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Tan ASL, Chen JT, Keen R, Scout N, Gordon B, Applegate J, Machado A, Hanby E, Liu S, Zulkiewicz B, Ramanadhan S, Obedin-Maliver J, Lunn MR, Viswanath K, Potter J. Culturally Tailored Anti-Smoking Messages: A Randomized Trial With U.S. Sexual Minority Young Women. Am J Prev Med 2024; 66:840-849. [PMID: 38065403 PMCID: PMC11034759 DOI: 10.1016/j.amepre.2023.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 11/30/2023] [Accepted: 12/01/2023] [Indexed: 01/09/2024]
Abstract
INTRODUCTION This study evaluated effects of exposure to culturally tailored anti-smoking ads versus control ads on quitting intentions, cigarette purchase intentions, and tobacco industry perceptions among young adult, cisgender and transgender, sexual minority women (SMW). STUDY DESIGN An online randomized controlled experiment with 1-month longitudinal follow-up was conducted. SETTING AND PARTICIPANTS About 2,214 U.S. SMW ages 18-30 were recruited via online survey panels (The PRIDE Study and Prolific), social media ads and posts, and HER dating app ads. Data were collected in 2021-2022. INTERVENTION Participants were randomly assigned to receive up to 20 tailored ads containing LGBTQ+ branding versus 20 control ads without LGBTQ+ branding over 4 weeks. Both conditions used identical anti-smoking statements and photographs (including several photographs of individuals who self-identified as SMW). MAIN OUTCOME MEASURES One-month follow-up intention to purchase cigarettes, intention to quit, marketing receptivity, pro-industry attitudes, and pro-industry beliefs were measured. Analyses were conducted in 2022-2023. Linear regression models predicted outcomes at 1-month follow-up with the randomized arm, adjusted for baseline measures of each outcome and stratified by smoking status (those who currently smoked and those who did not smoke). RESULTS Among those who smoked, follow-up intention to quit increased and intention to purchase cigarettes, marketing receptivity, pro-industry attitudes, and pro-industry beliefs decreased versus baseline in both arms. Follow-up pro-industry beliefs were significantly lower (B=-0.331, 95% CI -0.652, -0.010, p=0.043) in the tailored versus control arm, adjusted for baseline beliefs. Among those who did not smoke, marketing receptivity, pro-industry attitudes, and pro-industry beliefs decreased versus baseline in both arms. Follow-up outcomes did not differ significantly between arms. CONCLUSIONS These findings can inform future anti-smoking campaign development to reduce cigarette smoking-related disparities among young adult, cisgender and transgender, sexual minority women and serve as the basis for developing similar ads for other LGBTQ+ audiences. TRIAL REGISTRATION This study was registered in ClinicalTrials.gov (NCT04812795).
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Affiliation(s)
- Andy S L Tan
- Annenberg School for Communication, University of Pennsylvania, Philadelphia, Pennsylvania; Leonard Davis Institute of Health Economics, Philadelphia, Pennsylvania; Abramson Cancer Center, Tobacco and Environmental Carcinogenesis Program, Philadelphia, Pennsylvania.
| | - Jarvis T Chen
- Department of Social and Behavioral Sciences, Harvard TH Chan School of Public Health, Boston, Massachusetts
| | - Ryan Keen
- Department of Social and Behavioral Sciences, Harvard TH Chan School of Public Health, Boston, Massachusetts
| | - Nfn Scout
- National LGBT Cancer Network, Providence, Rhode Island
| | - Bob Gordon
- California LGBT Tobacco Education Partnership, San Francisco, California
| | | | | | - Elaine Hanby
- Annenberg School for Communication, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Sixiao Liu
- Department of Population Health Sciences, College of Medicine, University of Central Florida, Orlando, Florida
| | - Brittany Zulkiewicz
- Annenberg School for Communication, University of Pennsylvania, Philadelphia, Pennsylvania
| | | | - Juno Obedin-Maliver
- Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, California; The PRIDE Study/PRIDEnet, Stanford University School of Medicine, Stanford, California; Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, California
| | - Mitchell R Lunn
- The PRIDE Study/PRIDEnet, Stanford University School of Medicine, Stanford, California; Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, California; Division of Nephrology, Department of Medicine, Stanford University School of Medicine, Stanford, California
| | | | - Jennifer Potter
- The Fenway Institute, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts; Beth Israel Lahey Health, Boston, Massachusetts
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Li M, Chau K, Calabresi K, Wang Y, Wang J, Fritz J, Tseng TS. The Effect of Minority Stress Processes on Smoking for Lesbian, Gay, Bisexual, Transgender, and Queer Individuals: A Systematic Review. LGBT Health 2024. [PMID: 38557209 DOI: 10.1089/lgbt.2022.0323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024] Open
Abstract
Purpose: Lesbian, gay, bisexual, transgender, and queer (LGBTQ) individuals are more likely to smoke than non-LGBTQ individuals. Smoking has been posited as a coping mechanism for LGBTQ individuals facing minority stress. However, the exact relationship between minority stress and smoking behaviors among LGBTQ individuals is unclear. Therefore, the purpose of this systematic review was to examine how minority stress processes are associated with smoking behaviors for LGBTQ individuals. Methods: Searches of the PubMed and PsycINFO databases were conducted for smoking-, LGBTQ-, and minority stress-related terms. No date, geographic, or language limits were used. For inclusion, the study must have (1) been written in English, (2) had an LGBTQ group as the study population or a component of the study population, (3) assessed the cigarette smoking status of patients, and (4) assessed at least one minority stress-related process (internalized stigma, perceived stigma, or prejudice events). Results: The final review included 44 articles. Aside from two outlier studies, all of the reviewed studies exhibited that increased levels of minority stress processes (internalized queerphobia, perceived stigma, and prejudice events) were associated with increased probability of cigarette use in LGBTQ individuals. Increased minority stress was also associated with greater psychological distress/mental health decline. Conclusion: The findings of this review suggest that minority stress processes represent a contributing factor to smoking health disparities in LGBTQ populations. These results highlight the need for smoking cessation and prevention programs to address minority stress and improve smoking disparities in these populations.
