Associations between interpersonal violence and smoking cigarettes, ecigarettes, and dual use among Mexican adolescent students

Rosibel Rodríguez-Bolaños ^1* Evangelina Díaz Andrade ^2,3* Paula Ramírez-Palacios ¹ Anabel Rojas-Carmona ^4,5 Katia Gallegos-Carrillo ⁶ Inti Barrientos-Gutiérrez ¹ Lizeth Cruz-Jiménez ⁷ Dèsirée Vidaña-Pérez ⁷ Edna Arillo-Santillán ¹ James F Thrasher ^1,7

• ¹ National Institute of Public Health (Mexico), Cuernavaca, Mexico
• ² Department of Research. Health Services of Jalisco, Secretary of Health, Ciudad Guzmán, Jalisco, Mexico
• ³ University of Guadalajara, CUSur, Ciudad Guzmán, Jalisco, Mexico
• ⁴ University of the Sea, Oaxaca, Mexico
• ⁵ Federal University of Ceara, Fortaleza, Ceará, Brazil
• ⁶ Epidemiology and Health Services Research Unit, Mexican Social Security Institute, Cuernavaca, Mexico
• ⁷ University of South Carolina, Columbia, Missouri, United States

Objective. To assess associations between experienced violence and the use of combustible cigarettes, e-cigarettes, and of both products ("dual use") among adolescent students from Mexico.Methods. Data comes from an online survey among 3,046 adolescents (12-19 years) conducted between September and December 2021. Students reported experiences of neglect, physical, psychological, and sexual violence perpetrated by household members, and digital violence (by anyone) in the previous 12 months, as well as current (last 30 day) use of cigarettes and e-cigarette. In multinomial logistic models, exclusive cigarette use, exclusive e-cigarette use, and dual use (reference=no use) were regressed on experienced violence and covariates.Results. The prevalence of exclusive use of cigarettes was 1.4%, exclusive e-cigarette use was 6.1%, and 2.4% for dual use. Almost half (46.9%) of adolescents reported having been the target of physical violence, followed by psychological violence (42.6%), neglect (34.9%), digital violence (12.3%), and sexual violence (5.2%). In adjusted multinomial models, adolescents who experienced physical violence (Adjusted Relative Risk Ratios: ARRR=2.28, 95% CI [1.05-4.96]) were more likely to exclusively smoke cigarettes. Adolescents were also more likely to exclusively use e-cigarettes if they had been targeted by psychological or digital violence (ARRR=1.55, 95% CI [1.05-2.29] & ARRR=1.69, 95% CI [1.12-2.54], respectively). Experience of physical, digital, neglect, and sexual violence were positively associated with dual use.Experiences of violence may increase the likelihood of tobacco use, particularly dual use. Prevention programs may need to include the family environment to reduce violence.