VCOM Research Day Program Book 2023

Medical Student Research Publ ic Health

07 The Impact of Adverse Childhood Experiences on Alcohol and Tobacco Use in Virginia: Analysis of BRFSS 2019-2020 Dataset

Lorissa C Simpson, OMSII; Prerna M Yadav, OMSII; Theresa J McCann, PhD, MPH Corresponding author: lsimpson@vt.vcom.edu

Edward Via College of Osteopathic Medicine-Virginia Campus

Substance Use Disorder (SUD) is a condition that impacts 20.8 million Americans and their families. The DSM-5 defines SUD as, “patterns of symptoms caused by using a substance that an individual continues taking despite its negative effects.” Alcohol and tobacco are two substances that are leading preventable causes of morbidity and mortality in the United States. The Virginia Department of Health (VDH) reports an increase in alcohol-related deaths from 2016-2020, and that number is continuing to increase. In Virginia, 13.6% of adults identify as current smokers which is lower than the national average of 15.5%. However, despite these downtrends in tobacco use, smoking remains a formidable problem in public health in Virginia. It has been well documented that Adverse Childhood Experiences (ACEs) are contributing factors in SUD development. ACEs are defined as any potentially traumatic events that can have negative long-term effects on health and well-being. The current study seeks to analyze and

compare the different ACEs as potential risk factors for SUD in Virginia using data from the Behavioral Risk Factor Surveillance System (BRFSS). BRFSS is a randomized national telephone survey conducted by the Center for Disease Control and Prevention (CDC) that collects information about health-related risk behaviors including, but not limited to, ACEs. This study comprises a cross-sectional analysis of 2019-2020 data comparing the prevalence of exposure to ACEs to alcohol and tobacco use to determine the association of these types of traumatic events with substance use. Descriptive statistics with means and proportions were used to describe the data. ACEs were measured using an eleven-question scale and cumulative ACE scores were calculated by summing the positive responses for each participant. Participants with ACE scores of 0-3 were considered low risk, participants with ACE scores greater than 4 were considered high risk. Tobacco use was measured

using a four-point scale that included current everyday use, current occasional use, former use, and never used. Alcohol use was calculated using drinks per week where 0-13 drinks per week was considered low use and 14+ drinks per week was considered heavy use. A Pearson’s Chi Square was used to analyze these variables. Analysis demonstrated that there were statistically significant associations between both alcohol and tobacco use and higher versus lower ACE scores (p<0.001). These findings further support the current literature that has demonstrated associations between ACEs and substance use later in life and highlights the need for continued support and resources for those individuals in the state of Virginia.

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