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Affiliation(s)
- Mirandy Li
- Behavioral and Community Health Sciences, Louisiana State University Health Sciences Center School of Public Health, New Orleans, Louisiana, USA
- Louisiana State University Health Sciences Center School of Medicine, New Orleans, Louisiana, USA
| | - Kelly Chau
- Behavioral and Community Health Sciences, Louisiana State University Health Sciences Center School of Public Health, New Orleans, Louisiana, USA
- Louisiana State University Health Sciences Center School of Medicine, New Orleans, Louisiana, USA
| | - Kaitlyn Calabresi
- Louisiana State University Health Sciences Center School of Medicine, New Orleans, Louisiana, USA
| | - Yuzhi Wang
- Louisiana State University Health Sciences Center School of Medicine, New Orleans, Louisiana, USA
| | - Jack Wang
- Louisiana State University Health Sciences Center School of Medicine, New Orleans, Louisiana, USA
| | - Jackson Fritz
- Behavioral and Community Health Sciences, Louisiana State University Health Sciences Center School of Public Health, New Orleans, Louisiana, USA
- Louisiana State University Health Sciences Center School of Medicine, New Orleans, Louisiana, USA
| | - Tung Sung Tseng
- Behavioral and Community Health Sciences, Louisiana State University Health Sciences Center School of Public Health, New Orleans, Louisiana, USA
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Titus AR, Gamarel KE, Thrasher JF, Elliott MR, Fleischer NL. Exploring the Potential for Smoke-Free Laws to Reduce Smoking Disparities by Sexual Orientation in the USA. Int J Behav Med 2023; 30:448-454. [PMID: 35579845 PMCID: PMC9669255 DOI: 10.1007/s12529-022-10099-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/05/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND We examined associations between smoke-free laws and smoking outcomes in a nationally representative sample of US adults, including exploring whether these associations differed for heterosexual and sexual minority (SM) adults. METHODS We constructed county-level variables representing the percent of the population covered by state-, county-, or city-level smoke-free laws in workplaces and hospitality venues. We combined this information with restricted individual-level adult data with masked county identifiers from the National Health Interview Survey (NHIS), 2013-2018. We used modified Poisson regression to explore associations between each type of smoke-free law and the prevalence ratio (PR) of current smoking, and we used linear regression to explore associations with smoking intensity (mean cigarettes per day). We assessed interactions between smoke-free laws and SM status on the additive scale to determine whether associations were different for SM and heterosexual adults. RESULTS In adjusted models without interaction terms, smoke-free laws in hospitality venues were associated with lower prevalence of current smoking (PR = 0.93, 95% confidence interval (CI) = 0.89, 0.98). Both types of smoke-free laws were associated with lower mean cigarettes per day (workplace law change in mean = - 0.50, 95% CI = - 0.89, - 0.12; hospitality law change in mean = - 0.72, 95% CI = - 1.14,-0.30). We did not observe any statistically significant interactions by SM status, though statistical power was limited. CONCLUSIONS We did not find evidence that smoke-free laws were differentially associated with smoking outcomes for heterosexual and SM adults. Additional studies are needed to further explore the potential for tobacco control policies to address the elevated risk of smoking in SM communities.
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Affiliation(s)
- Andrea R Titus
- Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA.
| | - Kristi E Gamarel
- Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - James F Thrasher
- Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
- Tobacco Research, Center for Population Health Research, National Institute of Public Health, Cuernavaca, Mexico
| | - Michael R Elliott
- Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI, USA
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | - Nancy L Fleischer
- Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
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Denlinger-Apte RL, Cassidy RN, Donny EC, Godin J, Hatsukami DK, Strahley AE, Wiseman KD, Colby SM, Tidey JW. Qualitative reactions to a low nicotine product standard for cigarettes from adolescents and young adults living in the United States who smoke. Prev Med Rep 2023; 32:102163. [PMID: 36895826 PMCID: PMC9989690 DOI: 10.1016/j.pmedr.2023.102163] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 01/29/2023] [Accepted: 02/20/2023] [Indexed: 02/25/2023] Open
Abstract
The Biden Administration is considering a low nicotine product standard for cigarettes. This qualitative study examined reactions to a nicotine reduction policy among adolescents and young adults (AYA) who smoke cigarettes. After completing a lab study involving masked exposure either to low nicotine or normal nicotine research cigarettes and unmasked exposure to e-cigarettes varying in nicotine concentration and flavor, we conducted follow-up semi-structured interviews (N = 25) to explore participants' knowledge, attitudes, and perceptions of a low nicotine product standard and their anticipated tobacco use behavior after policy implementation. Interviews were audio-recorded, transcribed verbatim, double-coded, and analyzed using reflexive thematic analysis. Nearly half of participants supported the policy because they thought it would prevent young people from starting smoking and/or would help people quit. Reasons some participants opposed the policy included beliefs that adults should have the choice to smoke or that a nicotine reduction policy is counterintuitive because the government benefits from cigarette sales. Others believed the policy would be ineffective because youth could circumvent the policy (e.g., illicit market) or would increase their smoking to maintain the same nicotine level. Almost half of participants said they would quit smoking while the other half said they would continue smoking, although potentially reduce their smoking. Overall, our qualitative findings point to the need for pre-policy media campaigns targeting AYA who smoke to minimize negative reactions, dispel fears, and correct misperceptions as well as encourage quitting and provide information on accessing cessation resources.
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Affiliation(s)
- Rachel L Denlinger-Apte
- Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA
| | - Rachel N Cassidy
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI 02912, USA
| | - Eric C Donny
- Department of Physiology and Pharmacology, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA
| | - Julissa Godin
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI 02912, USA
| | - Dorothy K Hatsukami
- Masonic Cancer Center and Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN 55455, USA
| | - Ashley E Strahley
- Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA
| | - Kimberly D Wiseman
- Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA
| | - Suzanne M Colby
- Department of Psychiatry and Human Behavior, Brown University, Providence, RI 02912, USA
| | - Jennifer W Tidey
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI 02912, USA
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Lee DN, Stevens EM, Patterson JG, Wedel AV, Wagener TL, Keller-Hamilton B. Associations of Perceived Stress and Social Support on Health Behavior Changes in Sexual Minoritized Women During the COVID-19 Pandemic. WOMEN'S HEALTH REPORTS (NEW ROCHELLE, N.Y.) 2023; 4:182-190. [PMID: 37096125 PMCID: PMC10122219 DOI: 10.1089/whr.2022.0095] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/20/2022] [Indexed: 04/26/2023]
Abstract
Purpose We examined how perceived stress and social support were associated with changes in health behaviors during the COVID-19 pandemic among sexual minoritized women (SMW). Methods In an online convenience sample of SMW (N = 501, M age = 23.6), we used multinomial logistic regression models to estimate associations of perceived stress and social support (emotional, material, virtual, in-person) with self-reported changes (increased or decreased vs. no change) in fruit and vegetable intake, physical activity, sleep, tobacco, alcohol, and substance use during the pandemic. We also tested whether social support modified associations between perceived stress and changes in health behaviors. Models controlled for sexual orientation, age, race and ethnicity, and income. Results Perceived stress and social support were associated with changes in health and risk behaviors. Specifically, increased perceived stress was associated with decrease (odds ratio [OR] = 1.20, p = 0.01) and increase (OR = 1.12, p = 0.04) in fruit and vegetable intake, and increase in substance use (OR = 1.19, p = 0.04). Receiving in-person social support was associated with changes in decrease (OR = 10.10, p < 0.001) and increase (OR = 7.35, p < 0.01) in combustible tobacco use and increase in alcohol use (OR = 2.63, p = 0.01). Among SMW who never received material social support during the pandemic, increased perceived stress was associated with increased alcohol use (OR = 1.25, p < 0.01). Conclusions Perceived stress and social support were associated with SMW's health behavior changes during the pandemic. Future research may explore interventions to mitigate the effects of perceived stress and appropriately increase social support to promote health equity among SMW.
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Affiliation(s)
- Donghee N. Lee
- Division of Preventive and Behavioral Medicine, Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Elise M. Stevens
- Division of Preventive and Behavioral Medicine, Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Joanne G. Patterson
- Division of Health Behavior and Health Promotion, College of Public Health, The Ohio State University, The Ohio State University Comprehensive Cancer Center, Columbus, Ohio, USA
- Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, Columbus, Ohio, USA
| | - Amelia V. Wedel
- Department of Psychology, Syracuse University, Syracuse, New York, USA
| | - Theodore L. Wagener
- Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, Columbus, Ohio, USA
- Division of Medical Oncology, Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, Ohio, USA
| | - Brittney Keller-Hamilton
- Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, Columbus, Ohio, USA
- Division of Medical Oncology, Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, Ohio, USA
- Address correspondence to: Brittney Keller-Hamilton, PhD, MPH, Division of Medical Oncology, Department of Internal Medicine, The Ohio State University College of Medicine, 3650 Olentangy River Road, Columbus, OH 43214, USA.
