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Lee YH, Chang YC, Shelley M, López Castillo H. Sexual minority identifiers and their perception of illicit drug use risks in the US: Results from a National Survey. J Psychiatr Res 2024; 175:183-191. [PMID: 38735263 DOI: 10.1016/j.jpsychires.2024.05.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2024] [Revised: 04/26/2024] [Accepted: 05/02/2024] [Indexed: 05/14/2024]
Abstract
PURPOSE This study examined the relationship between sexual identities and perception of risks associated with illicit drug use among a nationally representative sample of US adults. METHODS We analyzed data from five waves of the National Survey on Drug Use and Health (NSDUH, 2015-2019), with 205,418 adult participants. Six survey questions assessing participants' perceptions of the risks associated with illicit drug use (LSD, heroin, and cocaine) were subjected to principal component analysis. Sex-stratified ordered logistic regressions were used to explore potential disparities in perceptions regarding the risk associated with illicit drug use among sexual minority identifiers. RESULTS Among male participants, approximately 11.3% and 1.8% of them perceived illicit drug use as moderate and low risks, respectively. About 6.0% of female participants perceived illicit drug use as moderate risk, and 1.1% of female participants perceived it as low risk. The sex-stratified regression models demonstrated that participants who identified as lesbian/gay or bisexual all had higher odds of reporting low perception of illicit drug use risks as compared to their heterosexual counterparts (all p < 0.01). CONCLUSIONS Illicit drug use prevention strategies should consider risk perception disparities by sexual minority populations.
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Affiliation(s)
- Yen-Han Lee
- Department of Health Sciences, College of Health Professions and Sciences, Academic Health Sciences Center, University of Central Florida. Orlando, FL, United States
| | - Yen-Chang Chang
- Center for General Education, National Tsing Human University, Taiwan
| | - Mack Shelley
- Departments of Statistics and Political Science, College of Liberal Arts and Sciences, Iowa State University. Ames, IA, United States
| | - Humberto López Castillo
- Department of Health Sciences, College of Health Professions and Sciences, Academic Health Sciences Center, University of Central Florida. Orlando, FL, United States; Department of Population Health Sciences, College of Medicine, Academic Health Sciences Center, University of Central Florida. Orlando, FL, United States.
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Joung KH, Okoye H, Rana M, Saewyc EM. Trends in substance use among sexual minority adolescents in South Korea. J SPEC PEDIATR NURS 2024; 29:e12425. [PMID: 38598084 DOI: 10.1111/jspn.12425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 03/20/2024] [Accepted: 03/25/2024] [Indexed: 04/11/2024]
Abstract
PURPOSE Substance use, that is of cigarettes, alcohol and chemical inhalants, is a major contributor to health-compromising behaviors and the related consequences among adolescents around the world. The purpose of this paper is to examine trends in this phenomenon in South Korea among sexually active adolescents who reported sexual minority behaviors as compared to their heterosexual (HS) peers. DESIGN AND METHODS This study used data from the annual web-based survey called Korea Youth Risk Behavior Survey in 5-year intervals: 2006, 2011, and 2016. From 2017, the questions regarding the gender of sex partners were excluded from the survey, thus no data is available for sexual minorities after 2016. Selected data (Unweighted n = 10,029) was used to assess whether substance use increased, decreased, or remained unchanged among adolescents who reported same-sex (SS) behaviors and bisexual (BS) behaviors compared to their peers reporting HS behaviors. Demographic variables included age and assigned gender. Substances referred to are cigarettes, alcohol, and chemical inhalants. Logistic regression models were sex-stratified according to assigned gender. Trend analyses were carried out to examine disparities in substance use among sexually active adolescents across the three survey years. RESULTS Across the three survey years, cigarette use, alcohol use, and problematic drinking declined among all sexually active youths, but there were some differences among the subgroups. In 2016, SS girls were more likely to use cigarettes than HS girls. The prevalence of alcohol use and problematic drinking among BS girls was relatively higher than among girls who exhibited either HS or SS behaviors. Inhalant use was very high among both boys and girls with SS and BS behaviors. PRACTICE IMPLICATIONS The findings of the study reveal disparities in substance use between sexual minority and heterosexual adolescents in South Korea. This creates an alarm for collecting data separately for sexually diverse youth in future Korean national surveys with a goal of reducing substance use among all adolescents.
