Changing pattern of smoking in relation to adverse childhood experiences among adolescents: a cross-sectional study in Bangkok, Thailand

Background: Youth cigarette smoking has decreased significantly over the last two decades. The Southeast Asian Region has the highest rates of tobacco use, but the trend is projected to decline rapidly, similar to levels seen globally. Methods: The aim of this study was to portray the changing pattern of smoking in relation to history of ACEs among adolescents. Data were extracted from the 2017 and 2019 rounds of the Bangkok Behavioral Surveillance Survey (BBSS), which sampled students in grades 11 and vocational Year 2 students, ages 13 to 17 years. A combined total of 8,200 adolescents participated: 4,126 in 2017 and 4,074 in 2019. Results: The prevalence of tobacco smoking in the previous 30 days was 14.7% (95% CI 13.4, 15.6) in 2017 and 7.7% (95% CI 7.0, 8.1) in 2019. Similarly, the proportion of adolescents with a history of ACEs declined slightly from 52.1% to 45.9%. Adolescents with ACEs were more likely to report smoking in the past 30 days. Conclusions: Future researchers should consider mechanisms for the ACE-smoking association and use of emerging tobacco products such as electronic cigarettes. Tobacco control efforts should focus on adolescents with ≥ 4 ACEs.