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Ehlke SJ, Ganz O, Kendzor DE, Cohn AM. Differences between adult sexual minority females and heterosexual females on menthol smoking and other smoking behaviors: Findings from Wave 4 (2016-2018) of the population assessment of tobacco and health study. Addict Behav 2022; 129:107265. [PMID: 35139462 PMCID: PMC9673077 DOI: 10.1016/j.addbeh.2022.107265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 01/14/2022] [Accepted: 01/29/2022] [Indexed: 11/01/2022]
Abstract
BACKGROUND Sexual minority females have higher rates of cigarette smoking than heterosexual females. Additionally, menthol cigarette use disproportionately impacts minority smokers, including sexual minority individuals. This study examined differences between sexual minority and heterosexual females on several smoking variables, including initiation with a menthol cigarette, and past 30-day cigarette and menthol cigarette use. METHODS Participants were female ever smokers (N = 11,576; n = 1,474, 12.7% sexual minority) who completed Wave 4 of the Population Assessment of Tobacco and Health Survey. Participants reported on the age they began smoking regularly (≤18 years old, 18-24, >25), whether they initiated with a menthol cigarette, past 30-day cigarette smoking and menthol cigarette use, cigarettes smoked per day (≤10, 11-20, >20), cigarette dependence (smoke ≤ 5 min of waking or > 5 min of waking), and whether they were a current (someday/every day) or former (no past year/current use) established smoker (≥100 lifetime cigarettes), or an experimental smoker (<100 lifetime cigarettes). Chi-square and multivariable logistic regression analyses examined differences between sexual minority females and heterosexual females on smoking variables. RESULTS Sexual minority female smokers began smoking regularly at an earlier age and smoked fewer cigarettes per day than heterosexual females. Sexual minority females were more likely to initiate smoking with a menthol cigarette (aOR = 1.27), report past 30-day smoking (aOR = 1.36) and menthol cigarette use (aOR = 1.24) compared to heterosexual females. There were no differences on cigarette dependence. CONCLUSIONS Given the high rates of initiation and current menthol smoking, policies to regulate menthol may decrease smoking disparities for sexual minority females.
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Affiliation(s)
- Sarah J Ehlke
- TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States.
| | - Ollie Ganz
- Department of Health Behavior, Society and Policy, Rutgers School of Public Health, Piscataway, NJ, United States; Rutgers Center for Tobacco Studies, Rutgers Biomedical and Health Sciences, New Brunswick, NJ, United States
| | - Darla E Kendzor
- TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States; Department of Family and Preventive Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Amy M Cohn
- TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States; Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
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Poole R, Carver H, Anagnostou D, Edwards A, Moore G, Smith P, Wood F, Brain K. Tobacco use, smoking identities and pathways into and out of smoking among young adults: a meta-ethnography. Subst Abuse Treat Prev Policy 2022; 17:24. [PMID: 35346260 PMCID: PMC8960094 DOI: 10.1186/s13011-022-00451-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/14/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This meta-ethnography investigates how young adults describe their tobacco use, smoking identities and pathways into and out of regular smoking, to inform future smoking prevention and harm reduction interventions. METHODS Eight databases were systematically searched using keywords and indexed terms. Studies were included if they presented qualitative data from young adults aged 16-25 reporting smoking histories and/or smoking identities from countries culturally similar to the UK. A systematic and rigorous meta-ethnographic approach was employed, consistent with Noblit and Hare's methodology. RESULTS Thirty papers were included. Reasons stated for taking up smoking and becoming a smoker included alleviating stress, transforming one's identity, and coping with the transition to further education, employment or leaving home. Many used smoking to aid acceptance within new peer groups, particularly when alcohol was present. Smoking was also perceived as an act of resistance and a coping mechanism for those with marginalised identities. Barriers to quitting smoking included young adults' minimisation or denial of the health risks of smoking and not identifying with "being a smoker". CONCLUSIONS This meta-ethnography may provide a blueprint to inform the development of health and wellbeing interventions designed specifically for young adults. Smoking cessation interventions should be co-designed with young adults based on their perceived needs, resonant with their desire to quit in the future at key milestones. Harm reduction interventions should address the social aspect of addiction, without reinforcing stigma, particularly for those with marginalised identities.
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Affiliation(s)
- Ria Poole
- European Centre for Environment and Human Health, University of Exeter Medical School, Royal Cornwall Hospital, Knowledge Spa, Cornwall, TR1 3DH, Truro, UK.
| | - Hannah Carver
- Salvation Army Centre for Addiction Services and Research, Faculty of Social Sciences, University of Stirling, FK9 4LA, Stirling, UK
| | - Despina Anagnostou
- Division of Human Health Sciences, Graduate School of Medicine, Kyoto University, 53 Shogoin Kawahara-cho, Sakyo Ward, 606-8507, Kyoto, Japan
| | - Adrian Edwards
- Division of Population Medicine, School of Medicine, Cardiff University, Neuadd Meirionydd, Heath Park, CF14 4YS, Cardiff, UK
| | - Graham Moore
- Centre for the Development and Evaluation of Complex Interventions for Public Health Improvement (DECIPHer), School of Social Sciences, Cardiff University, 1-3 Museum Place, CF10 3BD, Cardiff, UK
| | - Pamela Smith
- Division of Population Medicine, School of Medicine, Cardiff University, Neuadd Meirionydd, Heath Park, CF14 4YS, Cardiff, UK
| | - Fiona Wood
- Division of Population Medicine, School of Medicine, Cardiff University, Neuadd Meirionydd, Heath Park, CF14 4YS, Cardiff, UK
| | - Kate Brain
- Division of Population Medicine, School of Medicine, Cardiff University, Neuadd Meirionydd, Heath Park, CF14 4YS, Cardiff, UK
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Tan ASL, Hanby EP, Sanders-Jackson A, Lee S, Viswanath K, Potter J. Inequities in tobacco advertising exposure among young adult sexual, racial and ethnic minorities: examining intersectionality of sexual orientation with race and ethnicity. Tob Control 2021; 30:84-93. [PMID: 31857490 DOI: 10.1136/tobaccocontrol-2019-055313] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2019] [Revised: 11/08/2019] [Accepted: 11/18/2019] [Indexed: 12/21/2022]
Abstract
OBJECTIVE This study examined sexual orientation differences in encoded exposure to tobacco product ads and intersections with race and ethnicity. METHODS We analysed data from young adults (18-24) from the US Population Assessment of Tobacco and Health Study in 2013 and 2014 (N=9110). First, we compared encoded exposure to cigarette, electronic cigarette (e-cigarette), cigar and smokeless tobacco ads between sexual minorities (lesbian/gay, bisexual and something else) versus heterosexual young adults. We then analysed encoded ad exposure across sexual orientation, racial and ethnic subgroups. Analyses controlled for demographic and tobacco use variables. RESULTS Bisexual women had significantly higher prevalence of encoded exposure to cigarette and cigar ads compared with heterosexual women, and significantly higher prevalence of encoded e-cigarette ad exposure compared with both heterosexual and lesbian/gay women. There were no significant differences in encoded ad exposure between lesbian versus heterosexual women and between gay or bisexual men versus heterosexual men. Compared with heterosexual white counterparts, increased encoded ad exposures were reported by heterosexual black women (cigarette and cigar ads), black heterosexual men (cigar ads) and bisexual black women (cigarette and cigar ads). Compared with heterosexual non- Hispanic counterparts, increased encoded ad exposures were reported by bisexual Hispanic women (cigarette, e-cigarette and cigar ads) and heterosexual Hispanic men (cigarettes and cigar ads). CONCLUSION Sexual minority women of colour and black heterosexual women and men have increased encoded exposure to certain forms of tobacco ads. Further research is needed to address the impact of tobacco ads among multiple minority individuals based on sex, sexual orientation, race and ethnicity.
