Adverse childhood experiences and smoking status in children: A systematic review and meta-analysis

Adverse childhood experiences are a factor that can have a broad impact on different dimensions of health in different eras. This research aimed to investigate the relationship between adverse childhood experiences and smoking in children through a systematic review and meta-analysis. Three databases, including PubMed, Web of Science and Scopus, were selected for manuscript searches. These three databases were searched until July 2022. This search was limited to English. For this study, the odds ratio or risk ratio and 95% confidence interval were extracted. The odds ratio pool was performed using the random-effects method reported. An analysis was done based on the types of adverse childhood experiences and an analysis based on sex. The year of publication of the earliest and last publication included in this analysis was, respectively, 2003 and 2022. After screening the manuscripts, finally, 39 studies remained for this study. Adverse childhood experiences are associated with an increased risk of smoking in children [odds ratio 1.69; CI = 1.55–1.85; z = 11.80; p < 0.001; I² = 92.6%]. Components of adverse childhood experiences, including emotional abuse, emotional neglect, physical abuse, physical maltreatment and physical neglect, were associated with increased smoking. The present study showed that adverse childhood experiences provide a context that increases the possibility of smoking in children. It is necessary to pay attention to the dimensions of health and behaviour in this group.