The most incisive guide to issues facing the American family today . . . An invaluable resource for anyone wishing to stay on the cutting edge of research on family trends.

-W. Bradford Wilcox
Associate Professor of Sociology, University of Virginia 

Gasping for Breath

Bryce J. Christensen and Robert W. Patterson

Within a few years of the Surgeon General’s 1964 report on smoking, government officials required tobacco companies to print health warnings on cigarette packages. Perhaps it is time to start requiring divorce courts to carry similar warnings on divorce decrees, at least when children are affected. In an epidemiological investigation of lung cancer, researchers from the Centers for Disease Control and Prevention in Atlanta and Southern California’s Kaiser Permanente Group identify parental divorce as one of the adverse childhood experiences likely to increase a person’s risk of developing lung cancer.

Weighing data collected from 17,337 patients at the Kaiser Clinic in San Diego from 1995 to 1997, the researchers trace a clear linkage between adverse childhood experiences (or ACE) and subsequent risk of developing lung cancer. The types of adverse experiences considered are diverse and included suffering physical or sexual abuse, living with a depressed or mentally ill household member, and being exposed to domestic violence or illegal drug use. But prominent on the list was the experience of having parents separate or divorce.

When the researchers unfold their prime explanation of the connection between ACE and elevated risk of lung cancer, parental divorce fits the paradigm perfectly. The researchers argue that in large measure, adverse childhood experiences leave those affected distinctively vulnerable to lung cancer because these experiences often foster tobacco use. The pattern is clear: compared to peers whose parents stayed together, those who had experienced a parental divorce or separation were almost half again as likely to take up the tobacco habit (24.7 percent vs. 36.3 percent). To be sure, “smoking did not completely explain observed relationships between ACE and the occurrence of lung cancer” in the statistical models deployed in this study. Nor should this surprise anyone who knows how pervasively such experiences—especially including parental divorce—can affect children. Still, tobacco use seems to lie at the heart of this pathological dynamic.

The authors sum up their findings succinctly: “Insofar as stressful and traumatic childhood experiences contribute to the adoption of adverse health behaviours, such as smoking, and subsequent development of poor health outcomes, such as death from lung cancer, these childhood exposures should be recognized as underlying causes of premature mortality.” These authors recommend that “reducing the burden of adverse childhood experiences . . . be considered in health and social programs as a means of primary prevention of lung cancer as well as other smoking-related diseases.” Among other things, reducing the incidence of parental divorce is clearly a means of protecting long-term respiratory health.

(David W. Brown et al., “Adverse Childhood Experiences Are Associated with the Risk of Lung Cancer: A Prospective Cohort Study,” BHC Public Health 10.20, January 19, 2010).