Journal Article

Association of Cigarette Smoking With Interpersonal and Self-Directed Violence in a Large Community-Based Sample

Alan S. Lewis, Lindsay M. S. Oberleitner, Peter T. Morgan, Marina R. Picciotto and Sherry A. McKee

in Nicotine and Tobacco Research

Volume 18, issue 6, pages 1456-1462
Published in print June 2016 | ISSN: 1462-2203
Published online December 2015 | e-ISSN: 1469-994X | DOI:
Association of Cigarette Smoking With Interpersonal and Self-Directed Violence in a Large Community-Based Sample

More Like This

Show all results sharing these subjects:

  • Public Health and Epidemiology
  • Addictions and Substance Misuse


Show Summary Details



Substance use is a major risk factor for various forms of violence, yet how cigarette smoking influences violence outcomes is incompletely understood. We investigated associations between cigarette smoking and three types of violence in a large, nationally representative, community-based sample.


Adult subjects participating in both Wave 1 (2001–2002; N = 43 093) and Wave 2 (2004–2005; N = 34 653) of the National Epidemiological Survey on Alcohol and Related Conditions (NESARC) were stratified by daily cigarette smoking status at Wave 1, and individuals with unchanged smoking status between waves were analyzed (nonsmokers [consisting of never and former daily smokers]: N = 22 529; daily smokers: N = 7442). We created composites of other- and self-directed violence and victimization occurring between Waves 1 and 2, and performed logistic regression models, controlling for psychiatric diagnoses, alcohol and substance use, and relevant demographic covariates.


Daily smokers at Wave 1 were 2.1 (95% CI: 1.5–3.0), 2.5 (2.1–2.9), and 1.7 (1.5–2.1) times more likely than nonsmokers to report self-directed violence, other-directed violence, or victimization between Waves 1 and 2, respectively. Former daily smokers were significantly less likely to report other-directed violence than individuals who were never daily smokers.


Daily cigarette smoking is temporally associated with multiple forms of violence compared to never and former cigarette smokers, even when common covariates associated with violence are controlled. Smoking status should be carefully controlled for in studies designed to identify risk factors for violence, and may be a useful component of violence risk assessment.


The findings suggest that cigarette smoking status should be carefully and systematically controlled for in studies of violence risk factors. The findings also support further investigation of the utility of cigarette smoking status for violence risk assessment, and whether smoking cessation strategies mitigate violence risk.

Journal Article.  5093 words. 

Subjects: Public Health and Epidemiology ; Addictions and Substance Misuse

Full text: subscription required

How to subscribe Recommend to my Librarian

Users without a subscription are not able to see the full content. Please, subscribe or login to access all content. subscribe or purchase to access all content.