08/10/2026
“The Cigarette at 10” — What Dr. Felitti’s Story Reveals About Your Healthcare Spend
Dr. Vincent Felitti — co-creator of the CDC-Kaiser ACE Study, now used in screening tools worldwide — recently told me why he started smoking at age 10.
Not rebellion. Not curiosity. Powerlessness.
“No one ever discussed my thoughts about things,” he said. “I did not have freedom of choice in areas that were important to me.”
Here’s why that matters to anyone running a self-insured plan or a benefits budget:
Unresolved childhood adversity doesn’t stay in childhood. It shows up as adult health risk — and adult health risk shows up on your claims report.
The original ACE Study found a dose-response relationship: as ACE scores rise, so do rates of the leading chronic diseases driving the bulk of employer healthcare spend and disability claims. This isn’t theoretical for us — an SDSU School of Communication survey of the early R&D system that became enlightn™ found 81% of patients reported fewer healthcare visits after starting the program, with average visits dropping from 49.5 to 8.3 a year among those reporting change. Over 90% reported high satisfaction, and 98% said it motivated them to take better care of their health.
The part most wellness programs miss: it’s not enough to screen for adversity. You have to build in the protective factor — voice, choice, a trusted adult — or the risk just compounds into the next generation, and the next round of claims.
If you lead HR, benefits, or a self-insured health plan:
This is the layer most EAPs and wellness vendors don’t touch — the root driver behind utilization, not just symptom management downstream of it.
DM me “PILOT” and I’ll send you the employer overview and how the free pilot works.
Comment “ACE” for the 12-question enlightn™ assessment framework built with Dr. Felitti.
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