds ratios (AORs) of two SHS measures: (1) anyone living in the household uses combustible tobacco products, irrespective of them using that product in the home or not, and (2) anyone smoking inside the home. Individual and cumulative ACEs served as independent variables. Data from the 2020 NSCH included discrimination due to sexual orientation and gender identity as an ACE, for children 6–17, but prior years did not.&#xa0;Each additional ACE was associated with a 36% increase in odds of having a smoker in the household (AOR: 1.36; 95% CI: 1.29–1.44) and a 37% increase in odds of smoking occurring in the home (AOR: 1.37; 95% CI: 1.25–1.52). Most ACEs were associated with both SHS outcomes. Experiencing discrimination due to sexual orientation or gender identity was associated with 144% higher odds of smoking occurring in the home (AOR: 2.44; 95% CI: 1.15–5.17).&#xa0;The 2020 NSCH is among the first to include discrimination against sexual and gender minority identity as an ACE. This study highlights that this ACE impacts exposure to tobacco, potentially leading to early modeling of smoking behavior and exposure to the health harming impacts of SHS. Future work should continue to examine discrimination against sexual and gender minority youth as an ACE.</p>

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Early Life Adversity and Exposure to Secondhand Smoke among Children: Modeling Risk Health Behaviors and Increasing Environmental Tobacco Exposure

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年5月15日

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  • Héctor E. Alcalá,
  • Amanda E. Ng,
  • Nicholas Tkach,
  • Aditya Narayan

摘要

This study examined the association between adverse childhood experiences (ACEs), including discrimination due to sexual orientation and gender identity, and exposure to secondhand smoke (SHS). Using data from the 2018–2020 National Survey of Children’s Health (NSCH), logistic regression models calculated adjusted odds ratios (AORs) of two SHS measures: (1) anyone living in the household uses combustible tobacco products, irrespective of them using that product in the home or not, and (2) anyone smoking inside the home. Individual and cumulative ACEs served as independent variables. Data from the 2020 NSCH included discrimination due to sexual orientation and gender identity as an ACE, for children 6–17, but prior years did not. Each additional ACE was associated with a 36% increase in odds of having a smoker in the household (AOR: 1.36; 95% CI: 1.29–1.44) and a 37% increase in odds of smoking occurring in the home (AOR: 1.37; 95% CI: 1.25–1.52). Most ACEs were associated with both SHS outcomes. Experiencing discrimination due to sexual orientation or gender identity was associated with 144% higher odds of smoking occurring in the home (AOR: 2.44; 95% CI: 1.15–5.17). The 2020 NSCH is among the first to include discrimination against sexual and gender minority identity as an ACE. This study highlights that this ACE impacts exposure to tobacco, potentially leading to early modeling of smoking behavior and exposure to the health harming impacts of SHS. Future work should continue to examine discrimination against sexual and gender minority youth as an ACE.