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Romm KF, Berg CJ, Wang Y, Cohn AM. Patterns of Tobacco and Cannabis Use Among Sexual Minority Females and Males From PATH Wave 5: The Role of Sociodemographic and Psychosocial Correlates. SUBSTANCE USE & ADDICTION JOURNAL 2024; 45:397-407. [PMID: 38281150 DOI: 10.1177/29767342231222245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/30/2024]
Abstract
INTRODUCTION Although sexual minority (SM; vs heterosexual) individuals display higher rates of tobacco and cannabis use, limited research has examined sociodemographic and psychosocial correlates of single and co-use among this population. METHODS Participants were SM-identifying female (N = 2419; Mage = 27.80; 50.0% racial/ethnic minority) and male (N = 1142; Mage = 30.34; 46.1% racial/ethnic minority) adults from Wave 5 of the Population Assessment of Tobacco and Health study. Multinomial logistic regressions examined sociodemographic (ie, sexual identity, age, race/ethnicity, education, income) and psychosocial (ie, alcohol use, mental health, substance use) correlates of single and co-use (ie, no use [referent], tobacco-only, cannabis-only, co-use), controlling for state cannabis legalization, among SM females and males, separately. RESULTS The proportions of SM females reporting no use, tobacco-only, cannabis-only, and co-use were 37.9%, 24.0%, 10.5%, and 27.6%, respectively. Among males, 40.6%, 27.8%, 10.1%, and 21.5% reported no use, tobacco-only, cannabis-only, and co-use, respectively. Among females and males, substance use problems were associated with all 3 use groups (vs no use); past-month alcohol use was associated with cannabis-only and co-use; and mental health symptoms were associated with co-use (and cannabis-only in males). Sociodemographic correlates among females were: tobacco-only-identifying as bisexual (vs lesbian), White (vs Black), older, lower education, and lower income; cannabis-only-bisexual, other race (vs White); and co-use-White (vs Hispanic), lower education, and lower income. Among males, sociodemographic correlates were: tobacco-only-older, lower education, and lower income; cannabis-only-Black (vs White) and higher income. CONCLUSIONS Public health efforts to reduce tobacco and cannabis use among SM adults should target single versus co-use patterns and their corresponding sociodemographic, mental health, and substance use profiles.
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Affiliation(s)
- Katelyn F Romm
- TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Department of Pediatrics, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Carla J Berg
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
- George Washington Cancer Center, George Washington University, Washington, DC, USA
| | - Yan Wang
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Amy M Cohn
- TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Department of Pediatrics, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
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Ehlke SJ, Fitzer SA, Stamates AL, Kelley ML. Distal and Proximal Minority Stressors on Patterns of Tobacco and Cannabis Use Among Young Bisexual Women. SUBSTANCE USE & ADDICTION JOURNAL 2024; 45:390-396. [PMID: 38258836 PMCID: PMC11209863 DOI: 10.1177/29767342231222246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2024]
Abstract
BACKGROUND Bisexual women have high rates of tobacco and cannabis use, but few studies have examined co-use behavior in this population. Although the role of distal minority stressors (eg, discrimination) on substance use has been examined, fewer studies have examined proximal minority stressors (eg, negative sexual identity self-schemas). The current study was a secondary data analysis that examined patterns of tobacco and cannabis use, and the role of distal (instability of bisexuality, sexual irresponsibility of bisexual people, and hostility toward bisexual people) and proximal (illegitimacy of bisexuality, anticipated binegativity, internalized binegativity, and identity affirmation) bisexual-specific minority stressors among bisexual women. METHODS Participants were 224 young (aged 18-30 years old) self-identified bisexual women who reported on their past 30-day tobacco and cannabis use and completed measures of distal and proximal bisexual-specific minority stressors. Participants were categorized into one of 4 patterns: no use, tobacco use only, cannabis use only, and tobacco and cannabis co-use. RESULTS The most common pattern of past 30-day use was tobacco and cannabis co-use (39.1%). Results from a multinomial logistic regression revealed that bisexual women who reported higher illegitimacy of bisexuality, a proximal minority stressor, were significantly more likely to engage in tobacco and cannabis co-use, relative to no use. DISCUSSION Bisexual women have particularly high rates of substance use, with tobacco and cannabis co-use as the most common pattern. Incorporating the role of proximal minority stressors, and specifically, beliefs about the legitimacy of bisexuality, may be an important target of substance use interventions for bisexual women.
