Racial and Ethnic Differences in Current Use of Cigarettes, Cigars, and Hookahs Among Lesbian, Gay, and Bisexual Young Adults

Translational Tobacco Reduction Research Program, Mary Babb Randolph Cancer Center and Prevention Research Center, West Virginia University, PO Box 9190, Morgantown, WV 26506, USA.
Nicotine & Tobacco Research (Impact Factor: 3.3). 05/2011; 13(6):487-91. DOI: 10.1093/ntr/ntq261
Source: PubMed


Research demonstrates that lesbians, gays, and bisexuals (i.e., LGBs or sexual minorities) smoke more than their heterosexual peers, but relatively less is known about the heterogeneity within LGB populations, namely racial/ethnic differences. Moreover, smoking research on sexual minorities has focused mainly on cigarette smoking, with little attention to other forms of smoking, such as hookahs/water pipes.
Using a large national sample of college students, we examined differences by race and sexual orientation in prevalence of smoking cigarettes, cigars/cigarillos/clove cigarettes, and hookahs.
All LGB racial groups had higher cigarette smoking prevalence than their heterosexual racial group counterparts. Significantly more White and Hispanic LGBs smoked hookahs when compared, respectively, with White and Hispanic heterosexuals.
Given the higher prevalence of multiple forms of smoking among sexual minorities, the heterogeneity within sexual minority populations and the nuances of multiple identities (i.e., racial, ethnic, and sexual minority), targeted-if not tailored-prevention and cessation efforts are needed to address smoking disparities in these diverse communities. Prevention, intervention, and epidemiological research on smoking behaviors among college attending young adults should take into account other forms of smoking, such as hookah use.

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    • "Another vulnerable population that was revealed in this study in terms of WTS is the LGBT community, where 21% have used WTS in their lifetime and 6% were current users. Though it is well established that smoking rates are higher among sexual minorities (Blosnich et al., 2011), the finding that LGBT adults are twice as likely as heterosexuals to be current water pipe users deserves further investigation. More specific information is needed on the contexts and frequency of WTS use among this group, its relationship to regular cigarette smoking, and its distribution across different sexual minority communities to guide efforts that target those at most risk with prevention and tailored intervention strategies. "
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    ABSTRACT: To report prevalence and correlates of waterpipe tobacco smoking (WTS) use among U.S. adults. Data were from the 2009-2010 National Adult Tobacco Survey, a nationally representative sample of U.S. adults. Estimates of WTS ever and current use were reported overall, and by sex, age, race/ethnicity, educational attainment, annual household income, sexual orientation, and cigarette smoking status. State-level prevalence rates of WTS ever were reported using choropleth thematic maps for the overall population and by sex. The national prevalence of WTS ever was 9.8% and 1.5% for current use. WTS ever was more prevalent among those who are male (13.4%), 18-24 years old (28.4%) compared to older adults, non-Hispanic White (9.8%) compared to non-Hispanic Black, with some college education (12.4%) compared to no high school diploma, and reporting sexual minority status (21.1%) compared to heterosexuals. States with highest prevalence included DC(17.3%), NV(15.8%), and CA(15.5%). WTS is now common among young adults in the US and high in regions where cigarette smoking prevalence is lowest and smoke-free policies have a longer history. To reduce its use, WTS should be included in smoke-free regulations and state and federal regulators should consider policy development in other areas, including taxes, labeling, and distribution. Copyright © 2014. Published by Elsevier Inc.
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    ABSTRACT: OBJECTIVE: To conduct a systematic review of the literature examining risk factors/correlates of cigarette smoking among lesbian, gay and bisexual (ie, sexual minority) populations. METHODS: Sets of terms relevant to sexual minority populations and cigarette smoking were used in a simultaneous search of 10 databases through EBSCOhost. The search was limited to the peer-reviewed literature up to January 2011, using no geographic or language limits. For inclusion, the paper was required to: (1) have been written in English, (2) have sexual minorities (defined by either attraction, behaviour, or identity) included in the study population and (3) have examined some form of magnitude of association for risk factors/correlates of any definition of cigarette smoking. A total of 386 abstracts were reviewed independently, with 26 papers meeting all inclusion criteria. Abstracts were reviewed and coded independently by authors JB and JGLL using nine codes derived from the inclusion/exclusion criteria. RESULTS: Studies used various measures of sexual orientation and of smoking. Risk factors that could be considered unique to sexual minorities included internalised homophobia and reactions to disclosure of sexual orientation. Some studies also indicated common smoking risk factors experienced at higher rates among sexual minorities, including stress, depression, alcohol use and victimisation. CONCLUSIONS: This review identified risks that were associated with sexual minority status and common to the general population but experienced at potentially higher rates by sexual minorities. Government and foundation funds should be directed towards research on the origins of this disparity.
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    ABSTRACT: INTRODUCTION: Youths with a minority sexual orientation (i.e., gay, lesbian, bisexual, and mostly heterosexual) are at high risk for cigarette smoking. We examined sexual-orientation disparities in smoking during adolescence and emerging adulthood and investigated the role of age at first smoking in contributing to smoking disparities. METHODS: We used data from the Growing Up Today Study, a large longitudinal cohort of adolescents followed from ages 12 to 24 years (N = 13,913). Self-administered questionnaires filled out annually or biennially assessed age at first smoking, current smoking, frequency of smoking, number of cigarettes smoked daily, and nicotine dependence. Proportional hazards survival analysis and repeated measures regression estimated sexual-orientation differences in smoking. RESULTS: Compared with completely heterosexuals, lesbian/gay, bisexual, and mostly heterosexual youths smoked their first cigarette at younger ages, were more likely to be current smokers, and had higher frequency of smoking. Among past-year smokers, sexual-minority females smoked more cigarettes daily and scored higher on nicotine dependence than completely heterosexual females. In some instances, gender and age modified relationships between sexual orientation and smoking, with relative risk accentuated in female sexual minorities and in sexual minorities during younger ages. Younger age of smoking onset contributed to elevated smoking in mostly heterosexuals and bisexuals, and to a lesser extent in lesbians, but not in gay males.Conclusions:Sexual-orientation minorities are at greater risk for smoking during adolescence and emerging adulthood than heterosexuals. Disparities are larger in females and evident in early adolescence. Prevention and cessation efforts should target this population, preferably beginning in early adolescence.
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