Peer-reviewed article
Violence against children and substance abuse: A pooled study of 8 low- and middle-income countries
Abigail Puno, R Kim ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study analyzed data from 32,326 adolescents aged 13-24 across eight low- and middle-income countries to examine the link between violence experienced in childhood and substance abuse later in life. Children who experienced any type of violence—physical, sexual, or emotional—before age 18 were significantly more likely to smoke daily, binge drink, and use illegal drugs as adolescents and young adults. Sexual violence showed the strongest association with substance abuse, and the link was particularly pronounced for women.
Key points
- Any experience of violence in childhood was significantly associated with daily smoking (OR: 1.5), binge drinking (OR: 1.8), and drug use (OR: 1.9)
- Sexual violence had the strongest association with substance abuse outcomes compared to other types of violence
- Women who experienced sexual violence in childhood were more likely to abuse substances (OR: 3.3-3.7) than men who were sexually abused (OR: 1.2-2.1)
- The study used pooled data from Violence Against Children Surveys (VACS) conducted in 2017-2019 across eight countries
- Findings suggest need for violence prevention interventions and addressing substance abuse consequences in low- and middle-income countries
Limitations
The study is observational and establishes association but not causation. Cross-sectional or prospective design details are not specified in the abstract, limiting understanding of temporal relationships and potential confounding variables.
Abstract
Abstract Introduction Violence against children (VAC) has been linked to substance abuse later in life. However, most evidence of this association comes from high-income countries (HICs) and is understudied in the context of low- and middle-income countries (LMICs). Methods This study used the latest Violence Against Children Surveys (VACS) data from 2017-2019 across eight LMICs. The main exposure variable was defined as having experienced at least one type of violence (physical, sexual, or emotional) from any perpetrator before age 18. With the pooled dataset of 32,326 adolescents aged 13-24 years, a series of logistic regressions with country-fixed effects were estimated to examine the association between VAC and three substance abuse outcomes: smoking daily, binge drinking (i.e., more than four drinks a week) and use of illegal drugs in the last 30 days. Further, analyses based on the types of violence and whether the association differs by sex were performed. Results After adjusting for all covariates, any VAC experience was significantly associated with all three substance abuse outcomes: daily smoking (OR: 1.5, 95% CI 1.2,1.8), binge drinking (OR: 1.8, 95% CI 1.5, 2.2), and drug use (OR:1.9, 95% CI 1.5-2.3). Sexual violence, in particular, had the strongest association. Sex-stratified analyses revealed that women who experienced sexual violence in childhood were more likely (OR range 3.3-3.7) to engage in substance abuse than sexually abused men (OR range 1.2-2.1). Conclusions The findings highlight the need for interventions to prevent childhood violence and to address its consequences on substance abuse in LMICs. Key messages • Experience of any type of violence during childhood is significantly associated with daily smoking, binge drinking of alcohol, and drug use in later life. • Women who experience sexual violence in childhood are more likely to abuse substances than men who were sexually abused.