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Affiliation(s)
- Andy S L Tan
- Department of Medical Oncology, Division of Population Sciences, Center for Community-Based Research, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Elaine P Hanby
- Department of Medical Oncology, Division of Population Sciences, Center for Community-Based Research, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Ashley Sanders-Jackson
- Department of Advertising and Public Relations, College of Communication Arts and Science, Michigan State University, Lansing, Michigan, USA
| | - Stella Lee
- Department of Medical Oncology, Division of Population Sciences, Center for Community-Based Research, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Kasisomayajula Viswanath
- Department of Medical Oncology, Division of Population Sciences, Center for Community-Based Research, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Jennifer Potter
- The Fenway Institute at Fenway Health, Boston, Massachusetts, USA
- Department of Medicine, Beth Israel Lahey Health, Boston, Massachusetts, USA
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9
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Lee M, Jenkins WD, Adjei Boakye E. Cancer screening utilization by residence and sexual orientation. Cancer Causes Control 2020; 31:951-964. [PMID: 32833199 DOI: 10.1007/s10552-020-01339-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Accepted: 08/13/2020] [Indexed: 12/20/2022]
Abstract
PURPOSE Although few studies have examined screening uptake among sexual minorities (lesbian, gay, bisexual, queer), almost none have examined it in the specific context of rural populations. Therefore, our objective was to assess how cancer screening utilization varies by residence and sexual orientation. METHODS Publicly available population-level data from the 2014 and 2016 Behavioral Risk Factor Surveillance System were utilized. Study outcomes included recommended recent receipt of breast, cervical, and colorectal cancer screening. Independent variables of interest were residence (rural/urban) and sexual orientation (heterosexual/gay or lesbian/bisexual). Weighted proportions and multivariable logistic regressions were used to assess the association between the independent variables and the outcomes, adjusting for demographic, socioeconomic, and healthcare utilization factors. RESULTS Rates for all three cancer screenings were lowest in rural areas and among sexual minority populations (cervical: rural lesbians at 64.8% vs. urban heterosexual at 84.6%; breast: rural lesbians at 66.8% vs. urban heterosexual at 80.0%; colorectal for males: rural bisexuals at 52.4% vs. urban bisexuals at 81.3%; and colorectal for females: rural heterosexuals at 67.2% vs. rural lesbians at 74.4%). In the multivariate analyses for colorectal screening, compared to urban heterosexual males, both rural gay and rural heterosexual males were less likely to receive screening (aOR = 0.45; 95% = 0.24-0.73 and aOR = 0.79; 95% = 0.72-0.87, respectively) as were rural heterosexual females (aOR = 0.87; 95% = 0.80-0.94) compared to urban heterosexual females. For cervical screening, lesbians were less likely to receive screening (aOR = 0.62; 95% = 0.41-0.94) than heterosexuals, and there were no differences for breast screening. CONCLUSION We found that rural sexual minorities may experience disparities in cancer screening utilization associated with the compounding barriers of rural residence and sexual minority status, after adjusting for demographic, socioeconomic, and healthcare utilization factors. Further work is needed to identify factors influencing these disparities and how they might be addressed.
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Affiliation(s)
- Minjee Lee
- Department of Population Science and Policy, Southern Illinois University School of Medicine, Springfield, IL, USA. .,Simons Cancer Institute, Southern Illinois University School of Medicine, Springfield, IL, USA.
| | - Wiley D Jenkins
- Department of Population Science and Policy, Southern Illinois University School of Medicine, Springfield, IL, USA
| | - Eric Adjei Boakye
- Department of Population Science and Policy, Southern Illinois University School of Medicine, Springfield, IL, USA.,Simons Cancer Institute, Southern Illinois University School of Medicine, Springfield, IL, USA
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Blackwell CW, López Castillo H. Use of electronic nicotine delivery systems (ENDS) in lesbian, gay, bisexual, transgender and queer persons: Implications for public health nursing. Public Health Nurs 2020; 37:569-580. [DOI: 10.1111/phn.12746] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Revised: 04/09/2020] [Accepted: 04/24/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Christopher W. Blackwell
- Adult‐Gerontology Acute Care Nurse Practitioner Programs Department of Nursing Practice College of Nursing Academic Health Science Center University of Central Florida Orlando FL USA
| | - Humberto López Castillo
- Department of Health Sciences College of Health Professions and Sciences Orlando FL USA
- Department of Population Health Sciences College of Medicine Academic Health Science Center University of Central Florida Orlando FL USA
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11
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Delahanty J, Ganz O, Hoffman L, Guillory J, Crankshaw E, Farrelly M. Tobacco use among lesbian, gay, bisexual and transgender young adults varies by sexual and gender identity. Drug Alcohol Depend 2019; 201:161-170. [PMID: 31229704 DOI: 10.1016/j.drugalcdep.2019.04.013] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Revised: 04/01/2019] [Accepted: 04/01/2019] [Indexed: 01/02/2023]
Abstract
BACKGROUND Research shows that tobacco products are disproportionately used by sexual and gender minorities, known collectively as those who are lesbian, gay, bisexual, and transgender (LGBT). While usage varies within this population by identity, differences in tobacco use patterns are not well understood. The present study uses evaluation data for This Free Life, a tobacco public education campaign from the FDA, to examine differences in tobacco use among LGBT young adults by subgroups based on sex at birth, gender and sexual identity. METHODS Data are from 4,057 18-24 LGBT young adults who completed the baseline This Free Life evaluation survey in 2016. Multivariable logistic regression models examined differences in tobacco use (cigarettes, cigars, hookah and electronic nicotine products) and poly use (2+ of any product, 2+ combustibles, at least one combustible and one noncombustible) between LGBT subgroups (cisgender gay males, cisgender bisexual males, cisgender lesbian/gay females, cisgender bisexual females and gender minorities). RESULTS Sexual minority females were more likely than gay males to use any tobacco product, electronic nicotine products and hookah. Cisgender bisexuals were more likely than gay males and gender minorities to use electronic nicotine products. Cisgender bisexual males were less likely than all other groups to use cigarettes. Cisgender sexual minority females were more likely than gender minorities to engage in poly use. CONCLUSIONS Findings suggest that sexual minority females are more likely to use tobacco than other subgroups. More research can help campaign developers better understand reasons for intragroup differences in tobacco use among LGBT subgroups.
