Study Ties Violence to Smoking

Women who smoke and show signs of an alcohol problem are more likely to have been the victims of violence by an intimate partner, according to a study conducted by Harvard researchers and released earlier this week.

The study, which used data from written surveys given to 2,386 female medical patients in hospitals throughout Boston, found that a woman who smokes and has a drinking problem has a 33 percent likelihood of having been abused by her partner in the past year. Such a woman also has a 54 percent chance of having been abused during her lifetime, the study found.

“The results showed that physicians who are already asking about smoking and drinking and not asking about partner violence might be missing it,” said lead author Megan R. Gerber, a primary care physician at Cambridge Health Alliance who is also affiliated with Harvard Medical School and the Harvard School of Public Health (HSPH).

When women seek medical treatment, doctors usually question them about their smoking and drinking habits, but not about past abuse, said study co-author Michael L. Ganz, an assistant professor at HSPH.

“Fewer physicians ask about domestic violence,” Gerber said. “Time and comfort level are part of the reasons for that.”

She said that she hopes this new report, published in Archives of Internal Medicine, will reach more primary care physicians.

“The doctors who aren’t thinking about it, we wanted to get them to think about it,” she said.

Gerber said that the results may alert doctors to behavioral patterns that indicate past abuse.

“I don’t think there have been any studies that look at the predictive value of smoking and drinking and (past) domestic violence, and that’s what’s new about our study,” she said.

Ganz said the findings may prompt doctors to further explore a patient’s history. “It starts to push people in a direction to suggest that perhaps, for a certain subset of women, it’s worth asking about intimate partner violence,” he said.

The authors also hoped the study would raise awareness among women that past abuse might be a partial cause of excessive tobacco and alcohol use.

“In general, patients who experience trauma are more likely to experience chronic stress and use smoking and drinking as ways to alleviate the stress,” Gerber said.

Ganz added that a different study he conducted showed people who experience violence or live in a community they consider to be violent are more likely to smoke.

Co-author Laura A. McCloskey, an associate professor at the School of Social Policy at the University of Pennsylvania, offered another interpretation of the results.

“The other possibility is that women who smoke and drink might be more likely to partner with a man who smokes and drinks,” she said. “And such a man, especially one who drinks, may be more likely to abuse her.”

However, Gerber said, “Our study was not designed in a way to say which causes the other.”

­—Staff writer David Zhou can be reached at dzhou@fas.harvard.edu.