These adversities can be assessed either retrospectively or prospectively, using a range of validated tools such as the World Health Organisation’s Adverse Childhood Experiences International Questionnaire (ACEIQ) or clinician-based reports. Adverse childhood experiences (ACEs) include direct (physical abuse, sexual abuse, emotional abuse, physical neglect and emotional neglect), indirect (bullying, parental violence, parental substance misuse, parental incarceration, parental divorce/separation and parental suicide or self-harm) and extended harms (collective violence, community violence) to children. Physiological and neurobiological studies have found that such childhood adversities can lead to changes of neural networks, impaired nervous, endocrine and immune systems development resulting in chronic physiological dysfunction and damage. The World Health Organisation (WHO) reports that early childhood adversity such as child maltreatment is widespread, with 1 in 4 adults reporting being physically abused as children globally. Newton Bhabha Grant jointly funded by the Medical Research Council, UK (MR/N000390/1) and the Indian Council of Medical Research (ICMR/MRC-UK/3/M/2015-NCD-I). The results suggest enhancing current ACE resilience programmes and ‘trauma-informed’ approaches to tackling longer-term impact of ACEs in India. ConclusionĪCEs such as abuse and domestic violence are strongly associated with substance misuse, most commonly tobacco, in adolescent and young adult males in India. In adolescents, family level ACEs (adj OR 4.2, 95% CI 1.5–11.7) and collective level ACEs (adj OR 6.6, 95% CI 1.4–31.1) show associations with substance misuse whilst in young adults, child level ACEs such as maltreatment show similar strong associations (adj OR 2.0, 95% CI 1.1–3.5). Except for sexual abuse, males report more of every individual childhood adversity and are more likely to report misusing substances compared with females (87.3% vs. Resultsġ in 2 participants reported child maltreatment ACEs and family level ACEs. A random-effects, two-stage individual patient data meta-analysis explained the associations between ACEs and substance misuse with adjustments for confounders such as sex and family structure. ACEs were evaluated using the World Health Organisation (WHO) Adverse Childhood Experiences International Questionnaire whilst substance misuse was assessed using the WHO Alcohol, Smoking and Substance Involvement Screening Test. Methodsĭata from the Consortium on Vulnerability to Externalising Disorders and Addictions (cVEDA) in India was used ( n = 9010). The study aims to determine the prevalence of ACEs and its association with substance misuse. Adverse childhood experiences (ACEs) increases vulnerability to externalising disorders such as substance misuse.