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Affiliation(s)
- Janine Delahanty
- The Center for Tobacco Products at the Food and Drug Administration, White Oak, MD, USA.
| | - Ollie Ganz
- The Center for Tobacco Products at the Food and Drug Administration, White Oak, MD, USA.
| | - Leah Hoffman
- The Center for Tobacco Products at the Food and Drug Administration, White Oak, MD, USA.
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12
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Praeger R, Roxburgh A, Passey M, Mooney-Somers J. The prevalence and factors associated with smoking among lesbian and bisexual women: Analysis of the Australian National Drug Strategy Household Survey. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2019; 70:54-60. [PMID: 31082663 DOI: 10.1016/j.drugpo.2019.03.028] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Revised: 02/22/2019] [Accepted: 03/15/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND In many countries, sexual minority women smoke at higher rates than their heterosexual counterparts. Analyses tend to combine lesbian and bisexual women, preventing an understanding of relevant factors associated with smoking for each group. This analysis used a representative sample of the Australian population to compare tobacco use between heterosexual, lesbian and bisexual women, and examine factors associated with smoking among these groups. METHODS In a secondary analysis of data from the National Drug Strategy Household Survey (N = 23,855), descriptive statistics were produced for heterosexual (n = 11,776), lesbian (n = 135) and bisexual (n = 167) women. Multivariate logistic regression modelling was undertaken to assess which factors were associated with current smoking among the different groups. RESULTS Compared to heterosexual women, lesbian and bisexual women were more likely to be current smokers (OR 2.9(1.8,4.5) and OR 3.6(2.4, 5.4) respectively). Employment, income and psychological distress were significant factors associated with smoking for lesbian women. Recent illicit drug use was the only significant factor associated with smoking for bisexual women. CONCLUSIONS We need to better understand the psychological, social and cultural factors that influence initiation, and sustain smoking among lesbian and bisexual women. Our findings demonstrate that sexual minority women in Australia warrant specific policy attention in a national framework.
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Affiliation(s)
- Ruth Praeger
- University of Sydney, Faculty of Medicine and Health, Sydney Health Ethics, Level 1 Medical Foundation Building, 91-97 Parramatta Road, Camperdown, NSW, 2050, Australia.
| | - Amanda Roxburgh
- National Drug and Alcohol Research Centre (NDARC), University of New South Wales, Sydney, NSW, 2052, Australia.
| | - Megan Passey
- University of Sydney, Faculty of Medicine and Health, University Centre for Rural Health, 61 Uralba Street, Lismore, NSW, 2480, Australia.
| | - Julie Mooney-Somers
- University of Sydney, Faculty of Medicine and Health, Sydney Health Ethics, Level 1 Medical Foundation Building, 91-97 Parramatta Road, Camperdown, NSW, 2050, Australia.
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13
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Rice CE, Vasilenko SA, Fish JN, Lanza ST. Sexual minority health disparities: an examination of age-related trends across adulthood in a national cross-sectional sample. Ann Epidemiol 2019; 31:20-25. [PMID: 30792064 PMCID: PMC6606453 DOI: 10.1016/j.annepidem.2019.01.001] [Citation(s) in RCA: 68] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Revised: 11/30/2018] [Accepted: 01/05/2019] [Indexed: 12/22/2022]
Abstract
PURPOSE Sexual minorities experience significant health disparities across a variety of mental, behavioral, and physical health indicators. Yet, an understanding of the etiology and progression of sexual minority health disparities across the lifespan is limited. METHODS We used the U.S. National Epidemiologic Survey of Alcohol and Related Conditions III to evaluate the association between sexual minority status and seven past-year health outcomes (alcohol use disorder, tobacco use disorder, drug use disorder, major depressive episode, generalized anxiety disorder, sexually transmitted infection, and cardiovascular conditions). To do this, we used unadjusted and adjusted logistic regression among our study sample (n = 30,999; aged 18-65 years) and time-varying effect models to evaluate how sexual orientation differences in these outcomes vary across adulthood. RESULTS Relative to heterosexuals, sexual minorities had elevated odds of past-year alcohol use disorder and drug use disorder across all ages (18-65 years) although the magnitude of the disparity varies by age. Sexual minorities were also more likely to experience major depressive episode, generalized anxiety disorder, tobacco use disorder, sexually transmitted infection, and cardiovascular disease, but only at specific ages. CONCLUSIONS Sexual minority health disparities vary appreciably across the adult lifespan, thus elucidating critical periods for focused prevention efforts.
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Affiliation(s)
- Cara Exten Rice
- The Methodology Center, Pennsylvania State University, University Park, PA.
| | - Sara A Vasilenko
- Department of Human Development and Family Science, David B. Falk College of Sport and Human Dynamics, Syracuse University, Syracuse, NY
| | - Jessica N Fish
- Department of Family Science, School of Public Health, University of Maryland, Austin, TX
| | - Stephanie T Lanza
- The Prevention Research Center, Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA
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14
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Fallin-Bennett A, Goodin A. Substance Use and School Characteristics in Lesbian, Gay, Bisexual, and Heterosexual High School Students. THE JOURNAL OF SCHOOL HEALTH 2019; 89:219-225. [PMID: 30637738 DOI: 10.1111/josh.12731] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Accepted: 03/06/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND Tobacco, alcohol, and illicit drug use among lesbian, gay, and bisexual (LGB) high school students as well as related environment and school-level risk and protective factors were examined. METHODS Data was acquired from the 2015 CDC's Youth Behavior Risk Survey for Kentucky (N = 2577). Prevalence of substance use was calculated for all high school respondents by reported sexual orientation. Multivariate analyses estimated the relationship between school and environmental-level factors (eg, having an adult to talk to) and tobacco, alcohol, and illicit drug use via logistic regressions. Sexual orientation, gender, age, and race/ethnicity were covariates. RESULTS LGB students used tobacco, alcohol, and illicit drugs more frequently than their heterosexual counterparts. More LGB teens report facing school risk factors (eg, 37% LGB vs 20% heterosexual bullied at school, p ≤ .001; 17% LGB vs 5% heterosexual ever threatened or injured at school, p < .001; 13% LGB vs 7% heterosexual involved in a school fight, p = .001). Adjusting for school related risk factors, having an adult to talk to was associated with a reduced likelihood of daily smoking (adjusted odds ratio [aOR]: 0.43; 95% confidence interval [CI]: 0.26-0.73), past 30-day alcohol use (aOR: 0.71; 95% CI: 0.50-0.95), and ever marijuana use (aOR: 0.71; 95% CI: 0.50-1.00). CONCLUSION Innovative strategies are needed to create safe, supportive school environments. These strategies are particularly needed in predominately rural states like Kentucky.
