Stress as a Distal Predictor of Heavy Smoking Initiation in Young People.

Does the lifetime experience of stressful life events contribute to the development of a smoking habit? We analyze the effect of exposure to social stressors on the risk of heavy smoking, in a representative community sample of 1747 young adults in Miami, Florida. The effects of distal life stress are assessed in the context of a separate measure of more recent stress exposure. Level of distal stress exposure was shown to predict smoking independently of recent stress. Our analysis revealed that intervening stressful events do not mediate the influence of distal stress. We further investigate the extent to which stress effects may be mediated by the intervening onset of psychiatric and substance dependence disorders. A modest intervening role of disorder on the effects of recent stress was suggested. We conclude that the effect of social stress on the risk for smoking is cumulative over time. The findings support the assertion of life course epidemiology that information from the duration of the life course helps to predict eventual health behavior. The significant independent effect of early stress exposure implies that smoking prevention strategies should be targeted to persons much younger than the age known to be that of greatest risk for smoking initiation, and efforts should aim at youths with stressful histories. [ABSTRACT FROM AUTHOR]