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Affiliation(s)
| | - Helen Okoye
- School of Nursing, Stigma and Resilience Among Vulnerable Youth Center, University of British Columbia, British Columbia, Canada
| | - Monica Rana
- School of Nursing, Stigma and Resilience Among Vulnerable Youth Center, University of British Columbia, British Columbia, Canada
| | - Elizabeth M Saewyc
- School of Nursing, Stigma and Resilience Among Vulnerable Youth Center, University of British Columbia, British Columbia, Canada
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Rams A, D. Kowitt S, Ritchie C, Sutfin EL, Sheeran P, Noar SM. Awareness and Perceptions of US Food and Drug Administration's JUUL Marketing Denial Order: A National Study of US Adolescents. Nicotine Tob Res 2024; 26:467-473. [PMID: 37813094 PMCID: PMC10959063 DOI: 10.1093/ntr/ntad191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 08/18/2023] [Accepted: 09/27/2023] [Indexed: 10/11/2023]
Abstract
INTRODUCTION We examined awareness and perceptions of the US Food and Drug Administration (FDA) JUUL marketing denial order (MDO) that occurred in June 2022 among a nationally representative sample of US adolescents. AIMS AND METHODS Data were collected in August 2022 via an online survey (n = 1603). Adolescents were asked whether they had heard about the JUUL MDO, and, if yes, where they heard the news. Those who had heard were asked about the MDO's impact on their harm beliefs about JUUL and vape products in general. We examined correlates of awareness of the MDO and of increased JUUL and vape harm perceptions. RESULTS Twenty-seven percent of adolescents had heard about the MDO. Older adolescents (adjusted odds ratio [aOR] = 1.13) and LGBTQ+ adolescents (aOR = 2.05) had significantly higher odds of having heard the news, while those who identified as Black or African American had significantly lower odds of having heard (aOR = 0.56). Most participants who were aware of the MDO indicated that they had higher harm perceptions about JUUL itself (77.9%) and vapes in general (79.6%). Youths susceptible to vaping and current users were less likely to report increased harm perceptions about JUUL (B = -0.34 and -0.46, respectively) and vapes in general (B = -0.27 and -0.43) compared with youth not susceptible to vaping. CONCLUSIONS The results of this nationally representative survey demonstrate that over one-quarter of US youth heard about the JUUL MDO and the vast majority of those indicated increased harm perceptions about vapes. Large-scale news events about vaping can reach youth audiences and may impact what youth think about the harms of vaping. IMPLICATIONS Analysis of a nationally representative survey of adolescents aged 13-17 revealed that more than 25% had heard about the marketing denial order issued to JUUL Labs by the FDA in June of 2022. We also found that the vast majority of adolescents reported increased JUUL and vape harm perceptions in response to hearing about the MDO. This indicates that news coverage about vaping-including coverage of regulatory actions-can reach and potentially impact adolescents. It is therefore important to monitor news coverage about vaping, how it is framed and discussed across media platforms, and its reach among priority populations.