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Affiliation(s)
| | - Amie Goodin
- University of Florida, College of Pharmacy, 1225 Center Drive, Gainesville, FL 32610
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15
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Kolstee J, Deacon RM, Haidar S, Gray J, Mooney-Somers J. Changes in social networks are associated with lesbian, bisexual and queer women quitting smoking: An analysis of Australian survey data. Drug Alcohol Rev 2018; 38:76-81. [PMID: 30411427 DOI: 10.1111/dar.12873] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 10/08/2018] [Accepted: 10/09/2018] [Indexed: 11/29/2022]
Abstract
INTRODUCTION AND AIMS Lesbian, bisexual and queer (LBQ) women in Australia and internationally are smoking at least twice the rate of women in the general population. An understanding of smoking behaviours in this population is essential in order to develop effective interventions. Our analysis aimed to investigate differences in smoking patterns and contexts of smoking between current smokers and recent quitters (<2 years to 1 month). DESIGN AND METHODS Data were collected through an online anonymous survey conducted in mid-2015. Participants were recruited online from a variety of social networking sites and community-based mailing groups. RESULTS Overall 257 lesbian, bisexual and queer women completed the survey, 73% current smokers and 27% recent quitters; nearly all had smoked daily at some point in their lives. Multivariate analysis showed recent quitters were less likely to have some (adjusted odds ratio [aOR] 0.19, 95% confidence interval [CI] 0.05-0.71) or half/most/all (aOR 0.12, 95% CI 0.03-0.048) close friends who smoked compared to none, and were more likely to have a non-smoking (aOR 10.2, 95% CI 3.86-27.0) or no regular partner (aOR 4.01, 95% CI 1.47-10.9) than one who smoked. Non-Anglo-Australian women were also more likely to be recent quitters (aOR 2.45 [95% CI 1.10-5.42]) than Anglo-Australian women. DISCUSSION AND CONCLUSIONS Understanding the social significance of partners and friends in lesbian, bisexual and queer women's smoking and cessation efforts will be important for developing meaningful, effective and targeted interventions to address the persistent high rates of smoking in this population.
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Affiliation(s)
| | - Rachel M Deacon
- Drug and Alcohol Services, South Eastern Sydney Local Health District, Sydney, Australia.,Discipline of Addiction Medicine, Central Clinical School, Sydney Medical School, The University of Sydney, Sydney, Australia
| | | | | | - Julie Mooney-Somers
- Sydney Health Ethics, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
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16
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Bruce Baskerville N, Wong K, Shuh A, Abramowicz A, Dash D, Esmail A, Kennedy R. A qualitative study of tobacco interventions for LGBTQ+ youth and young adults: overarching themes and key learnings. BMC Public Health 2018; 18:155. [PMID: 29347920 PMCID: PMC5774159 DOI: 10.1186/s12889-018-5050-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Accepted: 01/10/2018] [Indexed: 12/23/2022] Open
Abstract
Background Smoking prevalence is very high among lesbian, gay, bisexual, transgendered and queer (LGBTQ+) youth and young adults (YYA) compared to non-LGBTQ+ YYA. A knowledge gap exists on culturally appropriate and effective prevention and cessation efforts for members of this diverse community, as limited interventions have been developed with and for this population, and there are very few studies determining the impact of these interventions. This study identifies the most salient elements of LGBTQ+ cessation and prevention interventions from the perspective of LGBTQ+ YYA. Methods Three descriptions of interventions tailored for LGBTQ+ YYA (group cessation counselling, social marketing, and a mobile phone app with social media incorporated), were shared with LGBTQ+ YYA via 24 focus groups with 204 participants in Toronto and Ottawa, Canada. Open-ended questions focused on their feelings, likes and dislikes, and concerns about the culturally modified intervention descriptions. Framework analysis was used to identify overarching themes across all three intervention descriptions. Results The data revealed eight overarching themes across all three intervention descriptions. Smoking cessation and prevention interventions should have the following key attributes: 1) be LGBTQ+ − specific; 2) be accessible in terms of location, time, availability, and cost; 3) be inclusive, relatable, and highlight diversity; 4) incorporate LGBTQ+ peer support and counselling services; 5) integrate other activities beyond smoking; 6) be positive, motivational, uplifting, and empowering; 7) provide concrete coping mechanisms; and 8) integrate rewards and incentives. Conclusions LGBTQ+ YYA focus group participants expressed a desire for an intervention that can incorporate these key elements. The mobile phone app and social media campaign were noted as potential interventions that could include all the essential elements. Electronic supplementary material The online version of this article (10.1186/s12889-018-5050-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- N Bruce Baskerville
- Propel Centre for Population Health Impact, University of Waterloo, Waterloo, Ontario, N2L 3G1, Canada.
| | - Katy Wong
- Propel Centre for Population Health Impact, University of Waterloo, Waterloo, Ontario, N2L 3G1, Canada
| | - Alanna Shuh
- Propel Centre for Population Health Impact, University of Waterloo, Waterloo, Ontario, N2L 3G1, Canada
| | - Aneta Abramowicz
- Propel Centre for Population Health Impact, University of Waterloo, Waterloo, Ontario, N2L 3G1, Canada
| | - Darly Dash
- Propel Centre for Population Health Impact, University of Waterloo, Waterloo, Ontario, N2L 3G1, Canada
| | - Aamer Esmail
- Sherbourne Health Centre, Toronto, Ontario, Canada
| | - Ryan Kennedy
- Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, USA
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17
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Bauermeister JA, Youatt EJ, Pingel ES, Soler JH, Johns MM. Psychosocial Obstacles to Smoking Cessation Attempts Among Young Adult Sexual Minority Women Who Smoke. Behav Med 2018. [PMID: 28632006 PMCID: PMC6082622 DOI: 10.1080/08964289.2017.1282853] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Sexual minority women (SMW; i.e., women who identify their sexuality as lesbian, bisexual, or something other than heterosexual) report greater smoking behaviors than their heterosexual counterparts across all ages. We conducted a multivariable regression to examine the correlates of prior smoking cessation attempts and smoking cessation intentions in a sample of young SMW who smoke (N = 338; aged 18-24 years). Covariates included sociodemographic characteristics (i.e., race/ethnicity, sexual identity, age, urbanity), general (i.e., perceived stress), and sexuality-specific (i.e., internalized homophobia) stressors, as well as smoking attitudes and subjective norms. Bisexual women (OR = 1.92, 95% CI: 1.11, 3.31) were more likely than lesbian counterparts to report a prior smoking cessation attempt. Prior cessation attempts were associated with less internalized homophobia (OR = 0.44, 95% CI: 0.27, 0.69) and positive attitudes toward smoking (OR = 2.17, 95% CI: 1.27, 3.70). Smoking cessation intentions in the next month were negatively associated with being a daily smoker (β = -0.14) and attitudes toward smoking (β = -0.19). Based on these findings, we underscore the need to address the risk correlates associated with SMW's quit attempts and include these in cessation interventions.
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Affiliation(s)
- Jose A. Bauermeister
- Department of Family and Community Health, University of Pennsylvania School of Nursing, Philadelphia, PA
| | - Emily J. Youatt
- Center for Sexuality & Health Disparities, University of Michigan, Ann Arbor, MI
| | | | - Jorge H. Soler
- Center for Sexuality & Health Disparities, University of Michigan, Ann Arbor, MI
| | - Michelle M. Johns
- Center for Sexuality & Health Disparities, University of Michigan, Ann Arbor, MI
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18
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Aylagas-Crespillo M, García-Barbero Ó, Rodríguez-Martín B. Barriers in the social and healthcare assistance for transgender persons: A systematic review of qualitative studies. ENFERMERIA CLINICA 2017; 28:S1130-8621(17)30152-3. [PMID: 29102529 DOI: 10.1016/j.enfcli.2017.09.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2016] [Revised: 08/30/2017] [Accepted: 09/06/2017] [Indexed: 10/18/2022]
Abstract
AIM To explore the barriers to requesting social and healthcare assistance perceived by transgender persons and professionals involved in the assistance. METHOD A meta-study, qualitative systematic review, of studies published in English or Spanish, exploring the barriers, perceived by transgender persons and social and healthcare professionals, that transgender persons have when they seek social and healthcare assistance was carried out in the following databases Medline (PubMed), Scopus, Web of Science, Spanish National Research Council, CUIDEN, ProQuest, PsycINFO and CINAHL. RESULTS Two thousand two hundred and sixty-one articles were found in the databases searched. Seven articles met all inclusion criteria and were included in this review. The professionals highlight the uncertainty when treating transgender persons and their lack of training. Transgender persons highlight the lack of information and the sense of helplessness it creates. Perceptions of transphobia, the fragmentation of services, administrative barriers, the lack of cultural sensitivity and professional training are also considered barriers to assistance. DISCUSSION The findings of this study provide key information for the design of plans and programmes to improve the quality of social and health care for transgender persons.
