Associations of Discrimination and Violence With Smoking Among Emerging Adults: Differences by Gender and Sexual Orientation

Translational Tobacco Reduction Research Program, Mary Babb Randolph Cancer Center and Prevention Research Center, Department of Community Medicine, West Virginia University, PO Box 9190, Morgantown, WV 26506, USA.
Nicotine & Tobacco Research (Impact Factor: 3.3). 12/2011; 13(12):1284-95. DOI: 10.1093/ntr/ntr183
Source: PubMed


Lesbian, gay, and bisexual (i.e., sexual minority) populations have higher smoking prevalence than their heterosexual peers, but there is a lack of empirical study into why such disparities exist. This secondary analysis of data sought to examine associations of discrimination and violence victimization with cigarette smoking within sexual orientation groups.
Data from the Fall 2008 and Spring 2009 National College Health Assessments were truncated to respondents of 18-24 years of age (n = 92,470). Since heterosexuals comprised over 90% of respondents, a random 5% subsample of heterosexuals was drawn, creating a total analytic sample of 11,046. Smoking status (i.e., never-, ever-, and current smoker) was regressed on general (e.g., not sexual orientation-specific) measures of past-year victimization and discrimination. To examine within-group differences, two sets of multivariate ordered logistic regression analyses were conducted: one set of models stratified by sexual orientation and another set stratified by gender-by-sexual-orientation groups.
Sexual minorities indicated more experiences of violence victimization and discrimination when compared with their heterosexual counterparts and had nearly twice the current smoking prevalence of heterosexuals. After adjusting for age and race, lesbians/gays who were in physical fights or were physically assaulted had higher proportional odds of being current smokers when compared with their lesbian/gay counterparts who did not experience those stressors.
When possible, lesbian/gay and bisexual groups should be analyzed separately, as analyses revealed that bisexuals had a higher risk profile than lesbians/gays. Further research is needed with more nuanced measures of smoking (e.g., intensity), as well as examining if victimization may interact with smoking cessation.

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Available from: John Blosnich, Oct 03, 2014
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    • "no English language publication has examined nonracial discrimination and smoking among South Africans.[26]However, several studies conducted outside of South Africa found positive associations between specific types of nonracial discrimination, such as sexual orientation,[27]sexism,2829immigration-based discrimination,[30]and smoking. This analysis examined the role of chronic and acute racial and nonracial discrimination in smoking among respondents to the South Africa Stress and Health Study (SASH), a representative sample of South African adults. "
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    ABSTRACT: Despite a long history of discrimination and persisting racial disparities in smoking prevalence, little research exists on the relationship between discrimination and smoking in South Africa. This analysis examined chronic (day-to-day) and acute (lifetime) experiences of racial and non-racial (eg, age, gender or physical appearance) discrimination and smoking status among respondents to the South Africa Stress and Health study. Logistic regression models were constructed using SAS-Callable SUDAAN. Both chronic racial discrimination (RR=1.45, 95% CI 1.14 to 1.85) and chronic non-racial discrimination (RR=1.69, 95% CI 1.37 to 2.08) predicted a higher risk of smoking, but neither type of acute discrimination did. Total (sum of racial and non-racial) chronic discrimination (RR=1.46, 95% CI 1.20 to 1.78) and total acute discrimination (RR=1.28, 95% CI 1.01 to 1.60) predicted a higher risk of current smoking. Racial and non-racial discrimination may be related to South African adults' smoking behaviour, but this relationship likely varies by the timing and frequency of these experiences. Future research should use longitudinal data to identify the temporal ordering of the relationships studied, include areas outside of South Africa to increase generalisability and consider the implications of these findings for smoking cessation approaches in South Africa.
    Full-text · Article · Apr 2014 · Tobacco control
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    • "The prevalence of any type of discrimination in the last year of 11.9% among the whole sample in the present study, was lower than the 21.4% [27] and 61.3% [23] among lesbian, gay, and bisexual and the 60% and 58% among men who have sex with men [28]. Finally, values ranged from 5.6% for physical assault to 37.4% for discrimination for gay/lesbian, and from 8.9% for physical assault to 32.6% for verbal threat of harm for bisexual [29]. The difference observed with the findings from previous experiences is highly relevant and this may partially be explained by the nature of the population, the sampling and recruitment strategies, the cultural attitudes, and the decade in which the studies were conducted. "
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    ABSTRACT: This cross-sectional study assessed the frequency of discrimination, harassment, and violence and the associated factors among a random sample of 1000 lesbian, gay men, and bisexual women and men recruited from randomly selected public venues in Italy. A face-to-face interview sought information about: socio-demographics, frequency of discrimination, verbal harassment, and physical and sexual violence because of their sexual orientation, and their fear of suffering each types of victimization. In the whole sample, 28.3% and 11.9% self-reported at least one episode of victimization because of the sexual orientation in their lifetime and in the last year. Those unmarried, compared to the others, and with a college degree or higher, compared to less educated respondents, were more likely to have experienced an episode of victimization in their lifetime. Lesbians, compared to bisexual, had almost twice the odds of experiencing an episode of victimization. The most commonly reported experiences across the lifetime were verbal harassment, discrimination, and physical or sexual violence. Among those who had experienced one episode of victimization in their lifetime, 42.1% self-reported one episode in the last year. Perceived fear of suffering violence because of their sexual orientation, measured on a 10-point Likert scale with a higher score indicative of greater fear, ranges from 5.7 for verbal harassment to 6.4 for discrimination. Participants were more likely to have fear of suffering victimization because of their sexual orientation if they were female (compared to male), lesbian and gay men (compared to bisexual women and men), unmarried (compared to the others), and if they have already suffered an episode of victimization (compared to those who have not suffered an episode). The study provides important insights into the violence experiences of lesbian, gay men, and bisexual women and men and the results may serve for improving policy initiatives to reduce such episodes.
    Full-text · Article · Aug 2013 · PLoS ONE
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    • "D'autres études ont montré que les abus sexuels dans l'enfance sont plus fréquemment déclarés soit par les femmes qui ont eu des rapports homosexuels (Hughes et al, 1997 ; Priebe et Svedin, 2012b; Roberts et al, 2012), soit par les bisexuelles puis les lesbiennes comparées aux hétérosexuelles (Freedner et al., 2002 ; Balsam et al., 2005 ; Austin et al., 2008b ; Hughes et al, 2010 ; Blosnich et Horn, 2011) soit par les lesbiennes en opposition aux hétérosexuelles (Hughes et al., 2001 ; Matthews et al., 2002 ; Smith et al., 2010). A contrario, aucune différence significative n'a été trouvée dans l'enquête Enveff en fonction du sexe des partenaires (Lhomond et Saurel-Cubizolles, 2006). "

    Full-text · Article · Jan 2013 · Nouvelles Questions Feministes
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