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Affiliation(s)
- Alissa Rams
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Sarah D. Kowitt
- Department of Family Medicine, School of Medicine, University of North Carolina, Chapel Hill, NC, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Caroline Ritchie
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Erin L Sutfin
- Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Paschal Sheeran
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Seth M Noar
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Hussman School of Journalism and Media, University of North Carolina at Chapel Hill, Chapel Hill
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Wedel AV, Patterson JG, Lee DN, Stevens EM, Wagener TL, Keller-Hamilton B. E-Cigarette Use among Sexual Minoritized Women and Nonbinary People Assigned Female at Birth: Assessing the Roles of Discrimination, Perceived Stress, and Social Support. Subst Use Misuse 2023; 58:1102-1109. [PMID: 37199173 PMCID: PMC10247437 DOI: 10.1080/10826084.2023.2212056] [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] [Indexed: 05/19/2023]
Abstract
Background: Young adult sexual minoritized women (SMW) are at disproportionate risk for e-cigarette use, which may in part be due to excess minority stress imposed by discrimination exposure. While discrimination exposure is associated with risk for combustible tobacco/nicotine use among SMW, similar associations have yet to be tested with e-cigarettes. Moreover, it is unknown if discrimination-related risk may be mitigated by protective factors such as social support. This study examined concurrent associations of discrimination, perceived stress, and social support with past 30-day e-cigarette use in a sample of young adult SMW during the COVID-19 pandemic. Methods: N = 501 SMW and nonbinary people assigned female at birth (AFAB) aged 18-30 completed an online survey. A series of logistic regressions examined associations of discrimination, perceived stress, and four forms of social support received during the COVID-19 pandemic with past-30-day e-cigarette use. Results: Among SMW, greater perceived stress (OR = 1.10, p = .03), but not discrimination exposure, was associated with e-cigarette use. Associations of discrimination with e-cigarette use were nonsignificant when most forms of social support (emotional, material/financial, and virtual) were accounted for. Associations of perceived stress with e-cigarette use were strongest among those who needed but did not receive material support. Conclusions: Perceived stress, but not discrimination exposure, was associated with risk for e-cigarette use among young SMW during the COVID-19 pandemic. Effects of nonspecific stress may be compounded by insufficient material/financial support.
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Affiliation(s)
- Amelia V. Wedel
- Department of Psychology, Syracuse University, Syracuse, New York, USA
| | - Joanne G. Patterson
- Division of Health Behavior and Health Promotion, The Ohio State University College of Public Health, Columbus, Ohio, USA
- Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, Columbus, Ohio, USA
| | - 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
| | - 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
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Pang RD, Mason TB, Kapsner AK, Leventhal AM. Parsing Intra- and Inter-Individual Covariation Between the Sensory Attributes and Appeal of E-Cigarettes: Associations and Gender Differences. Nicotine Tob Res 2022; 24:1012-1019. [PMID: 34891167 PMCID: PMC9199929 DOI: 10.1093/ntr/ntab255] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 11/24/2021] [Accepted: 12/08/2021] [Indexed: 12/30/2022]
Abstract
INTRODUCTION Perceived sensory attributes of e-cigarettes may associate with their appeal. However, limited studies have accounted for individuals' variability in sensory attributes or have addressed how associations of sensory attributes with appeal may differ by gender. METHODS Individuals (n = 119, 32.8% female) who currently used combustible cigarettes and/or e-cigarettes attended one laboratory session in which they completed a standardized e-cigarette puffing procedure according to a 10 Flavor (green apple, strawberry, chocolate, vanilla, menthol, koolada, peppermint, spearmint, subtle tobacco, and full-flavored tobacco) × 2 Nicotine Formulation (free-base, salt) double-blind factorial design. The mean nicotine concentration was 23.4 (SD = 0.9) mg/mL in the nicotine salt formulations and 23.8 (SD = 1.7) mg/mL in the free-base formulations. Following each trial, participants completed ratings of sensory attributes (sweet, smooth, cool, bitter, harsh) and appeal (mean of liking, disliking [reverse-scored], and willingness-to-use-again ratings). Sensory attributes were partitioned into between-person and within-person variables. Gender was tested as a moderator of associations of sensory attributes with appeal. RESULTS Sweet, smooth, and cool sensory attributes positively associated with appeal at the between- and within-person level (ps < .001). Bitter and harsh negatively associated with appeal at the between- and within-person level (ps < .001). The associations of between-person sweet, smooth, and cool ratings with appeal was larger in males compared to females. The associations of within-person smooth, bitter, and harsh with appeal was larger in females compared to males. CONCLUSIONS This study showed important gender differences in associations of sensory attributes and appeal. IMPLICATIONS While evidence suggests that sensory attributes may contribute to the appeal of e-cigarettes, there is little experimental evidence accounting for individual variability in sensory attributes and whether sensory attribute-appeal associations differ by gender. The current study provides evidence that average sweet, cool, and smooth ratings positively associated with appeal and that these associations were larger in males. Within-person bitter, harsh, and smooth ratings significantly associated with appeal in both genders, but these associations were larger in females compared to males. Data from the current report reinforces the need for researchers to study gender stratified effects in tobacco regulatory science.