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Affiliation(s)
- Marina Aylagas-Crespillo
- Universidad de Castilla-La Mancha, Facultad de Terapia Ocupacional, Logopedia y Enfermería, Talavera de la Reina, Toledo, España
| | - Óscar García-Barbero
- Universidad de Castilla-La Mancha, Facultad de Terapia Ocupacional, Logopedia y Enfermería, Talavera de la Reina, Toledo, España
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19
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Other Tobacco Product Use Among Sexual Minority Young Adult Bar Patrons. Am J Prev Med 2017; 53:327-334. [PMID: 28495220 PMCID: PMC5747957 DOI: 10.1016/j.amepre.2017.03.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2016] [Revised: 02/17/2017] [Accepted: 03/02/2017] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Lesbian, gay, and bisexual (LGB) individuals smoke at rates 1.5-2 times higher than the general population, but less is known about LGB consumption of other tobacco products (OTPs) and gender differences. OTP use among young adult LGB bar patrons and the relationship among past quit attempts, intention to quit, and binge drinking with OTP use was examined. METHODS A cross-sectional survey of young adults (aged 18-26) in bars/nightclubs in seven U.S. cities between 2012 and 2014 (N=8,010; 1,101 LGB participants) was analyzed in 2016. Logistic regressions examined current use of five OTPs (cigarillos, electronic cigarettes, hookah, chewing tobacco, and snus) and sexual minority status, adjusting for demographics and comparing LB women and GB men with their heterosexual counterparts. RESULTS LGB bar/nightclub patrons used all OTPs more than their heterosexual counterparts. LB women were more likely than heterosexual women to use cigarillos, electronic cigarettes, hookah, chew, and snus. GB men were more likely than heterosexual men to smoke cigarillos, electronic cigarettes, hookah, and use chew and snus. Past-year quit attempt was associated with increased odds of electronic cigarette use in men and women, and increased odds of dual use (cigarettes and OTPs) among men. Intention to quit was negatively associated with dual use among women. Binge drinking was associated with increased use of all OTPs across genders. CONCLUSIONS LGB bar-going young adults are at higher risk for OTP use than their heterosexual counterparts. Bar-based interventions are needed to address all forms of tobacco use in this high-risk group.
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Hafeez H, Zeshan M, Tahir MA, Jahan N, Naveed S. Health Care Disparities Among Lesbian, Gay, Bisexual, and Transgender Youth: A Literature Review. Cureus 2017. [PMID: 28638747 PMCID: PMC5478215 DOI: 10.7759/cureus.1184] [Citation(s) in RCA: 93] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
About 3.5% Americans identify themselves as lesbian, gay, or bisexual while 0.3% identify themselves as transgender. The LGBT (lesbian, gay, bisexual, and transgender) community belongs to almost every race, ethnicity, religion, age, and socioeconomic group. The LGBT youth are at a higher risk for substance use, sexually transmitted diseases (STDs), cancers, cardiovascular diseases, obesity, bullying, isolation, rejection, anxiety, depression, and suicide as compared to the general population. LGBT youth receive poor quality of care due to stigma, lack of healthcare providers' awareness, and insensitivity to the unique needs of this community. The main objective of this literature review is to highlight the challenges faced by the LGBT youth and to enhance the awareness among physicians about the existing disparities in order to provide a more comprehensive, evidence-based, and humane medical care to this community.
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Affiliation(s)
| | - Muhammad Zeshan
- Department of Psychiatry, Bronx Lebanon Hospital Icahn School of Medicine at Mount Sinai, Bronx, NY
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21
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Deacon RM, Mooney-Somers J. Smoking prevalence among lesbian, bisexual and queer women in Sydney remains high: Analysis of trends and correlates. Drug Alcohol Rev 2017; 36:546-554. [PMID: 28211962 DOI: 10.1111/dar.12477] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2016] [Revised: 07/09/2016] [Accepted: 08/01/2016] [Indexed: 11/27/2022]
Abstract
INTRODUCTION AND AIMS To investigate smoking prevalence trends and correlates among lesbian, bisexual and queer-identifying (LBQ) women in Sydney, Australia. DESIGN AND METHODS Data from 5007 respondents to a repeated cross-sectional community survey were used to examine smoking trends between 2004 and 2014. Multinomial logistic regression was used to examine smoking correlates. RESULTS Thirty percent of respondents were current smokers, including 48% of 16 to 24-year-olds. A slight decrease in all-ages smoking over time was not reflected in the youngest age group. LBQ women who smoke have fewer economic, social and psychological resources than both women who never smoke and ex-smokers. High levels of alcohol and illicit drug use are also correlated with current smoking. DISCUSSION AND CONCLUSIONS Population-wide interventions have failed to address the persistently high prevalence of smoking among this sample of LBQ women. Tailored interventions may find utility focusing on personal resilience to deal with general and sexuality-specific stressors, as well as attending to poly-substance use. Acknowledgment of LBQ women as a priority group for tobacco reduction is urgently needed. We call on tobacco control agencies to consider sexuality and gender orientation in policy and partner with lesbian, gay, bisexual and transgender community organisations to develop culturally appropriate interventions. [Deacon RM, Mooney-Somers J Smoking prevalence among lesbian, bisexual and queer women in Sydney remains high: Analysis of trends and correlates Drug Alcohol Rev 2017;36:546-554].
