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Sexual Orientation Discrimination and Tobacco Use Disparities in the United States.
Nicotine Tob Res. 2019 03 30; 21(4):523-531.NT

Abstract

INTRODUCTION

Differences in tobacco/nicotine use by sexual orientation are well documented. Development of interventions requires attention to the etiology of these differences. This study examined associations among sexual orientation discrimination, cigarette smoking, any tobacco/nicotine use, and DSM-5 tobacco use disorder (TUD) in the United States.

METHODS

We used data from the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions based on in-person interviews with a nationally representative sample of noninstitutionalized US adults. Approximately 8.3% of the target population was estimated to have same-sex sexual attraction, 3.1% had at least one same-sex sexual partner in the past-year, and 2.8% self-identified as lesbian, gay, or bisexual.

RESULTS

Sexual attraction, sexual behavior, and sexual identity were significantly associated with cigarette smoking, any tobacco/nicotine use, and DSM-5 TUD. Risk of all tobacco/nicotine outcomes was most pronounced for bisexual adults across all three sexual orientation dimensions. Approximately half of sexual minorities who identified as lesbian or gay and one-fourth of those who identified as bisexual reported past-year sexual orientation discrimination. Sexual minorities who experienced high levels of past-year sexual orientation discrimination had significantly greater probability of past-year cigarette smoking, any tobacco/nicotine use, and TUD relative to sexual minorities who experienced lower levels of sexual orientation discrimination or no discrimination.

CONCLUSIONS

Sexual minorities, especially bisexual adults, are at heightened risk of cigarette smoking, any tobacco/nicotine use, and DSM-5 TUD across all three major sexual orientation dimensions. Tobacco prevention and cessation efforts should target bisexual adults and consider the role that sexual orientation discrimination plays in cigarette smoking and treatment of TUD.

IMPLICATIONS

Differences in tobacco/nicotine use by sexual orientation are well documented, but little is known about differences across all three sexual orientation dimensions (attraction, behavior, and identity) or the origins of these differences. This study is the first to show that differences in tobacco/nicotine use across the three sexual orientation dimensions for respondents who were exclusively heterosexually-oriented were minimal, but varied more substantially among sexual minority women and men across the three sexual orientation dimensions. Sexual minorities who experienced high levels of past-year sexual orientation discrimination had significantly greater probability of cigarette smoking, any tobacco/nicotine use and DSM-5 tobacco use disorder.

Authors+Show Affiliations

Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan, Ann Arbor, MI. Institute for Research on Women and Gender, University of Michigan, Ann Arbor, MI.School of Nursing and Department of Psychiatry, Columbia University, New York, NY.College of Nursing, University of Illinois at Chicago, Chicago, IL.Department of Health Education and Promotion, College of Health and Human Performance, East Carolina University, Greenville, NC.Institute for Social Research, Survey Research Center, University of Michigan, Ann Arbor, MI.Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan, Ann Arbor, MI. Institute for Research on Women and Gender, University of Michigan, Ann Arbor, MI. Addiction Center, Department of Psychiatry, University of Michigan, Ann Arbor, MI.Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan, Ann Arbor, MI.

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

29300994

Citation

McCabe, Sean Esteban, et al. "Sexual Orientation Discrimination and Tobacco Use Disparities in the United States." Nicotine & Tobacco Research : Official Journal of the Society for Research On Nicotine and Tobacco, vol. 21, no. 4, 2019, pp. 523-531.
McCabe SE, Hughes TL, Matthews AK, et al. Sexual Orientation Discrimination and Tobacco Use Disparities in the United States. Nicotine Tob Res. 2019;21(4):523-531.
McCabe, S. E., Hughes, T. L., Matthews, A. K., Lee, J. G. L., West, B. T., Boyd, C. J., & Arslanian-Engoren, C. (2019). Sexual Orientation Discrimination and Tobacco Use Disparities in the United States. Nicotine & Tobacco Research : Official Journal of the Society for Research On Nicotine and Tobacco, 21(4), 523-531. https://doi.org/10.1093/ntr/ntx283
McCabe SE, et al. Sexual Orientation Discrimination and Tobacco Use Disparities in the United States. Nicotine Tob Res. 2019 03 30;21(4):523-531. PubMed PMID: 29300994.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Sexual Orientation Discrimination and Tobacco Use Disparities in the United States. AU - McCabe,Sean Esteban, AU - Hughes,Tonda L, AU - Matthews,Alicia K, AU - Lee,Joseph G L, AU - West,Brady T, AU - Boyd,Carol J, AU - Arslanian-Engoren,Cynthia, PY - 2017/08/31/received PY - 2017/12/28/accepted PY - 2018/1/5/pubmed PY - 2020/1/8/medline PY - 2018/1/5/entrez SP - 523 EP - 531 JF - Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco JO - Nicotine Tob Res VL - 21 IS - 4 N2 - INTRODUCTION: Differences in tobacco/nicotine use by sexual orientation are well documented. Development of interventions requires attention to the etiology of these differences. This study examined associations among sexual orientation discrimination, cigarette smoking, any tobacco/nicotine use, and DSM-5 tobacco use disorder (TUD) in the United States. METHODS: We used data from the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions based on in-person interviews with a nationally representative sample of noninstitutionalized US adults. Approximately 8.3% of the target population was estimated to have same-sex sexual attraction, 3.1% had at least one same-sex sexual partner in the past-year, and 2.8% self-identified as lesbian, gay, or bisexual. RESULTS: Sexual attraction, sexual behavior, and sexual identity were significantly associated with cigarette smoking, any tobacco/nicotine use, and DSM-5 TUD. Risk of all tobacco/nicotine outcomes was most pronounced for bisexual adults across all three sexual orientation dimensions. Approximately half of sexual minorities who identified as lesbian or gay and one-fourth of those who identified as bisexual reported past-year sexual orientation discrimination. Sexual minorities who experienced high levels of past-year sexual orientation discrimination had significantly greater probability of past-year cigarette smoking, any tobacco/nicotine use, and TUD relative to sexual minorities who experienced lower levels of sexual orientation discrimination or no discrimination. CONCLUSIONS: Sexual minorities, especially bisexual adults, are at heightened risk of cigarette smoking, any tobacco/nicotine use, and DSM-5 TUD across all three major sexual orientation dimensions. Tobacco prevention and cessation efforts should target bisexual adults and consider the role that sexual orientation discrimination plays in cigarette smoking and treatment of TUD. IMPLICATIONS: Differences in tobacco/nicotine use by sexual orientation are well documented, but little is known about differences across all three sexual orientation dimensions (attraction, behavior, and identity) or the origins of these differences. This study is the first to show that differences in tobacco/nicotine use across the three sexual orientation dimensions for respondents who were exclusively heterosexually-oriented were minimal, but varied more substantially among sexual minority women and men across the three sexual orientation dimensions. Sexual minorities who experienced high levels of past-year sexual orientation discrimination had significantly greater probability of cigarette smoking, any tobacco/nicotine use and DSM-5 tobacco use disorder. SN - 1469-994X UR - https://www.unboundmedicine.com/medline/citation/29300994/Sexual_Orientation_Discrimination_and_Tobacco_Use_Disparities_in_the_United_States_ L2 - https://academic.oup.com/ntr/article-lookup/doi/10.1093/ntr/ntx283 DB - PRIME DP - Unbound Medicine ER -