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Affiliation(s)
- Raina D Pang
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, Los Angeles, CA, USA
- Department of Psychology, University of Southern California, Los Angeles, CA, USA
| | - Tyler B Mason
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, Los Angeles, CA, USA
| | - Addison K Kapsner
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, Los Angeles, CA, USA
| | - Adam M Leventhal
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, Los Angeles, CA, USA
- Department of Psychology, University of Southern California, Los Angeles, CA, USA
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Azagba S, Shan L. Exposure to tobacco and e-cigarette advertisements by sexual identity status among high school students. Addict Behav 2022; 125:107165. [PMID: 34749170 DOI: 10.1016/j.addbeh.2021.107165] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 10/25/2021] [Accepted: 10/26/2021] [Indexed: 11/20/2022]
Abstract
INTRODUCTION The literature on tobacco advertising among sexual minorities is relatively scarce. This study examined the association between exposure to tobacco products and e-cigarettes advertisements and sexual identity. METHODS Data were from the 2020 National Youth Tobacco Survey (n = 7223). The prevalence of exposure to tobacco marketing through various channels was estimated among high school students and by sexual identity subgroups. Multivariable logistic regressions were used to examine the association between sexual identity status and exposure to tobacco and e-cigarette advertisements. RESULTS The proportion of sexual minority adolescents who reported exposure to tobacco and e-cigarette advertisements was higher than heterosexuals. In multivariable analysis, gay or lesbian youth (aOR 1.45, 95% CI, 1.04-2.02) had higher odds of any exposure to tobacco and e-cigarette advertisement than heterosexuals. Regarding the channel of advertisement exposure, sexual minorities were more likely to be exposed via newspapers/magazines for cigarettes or other tobacco products. Likewise, gay or lesbian youth and those not sure about their sexual identity had higher odds of exposure via newspapers/magazines for e-cigarettes. Analysis stratified by sex showed significant differences, with gay or lesbian males more likely to be exposed to any tobacco and e-cigarette advertisements via the internet, newspapers/magazines, and TV/streaming services. Males not sure about their sexual identity are more likely to be exposed to tobacco and e-cigarette advertisements via newspapers/magazines. CONCLUSIONS Overall, sexual minority adolescents had high exposure to tobacco products and e-cigarette advertisements, especially males. Prevention and intervention efforts targeting this population could help reduce the well-established tobacco use disparities.
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Affiliation(s)
- Sunday Azagba
- Ross and Carol Nese College of Nursing, Penn State, University Park, Pennsylvania, United States.
| | - Lingpeng Shan
- Division of Biostatistics, College of Public Health, The Ohio State University, United States
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Beck DC, Veliz PT, McCabe SE, Boyd CJ, Evans-Polce R. Cigarette, e-cigarette, and dual use during the third trimester of pregnancy in a national sample of heterosexual and sexual minority women. Am J Addict 2021; 30:593-600. [PMID: 34472675 DOI: 10.1111/ajad.13217] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 07/15/2021] [Accepted: 08/11/2021] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Research investigating e-cigarettes/e-products and dual use with cigarettes among pregnant sexual minority individuals in the United States is lacking. This study addresses this gap using a national sample. METHODS Two waves of national panel data (2015-2018) from the Population Assessment of Tobacco and Health study were used. The sample included 1842 women, 237 identified as sexual minorities (n = 17 lesbian, n = 177 bisexual, n = 43 something else), who indicated pregnancy during the past 12 months at Waves 3 or 4. Covariates included race, ethnicity, past-year income, and education. Cigarette, e-cigarette, or dual use was examined during the last trimester. RESULTS Sexual minorities had higher adjusted odds of cigarette use during their last trimester of pregnancy relative to heterosexual women (adjusted odds ratio [AOR] = 1.55, 95% confidence interval [CI] = 1.08, 2.23). Bisexual women had higher odds of smoking cigarettes during their third trimester compared with heterosexual women (AOR = 1.82, 95% CI = 1.21, 2.72). Lesbian women were more likely to use e-cigarettes/e-products (AOR = 9.15, 95% CI = 2.29, 36.5) and indicate dual use (AOR = 6.00, 95% CI = 1.43, 25.1) during their third trimester of pregnancy compared with heterosexual women. CONCLUSION AND SCIENTIFIC SIGNIFICANCE Maternal health among US sexual minority women would benefit from clinicians equipped to provide accurate information and support for Food and Drug Administration-approved smoking cessation, information about e-cigarettes/e-products, and dual use. This study is the first to examine cigarette, e-cigarette, and dual use during the third trimester of pregnancy using a national sample, with specific attention to differences in sexual orientation.