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Affiliation(s)
- Rachel M Deacon
- The Langton Centre, South Eastern Sydney Local Health District, Sydney, Australia.,Central Clinical School, The University of Sydney, Sydney, Australia
| | - Julie Mooney-Somers
- Centre for Values, Ethics and the Law in Medicine, University of Sydney, Sydney, Australia
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22
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Baskerville NB, Dash D, Shuh A, Wong K, Abramowicz A, Yessis J, Kennedy RD. Tobacco use cessation interventions for lesbian, gay, bisexual, transgender and queer youth and young adults: A scoping review. Prev Med Rep 2017; 6:53-62. [PMID: 28271021 PMCID: PMC5328933 DOI: 10.1016/j.pmedr.2017.02.004] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Revised: 02/06/2017] [Accepted: 02/13/2017] [Indexed: 12/02/2022] Open
Abstract
Smoking prevalence among LGBTQ + youth and young adults is alarmingly high compared to their non-LGBTQ + peers. The purpose of the scoping review was to assess the current state of smoking prevention and cessation intervention research for LGBTQ + youth and young adults, identify and describe these interventions and their effectiveness, and identify gaps in both practice and research. A search for published literature was conducted in PubMed, Scopus, CINAHL, PsychInfo, and LGBT Life, as well as an in-depth search of the grey literature. All English articles published or written between January 2000 and February 2016 were extracted. The search identified 24 records, of which 21 were included; 11 from peer reviewed sources and 10 from the grey literature. Of these 21, only one study targeted young adults and only one study had smoking prevention as an objective. Records were extracted into evidence tables using a modified PICO framework and a narrative synthesis was conducted. The evidence to date is drawn from methodologically weak studies; however, group cessation counselling demonstrates high quit rates and community-based programs have been implemented, although very little evidence of outcomes exist. Better-controlled research studies are needed and limited evidence exists to guide implementation of interventions for LGBTQ + youth and young adults. This scoping review identified a large research gap in the area of prevention and cessation interventions for LGBTQ youth and young adults. There is a need for effective, community-informed, and engaged interventions specific to LGBTQ + youth and young adults for the prevention and cessation of tobacco. We conducted a scoping review on cessation programs for LGBTQ + young adults. A large research gap in the area of tobacco control for LGBTQ + young adults exists. Tobacco control interventions specific to LGBTQ + youth and young adults are needed.
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Affiliation(s)
- N. Bruce Baskerville
- Propel Centre for Population Health Impact, University of Waterloo, Canada
- Corresponding author at: Propel Centre for Population Health Impact, University of Waterloo, Waterloo, Ontario N2L 3G1, Canada.Propel Centre for Population Health ImpactUniversity of WaterlooWaterlooOntarioN2L 3G1Canada
| | - Darly Dash
- Propel Centre for Population Health Impact, University of Waterloo, Canada
| | - Alanna Shuh
- Propel Centre for Population Health Impact, University of Waterloo, Canada
| | - Katy Wong
- Propel Centre for Population Health Impact, University of Waterloo, Canada
| | - Aneta Abramowicz
- Propel Centre for Population Health Impact, University of Waterloo, Canada
| | - Jennifer Yessis
- Propel Centre for Population Health Impact, University of Waterloo, Canada
| | - Ryan D. Kennedy
- Institute for Global Tobacco Control, Department of Health, Behavior & Society, Johns Hopkins Bloomberg School of Public Health, United States
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23
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Floyd SR, Pierce DM, Geraci SA. Preventive and Primary Care for Lesbian, Gay and Bisexual Patients. Am J Med Sci 2016; 352:637-643. [DOI: 10.1016/j.amjms.2016.05.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2016] [Accepted: 05/10/2016] [Indexed: 01/02/2023]
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Baskerville NB, Dash D, Wong K, Shuh A, Abramowicz A. Perceptions Toward a Smoking Cessation App Targeting LGBTQ+ Youth and Young Adults: A Qualitative Framework Analysis of Focus Groups. JMIR Public Health Surveill 2016; 2:e165. [PMID: 27864164 PMCID: PMC5135733 DOI: 10.2196/publichealth.6188] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Revised: 10/27/2016] [Accepted: 10/29/2016] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The prevalence of smoking among lesbian, gay, bisexual, trans, queer, and other sexual minority (LGBTQ+) youth and young adults (YYA) is significantly higher compared with that among non-LGBTQ+ persons. However, in the past, interventions were primarily group cessation classes that targeted LGBTQ+ persons of all ages. mHealth interventions offer an alternate and modern intervention platform for this subpopulation and may be of particular interest for young LGBTQ+ persons. OBJECTIVE This study explored LGBTQ+ YYA (the potential users') perceptions of a culturally tailored mobile app for smoking cessation. Specifically, we sought to understand what LGBTQ+ YYA like and dislike about this potential cessation tool, along with how such interventions could be improved. METHODS We conducted 24 focus groups with 204 LGBTQ+ YYA (aged 16-29 years) in Toronto and Ottawa, Canada. Participants reflected on how an app might support LGBTQ+ persons with smoking cessation. Participants indicated their feelings, likes and dislikes, concerns, and additional ideas for culturally tailored smoking cessation apps. Framework analysis was used to code transcripts and identify the overarching themes. RESULTS Study findings suggested that LGBTQ+ YYA were eager about using culturally tailored mobile apps for smoking cessation. Accessibility, monitoring and tracking, connecting with community members, tailoring, connecting with social networks, and personalization were key reasons that were valued for a mobile app cessation program. However, concerns were raised about individual privacy and that not all individuals had access to a mobile phone, users might lose interest quickly, an app would need to be marketed effectively, and app users might cheat and lie about progress to themselves. Participants highlighted that the addition of distractions, rewards, notifications, and Web-based and print versions of the app would be extremely useful to mitigate some of their concerns. CONCLUSIONS This study provided insight into the perspectives of LGBTQ+ YYA on a smoking cessation intervention delivered through a mobile app. The findings suggested a number of components of a mobile app that were valued and those that were concerning, as well as suggestions on how to make a mobile app cessation program successful. App development for this subpopulation should take into consideration the opinions of the intended users and involve them in the development and evaluation of mobile-based smoking cessation programs.
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Affiliation(s)
- N Bruce Baskerville
- Propel Centre for Population Health ImpactApplied Health SciencesUniversity of WaterlooWaterloo, ONCanada
| | - Darly Dash
- Propel Centre for Population Health ImpactApplied Health SciencesUniversity of WaterlooWaterloo, ONCanada
| | - Katy Wong
- Propel Centre for Population Health ImpactApplied Health SciencesUniversity of WaterlooWaterloo, ONCanada
| | - Alanna Shuh
- Propel Centre for Population Health ImpactApplied Health SciencesUniversity of WaterlooWaterloo, ONCanada
| | - Aneta Abramowicz
- Propel Centre for Population Health ImpactApplied Health SciencesUniversity of WaterlooWaterloo, ONCanada
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Abstract
In this study, we link together moments of discrimination described by young bisexual women. We do so in order to theorize about associations between negative stereotypes heard early in one’s life and later minimization of personal discrimination. Using interviews with 13 young women, we sought to understand the types of negative messages participants heard about “bi/sexuality” as well as the ways that they perceived or did not perceive themselves as having experienced discrimination related to their sexuality. We found that family members and friends often described participants’ bisexuality as “disgusting,” “difficult to understand,” or “hot,” and participants described their own experiences with discrimination as “no big deal.” We use this analysis to build on previous research concerning microaggressions, sexual stigma, and denial of discrimination to discuss how familial, social, and political environments create a set of conditions in which later injustices are imagined as normative and inevitable. Finally, we discuss the methodological dilemmas facing feminist psychologists who aim to analyze discrimination and the challenges in documenting individuals’ experiences of stigma, which may be imagined as no big deal to individuals, but are in fact unjust. It is imperative to develop strategies to recognize, document, and critically assess how injustice becomes all too normal for some and the role that feminist psychology can play in changing this. A podcast conversation with the author of this article is available on PWQ 's website at http://pwq.sagepub.com/site/misc/Index/Podcasts.xhtml
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Affiliation(s)
- Sara I. McClelland
- Departments of Psychology and Women’s Studies, University of Michigan, Ann Arbor, MI, USA
| | - Jennifer D. Rubin
- Departments of Psychology and Women’s Studies, University of Michigan, Ann Arbor, MI, USA
| | - José A. Bauermeister
- Department of Family and Community Health, School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
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