Behavioral and Psychological Impacts of Childhood Sexual Abuse: A Psychosocial Analysis Among Young Adults

Background: Childhood sexual abuse (CSA) is a pervasive public health issue with enduring psychosocial consequences. Contemporary, population‑based estimates among young adults and their associations with stress and tobacco behaviors remain undercharacterized.Methods: This study employed a cross-sectional analysis of the 2023 Behavioral Risk Factor Surveillance System (BRFSS) data among U.S. adults aged 18–34 (N = 6,252). CSA was measured via the Adverse Childhood Experiences (ACE) module and dichotomized (ever vs. never). Primary correlates included self‑reported stress (low/medium/high), cigarette smoking (never, someday, everyday, former), e‑cigarette use (yes/no), and sociodemographics (sex, sexual orientation, transgender identity, race/ethnicity, education, income). Survey‑weighted descriptive statistics and multivariable logistic regression (survey procedures) estimated adjusted odds ratios (aORs) and 95% CIs.Results: In the general population, the unweighted prevalence of CSA was 6.4% (n = 400), while the weighted prevalence was approximately 5.8%. In adjusted model, high stress was associated with a greater odds of reporting CSA (aOR = 1.93; 95% CI: 1.07–3.48) compared to low stress. Tobacco-related behaviors were also associated with CSA, including daily smoking (aOR = 3.16), former smoking (aOR= 1.99), occasional smoking (aOR =1.82), and e-cigarette use (aOR =1.95). Higher socioeconomic status was found to have a protective effect on CSA. Being a college graduate (aOR = 0.44) and having an annual household income of more than $100,000 (aOR = 0.48) were associated with reduced odds of CSA. Race/ethnicity was not statistically significant after adjustment. Conclusions: CSA remains common among US young adults and is associated with higher stress, tobacco use, and socioeconomic disadvantage; sexual minority men show elevated odds. Findings underscore the need for trauma‑informed, equity‑centered prevention and integrated behavioral health and tobacco control strategies tailored to young adults and sexual/gender minority populations.Keywords: childhood sexual abuse; young adults; stress; e‑cigarettes; tobacco; BRFSS; sexual orientation; health disparities.