To the Editor: I disagree with the conclusion
of Dr Anda and colleagues1 that " . . .
nicotine provides pharmacological relief from the effects of adverse childhood
experiences." Instead, their data clearly show that nicotine dependency is
associated with heightened sadness and depression, just as we have shown that
tobacco smoking leads to increased stress, with smokers being more stressed
than nonsmokers.2 Anda et al showed that
for every level of adverse childhood experience such as verbal or physical
abuse and other stressful events, more smokers than nonsmokers reported depression
or sadness during the previous year. Moreover, this was found among those
who reported no severe adverse childhood experiences, just as it also occurred
in those who had suffered many adverse childhood experiences. Thus, smoking
provided an additional source of psychological distress, independent of the
level of adverse childhood experience. Their data provide no evidence to support
the notion that smoking helps control mood.
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