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Affiliation(s)
- Sarah J. Ehlke
- Department of Psychology, Old Dominion University, Norfolk, VA, USA
- Virginia Consortium Program in Clinical Psychology, Norfolk, VA, USA
| | | | - Amy L. Stamates
- Department of Psychology, University of Rhode Island, Kingston, RI, USA
| | - Michelle L. Kelley
- Department of Psychology, Old Dominion University, Norfolk, VA, USA
- Virginia Consortium Program in Clinical Psychology, Norfolk, VA, USA
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Romm KF, Berg CJ. Disparities in Transitions From E-cigarette Use to Other Tobacco Use Patterns Among Sexual Minority Versus Heterosexual Women and Men in the United States. SUBSTANCE USE & ADDICTION JOURNAL 2024; 45:515-522. [PMID: 38477014 DOI: 10.1177/29767342241232763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/14/2024]
Abstract
INTRODUCTION Despite elevated rates of e-cigarette use among sexual minority versus heterosexual young adults, limited research has examined sexual identity in relation to transitions from e-cigarette use to other tobacco use patterns. METHODS We analyzed data from 608 US young adults in a 2-year study (2018-2020) who reported using e-cigarettes in the past 6 months (time period between assessments) but no other tobacco product at baseline (Fall 2018). Multinomial logistic regressions among women and men, separately, examined associations between sexual identity and past 6-month tobacco use in Fall 2020 (nonuse [referent group] vs e-cigarette only, other tobacco product only, e-cigarette and other tobacco product dual use), controlling for age and race/ethnicity. RESULTS Among women (n = 340; mean [M]age = 23.42; n = 147 [43.4%] sexual minority; 29.4% racial/ethnic minority), 34.4% reported nonuse at follow-up, 26.8% e-cigarette only, 10.3% other tobacco product only, and 28.5% e-cigarette and other tobacco product dual use. Sexual minority (vs heterosexual) women displayed greater odds of e-cigarette-only use, as well as dual use relative to nonuse at follow-up. Among men (n = 244; Mage = 24.30; n = 51 [20.9%] sexual minority; 36.1% racial/ethnic minority), 25.4% reported no use, 20.9% e-cigarette only, 17.2% other tobacco product only, and 36.5% dual use at follow-up. Sexual minority (vs heterosexual) men displayed lower odds of e-cigarette only, other tobacco product only, and dual use relative to nonuse at follow-up. CONCLUSIONS Research is needed to assess and intervene on tobacco/nicotine product perceptions (eg, harm, social acceptability) and reasons for use (eg, mood regulation) associated with high-risk tobacco use patterns and trajectories, particularly among sexual minority young adult women who may have distinct profiles and risks associated with use.
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Affiliation(s)
- Katelyn F Romm
- TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Department of Pediatrics, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Carla J Berg
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
- George Washington Cancer Center, George Washington University, Washington, DC, USA
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Romm KF, McDonald S, DiLissio E, Dearfield C, Berg CJ. Disparities in Cannabis Use among Female and Male Sexual Minority Young Adults in the US: The Role of Parenting Behaviors. CANNABIS (ALBUQUERQUE, N.M.) 2024; 7:163-176. [PMID: 38975593 PMCID: PMC11225982 DOI: 10.26828/cannabis/2024/000236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 07/09/2024]
Abstract
Introduction Despite cannabis use disparities among sexual minority (SM; vs. heterosexual) young adults (SMYAs), little research has explored social influences contributing to these disparities. This study examined sexual identity subgroup differences in parenting behaviors and associations among parenting behaviors and cannabis use behaviors among YA subgroups. Methods Participants were female (N=416; 44.7% bisexual, 7.2% lesbian) and male (N=228; 11.0% bisexual, 13.2% gay) YAs (ages 18-29) recruited via social media from 6 US cities. Bivariate analyses examined differences in perceived parenting (psychological control, behavioral control, knowledge, autonomy support, warmth, communication, cannabis disapproval), any past-month (current) cannabis use, and current cannabis use frequency across sexual identity subgroups. Multivariable regression examined associations among sexual identity and parenting behaviors with cannabis use outcomes. Results Among female YAs, bisexual (vs. heterosexual) YAs had greater odds of cannabis use, reported more frequent use, and reported greater parental psychological control and less behavioral control, autonomy support, warmth, and communication; greater psychological control was associated with both outcomes; less autonomy support was associated with current use; and less warmth and communication were associated with use frequency. Among male YAs, gay and bisexual (vs. heterosexual) YAs had greater odds of current use and reported more frequent use and greater psychological control; gay (vs. heterosexual) YAs reported greater behavioral control and less autonomy support, warmth, and communication; and greater psychological control and less warmth and communication were associated with both outcomes. Conclusions Cannabis prevention/cessation programs should target specific parenting behaviors that differentially impact cannabis use outcomes among specific SMYA subgroups.
