Lesbian, Gay, Bisexual, and Transgender Smokers: Correlations with External Health Control, Health Expectations, and Shame-Focused Coping Strategies

The psychometric properties of the Italian adaptation of the Health Orientation Scale (HOS)

Background

A novel approach suggested that cognitive and dispositional features may explain in depth the health behaviors adoption and the adherence to prevention programs. The Health Orientation Scale (HOS) has been extensively used to map the adoption of health and unhealthy behaviors according to cognitive and dispositional features. Coherently, the main aim of the current research was to assess the factor structure of the Italian version of the HOS using exploratory and confirmatory factor analysis and testing the construct validity of the scale by assessing differences in health orientations between tobacco cigarette smokers and nonsmokers.

Method

The research protocol was organized in two studies. Study 1 evaluated the dimensionality of the HOS in a sample of Northern Italian healthy people. Three hundred and twenty-one participants were enrolled; they were 229 women (71.3%) and 92 men (28.7%). In Study 2, the factor structure and construct validity of the HOS Italian version was assessed trough confirmatory factor analysis using a tobacco cigarette smokers and nonsmokers population. Two hundred and nineteen participants were enrolled; they were 164 women (75.2%) and 55 men (24.8%).

Results

In Study 1, a seven factors solution was obtained explaining 60% of cumulative variance instead of 10 factors solution of the original version of the HOS. In Study 2, the factor structure of the Italian version of the HOS was confirmed and applied to the smokers and nonsmokers; nonsmokers reported higher values than smokers in Factor 1 (MHPP) [t (208) = − 2.739 p < .007] (CI 95–4.96% to −.809), Factor 2 (HES) [t (209) = − 3.387 p < .001] (CI 95–3.93% to -. 1.03), Factor 3 (HIC) [t(213) = − 2.468 p < .014] (CI 95–2.56% to −.28) and Factor 7 (HEX) [t(217) = − 3.451 p < .001] (CI 95%- 1.45 to .39).

Conclusions

Results of the Italian adaptation of HOS lead to a partial redistribution of items and confirmed 7 subscales to distinguish psycho-cognitive dispositional dimensions involved in health orientation styles.

LGBT friendly healthcare providers' tobacco treatment practices and recommendations

PURPOSE

This study aimed to describe lesbian, gay, bisexual, and transgender (LGBT) friendly providers' (1) smoking cessation recommendations to LGBT patients and (2) tobacco treatment practices for transgender patients.

DESIGN AND METHODS

In-depth, semistructured phone interviews were conducted with 13 healthcare providers.

FINDINGS

Four overarching themes emerged: (1) providing tobacco treatment services for LGBT patients; (2) barriers to LGBT smoking cessation; (3) prescribing practices for transgender individuals taking estrogen hormone therapy; (4) provider community outreach to promote LGBT smoking cessation.

PRACTICE IMPLICATIONS

Holistic tobacco treatment services are needed to address LGBT-specific barriers to tobacco cessation, such as stress, identity-related factors, and inadequate healthcare access.

Perceived sex discrimination amplifies the effect of antagonism on cigarette smoking

INTRODUCTION

Compared to men, the decline in smoking during the past few decades has been slower for women, and smoking-related morbidity and mortality has increased substantially. Identifying sex-specific risk factors will inform more targeted intervention/prevention efforts. The purpose of this research is to examine the interactive effect of psychological (trait antagonism) and social (perceived sex discrimination) factors on current cigarette smoking and whether these effects differ by sex.

METHODS

Participants in the Healthy Aging in Neighborhoods of Diversity across the Life Span study (HANDLS; N = 454) and participants in the Health and Retirement Study (HRS; N = 8,155) completed measures of antagonism, perceived sex discrimination, and reported whether they smoked currently. Logistic regressions were used to predict smoking from antagonism, discrimination, and their interaction.

RESULTS

Antagonism was associated with an increased risk of smoking. For women, there was an interaction between antagonism and discrimination: among women who perceived sex discrimination, every standard deviation increase in antagonism was associated with a 2.5 increased risk of current smoking in HANDLS (odds ratio [OR] = 2.54, 95% confidence interval [CI] = 1.46-4.39) and an almost 1.5 increased risk in HRS (OR = 1.43, 95% CI = 1.18-1.73). This interaction was not significant for men in either sample.

CONCLUSION

In 2 independent samples, perceived sex discrimination amplified the effect of antagonism on cigarette smoking for women but not men. A hostile disposition and a perceived hostile social environment have a synergistic effect on current cigarette smoking for women.

Awareness of media-based antitobacco messages among a community sample of LGBT individuals

PURPOSE

Study objectives were to measure awareness of general antitobacco messages in LGBT-focused and general media outlets among LGBT (lesbian, gay, bisexual, and transgender) individuals and to examine associations between sociodemographic characteristics and awareness levels.

METHOD

Data were based on cross-sectional survey data from a racially diverse sample of participants (N = 726). Participants were primarily male (69.3%), with smaller percentages of female (21.8%) and transgender (8.9%). The median age was 31 years.

RESULTS

A higher proportion of participants reported awareness of antitobacco messages in general media outlets compared to LGBT-specific media outlets. Awareness of antitobacco messages in general media was positively associated with current smoking and negatively associated with female gender and Latino ethnicity. Awareness of antitobacco messages in LGBT media was positively associated with younger age, current smoking, frequent reading of LGBT newspapers or magazines, and frequent attendance at LGBT bars and negatively associated with Latino ethnicity.

CONCLUSIONS

Despite frequent readership, awareness of antitobacco messages in LGBT newspapers/magazines was quite low. We speculate that low awareness is related to the absence of antitobacco messages in LGBT-related media. LGBT-specific media outlets provide an important opportunity for future antitobacco campaigns.