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Affiliation(s)
- Dana C Beck
- National Clinician Scholars Program, University of Michigan School of Nursing, Ann Arbor, Michigan, USA
| | - Phil T Veliz
- Center for the Study of Drugs, Alcohol, Smoking, and Health, University of Michigan School of Nursing, Ann Arbor, Michigan, USA
| | - Sean E McCabe
- Center for the Study of Drugs, Alcohol, Smoking, and Health, University of Michigan School of Nursing, Ann Arbor, Michigan, USA
| | - Carol J Boyd
- Center for the Study of Drugs, Alcohol, Smoking, and Health, University of Michigan School of Nursing, Ann Arbor, Michigan, USA
| | - Rebecca Evans-Polce
- Center for the Study of Drugs, Alcohol, Smoking, and Health, University of Michigan School of Nursing, Ann Arbor, Michigan, USA
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Azagba S, Shan L. Tobacco Craving, Nicotine Dependence, and Quit Intentions among LGB and Non-LGB High School Students: A Quasi-Experimental Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:9000. [PMID: 34501586 PMCID: PMC8431691 DOI: 10.3390/ijerph18179000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Revised: 08/20/2021] [Accepted: 08/23/2021] [Indexed: 11/16/2022]
Abstract
There is evidence of higher tobacco use among lesbian or gay and bisexual (LGB) populations. However, a limited number of studies have examined whether there are differences in potential indicators of future tobacco cessation behaviors between LGB and non-LGB populations. This study examined whether sexual identity is associated with craving, nicotine dependence, and quit intentions among high school students. Data were drawn from the 2020 National Youth Tobacco Survey (n = 1642). A propensity score matching (PSM) technique was used to address covariate imbalance among sexual identity groups. Additionally, subgroup analyses were performed for both males and females. The PSM results showed higher odds of craving among students who were gay or lesbian (aOR, 1.70; 95% CI = 1.13-2.55) and bisexual (aOR, 1.89; 95% CI = 1.23-2.92) compared to heterosexual (straight) students. In the sex-based subgroup analyses, we found that gay or lesbian (aOR, 1.92; 95% CI = 1.10-3.34) and bisexual (aOR, 3.12; 95% CI, 1.46-6.66) male students had significantly higher odds of craving when compared to heterosexual/straight male adolescents. However, the association was not significant in female students. Additionally, female bisexuals had significantly lower odds for quit intention (aOR, 0.48; 95% CI = 0.29-0.81) when compared to heterosexual/straight female adolescents. Results also showed no significant differences between LGB and non-LGB students for nicotine dependence. Sexual minority adolescents, especially male adolescents, were more likely to have tobacco cravings and bisexual females had lower odds of quit intention than heterosexual peers. Prevention efforts targeting this subpopulation may be beneficial.
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Affiliation(s)
- Sunday Azagba
- Ross and Carol Nese College of Nursing, The Pennsylvania State University, University Park, PA 16802, USA
| | - Lingpeng Shan
- Division of Biostatistics, College of Public Health, The Ohio State University, Columbus, OH 43210, USA;
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Grigsby TJ, Schnarrs PW, Lunn MR, Benjamin SM, Lust K, Forster M. Adverse Childhood Experiences and Past 30-Day Cigarette and E-Cigarette Use Among Sexual and Gender Minority College Students. LGBT Health 2021; 8:433-438. [PMID: 34129400 DOI: 10.1089/lgbt.2020.0456] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Purpose: Sexual and gender minority (SGM) young adults report disproportionately higher rates of tobacco and nicotine product use. This study assessed the role of adverse childhood experiences (ACEs) in nicotine and tobacco product use among SGM young adults. Methods: A cross-sectional survey was administered to 11,694 college students (ages 18-29 years) between 2017 and 2018 in California, Minnesota, and Texas. Results: For every additional ACE reported, the odds of cigarette, e-cigarette, and dual use increased for all students, with significantly higher past 30-day cigarette use among ACE-exposed SGM students. Conclusion: ACEs are an important contributing factor to tobacco-related disparities facing SGM groups.