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Affiliation(s)
- Katelyn F. Romm
- TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center
- Department of Pediatrics, College of Medicine, University of Oklahoma Health Sciences Center
| | - Sunny McDonald
- TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center
- Department of Psychology, Rose State College
| | - Emma DiLissio
- Department of Women's Health, University of Pennsylvania
| | - Craig Dearfield
- Department of Epidemiology, Milken Institute School of Public Health, George Washington University
| | - Carla J. Berg
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University
- George Washington Cancer Center, George Washington University
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Osborn C, Pike Moore S, Koopman Gonzalez S, Quisenberry A, Klein E, Trapl E. Come for the Tobacco, Stay for the Flavor: Flavored Cigarillo-Use Trajectories Among Young Adult Sexual Gender Minority Women. Nicotine Tob Res 2024; 26:S112-S120. [PMID: 38817030 PMCID: PMC11140217 DOI: 10.1093/ntr/ntad168] [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: 11/30/2022] [Revised: 07/14/2023] [Accepted: 09/01/2023] [Indexed: 06/01/2024]
Abstract
INTRODUCTION The purpose of this research was to identify how young adult sexual gender minority (SGM) women who use cigarillos may respond to cigar flavor restrictions. AIMS AND METHODS Young adults aged 21-28 years in the United States who currently use cigarillos were recruited between October 2020 and April 2021 to participate in an online survey. Due to high prevalence of cigarillo use among individuals who identify as sexual and/or gender minority (SGM) women, their (n = 192) flavored tobacco-use behaviors and anticipated responses to cigarillo flavor restrictions were compared to cisgender heterosexual (CisHet) women (n = 110). Logistic regression was used to model cigarillo cessation and product-switching behaviors (flavored and unflavored). RESULTS SGM women were significantly less likely to report the use of flavor at the initiation of cigarillo use (61.7% vs. 86.1%) but were no different in current flavor use compared to CisHet women, with more than 80% of all women using any flavor. SGM women were 2.36 times as likely to say they would discontinue using cigarillos if flavors were unavailable. Among those who would continue using cigarillos, SGM women were 4.53 times as likely to endorse switching to an unflavored tobacco product but had the same likelihood of saying they would switch to flavored product compared to CisHet women. CONCLUSIONS Flavor restriction policies may not reduce the initiation of cigarillos among SGM women and may elicit differential cigarillo use and tobacco product substitution by SGM identity. Flavor restriction policies should be coupled with targeted cessation resources to address potential remaining disparities. IMPLICATIONS SGM US women have a unique cigarillo-use trajectory. These women are more likely to initiate cigarillos without flavor and then later integrate it into their behavior. National cigar flavor restrictions are expected to have a greater impact decreasing cigarillo initiation among CisHet women and decreasing current cigarillo use among SGM women. However, for those who would continue using unflavored cigarillos, SGM women may remain at risk for nicotine dependence due to increased product substitution. SGM women should be prioritized for cessation resources to reduce tobacco-use disparities leading up to and following the implementation of cigar flavor restrictions.