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Affiliation(s)
- Timothy J Grigsby
- Department of Environmental and Occupational Health, University of Nevada, Las Vegas, Las Vegas, Nevada, USA
| | - Phillip W Schnarrs
- Department of Population Health, Dell School of Medicine, University of Texas at Austin, Austin, Texas, USA.,Population Research Center, University of Texas at Austin, Austin, Texas, USA
| | - Mitchell R Lunn
- Division of Nephrology, Department of Medicine, Stanford University, Stanford, California, USA.,The PRIDE Study/PRIDEnet, Stanford University School of Medicine, Stanford, California, USA
| | - Stephanie M Benjamin
- Department of Health Sciences, California State University, Northridge, Northridge, California, USA
| | - Katherine Lust
- Department of Pediatrics and School of Public Health, University of Minnesota, Twin Cities, Minneapolis, Minnesota, USA
| | - Myriam Forster
- Department of Health Sciences, California State University, Northridge, Northridge, California, USA
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Li J, Berg CJ, Weber AA, Vu M, Nguyen J, Haardörfer R, Windle M, Goodman M, Escoffery C. Tobacco Use at the Intersection of Sex and Sexual Identity in the U.S., 2007-2020: A Meta-Analysis. Am J Prev Med 2021; 60:415-424. [PMID: 33218922 DOI: 10.1016/j.amepre.2020.09.006] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 08/26/2020] [Accepted: 09/14/2020] [Indexed: 12/19/2022]
Abstract
CONTEXT A 2009 systematic review synthesized data between 1987 and 2007 and revealed a higher prevalence of smoking among sexual minority populations than among heterosexuals. Subsequently, growing attention to tobacco use among sexual minority populations has spurred more literature on this issue because higher tobacco use prevalence has been found in certain sexual minority subgroups relative to others. However, a population-level synthesis of tobacco use prevalence by sexual minority subgroup has not been done for the past decade. EVIDENCE ACQUISITION Investigators conducted a meta-analysis by searching MEDLINE, Web of Science, EMBASE, and PsycINFO for U.S.-based studies published between 2007 and 2020 that specifically reported tobacco use prevalence among adults and separated the sexes and gays/lesbians versus bisexuals. Using random-effects models, meta-prevalence estimates, 95% CIs, and heterogeneity (I2) were calculated for each sexual minority subgroup. EVIDENCE SYNTHESIS A total of 30 studies were included in the meta-analysis. The highest current cigarette use prevalence estimates were found among bisexual women (37.7%), followed by lesbians (31.7%), gay men (30.5%), and bisexual men (30.1%). Heterosexual men (21.0%) and women (16.6%) had the lowest prevalence. CONCLUSIONS Tobacco use prevalence among sexual minorities during 2007-2020 remained at similarly high levels as those during 1987-2007, and tobacco use disparity between sexual minorities and heterosexuals persisted in the past decade. Significant heterogeneity existed in tobacco use across sexual minority subgroups, with bisexual women having the highest prevalence. These findings are critical for increasing decision maker's awareness and action to address sexual minorities' persistent high prevalence of tobacco use, particularly among bisexual women.
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Affiliation(s)
- Jingjing Li
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Carla J Berg
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, District of Columbia; George Washington Cancer Center, George Washington University, Washington, District of Columbia
| | - Amber A Weber
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Milkie Vu
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Justin Nguyen
- Emory College of Arts and Sciences, Emory University, Atlanta, Georgia
| | - Regine Haardörfer
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Michael Windle
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Michael Goodman
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Cam Escoffery
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, Georgia.
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