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Affiliation(s)
- Catherine Osborn
- Department of Population and Quantitative Health Sciences, Prevention Research Center for Healthy Neighborhoods at Case Western Reserve University, Cleveland, OH, USA
| | - Stephanie Pike Moore
- Department of Population and Quantitative Health Sciences, Prevention Research Center for Healthy Neighborhoods at Case Western Reserve University, Cleveland, OH, USA
| | - Sarah Koopman Gonzalez
- Department of Population and Quantitative Health Sciences, Prevention Research Center for Healthy Neighborhoods at Case Western Reserve University, Cleveland, OH, USA
| | - Amanda Quisenberry
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Elizabeth Klein
- Division of Health Behavior & Health Promotion, The Ohio State University College of Public Health, Columbus, OH, USA
| | - Erika Trapl
- Department of Population and Quantitative Health Sciences, Prevention Research Center for Healthy Neighborhoods at Case Western Reserve University, Cleveland, OH, USA
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Fitzpatrick I, Byrne D, Gilmore AB, Hasan F, Cranwell J. Quantifying and characterising tobacco content in the most in-demand streamed series in 10 low/middle-income countries in 2019. Tob Control 2023; 33:45-51. [PMID: 35750485 PMCID: PMC10803995 DOI: 10.1136/tobaccocontrol-2022-057278] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 05/31/2022] [Indexed: 11/03/2022]
Abstract
BACKGROUND In line with the Framework Convention for Tobacco Control (FCTC) Article 13, the advertising and promotion of tobacco products is increasingly restricted. However, popular media continues to pose an exposure risk to youth populations (aged 13-18 years), including in low/middle-income countries (LMICs). This study presents a novel method to record the prevalence of tobacco depictions in streamed media content and the characterisation of that content. OBJECTIVES Evaluate the frequency and characterisation of tobacco depictions in streamed content in LMICs. METHODS Presence of tobacco depictions was evaluated in the four most in-demand series across 10 LMICs for the year 2019; this list included series that were released from 2017 onwards (2017-2019). Each character identified using tobacco was coded against 13 characterisation variables that recorded key demographic information as well as contextual information. RESULTS The majority of series (72%, 13 of 18) analysed contained at least one depiction of tobacco use. 38% of tobacco depictions (359 of 941) occurred in content deemed suitable for audiences aged 15 years and up. 113 characters were depicted using tobacco across 38 episodes. 'Star' actors, featuring in opening credits with active profiles on the Internet Movie Database, accounted for 73% of tobacco-using characters (83 of 113). 5% of characters depicted using tobacco (6 of 113) were coded as minors (under 18 years). CONCLUSION The continued prevalence of positively characterised tobacco content in youth-focused streamed content that is in high demand in LMICs poses a risk as a driver of smoking uptake in youth populations. There is an urgent need to better enforce tobacco advertising, promotion and sponsorship legislation in LMICs, and to update WHO FCTC guidance in line with rapidly evolving media platforms and content that is available internationally.
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Affiliation(s)
- Iona Fitzpatrick
- Tobacco Control Research Group, Department for Health, University of Bath, Bath, UK
| | - Danielle Byrne
- Tobacco Control Research Group, Department for Health, University of Bath, Bath, UK
| | - Anna B Gilmore
- Tobacco Control Research Group, Department for Health, University of Bath, Bath, UK
| | - Farheen Hasan
- Tobacco Control Research Group, Department for Health, University of Bath, Bath, UK
| | - Joanne Cranwell
- UK Centre for Tobacco and Alcohol Studies, Department for Health, University of Bath, Bath, UK
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Romm KF, Cohn AM, Beebe LA, Berg CJ. Disparities in cannabis use outcomes, perceived risks and social norms across sexual orientation groups of US young adult women and men. HEALTH EDUCATION RESEARCH 2023; 38:513-526. [PMID: 37756620 PMCID: PMC10714042 DOI: 10.1093/her/cyad038] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 08/08/2023] [Accepted: 09/08/2023] [Indexed: 09/29/2023]
Abstract
Little research has examined mechanisms driving cannabis use disparities among sexual minority (SM; versus heterosexual) young adults (YAs). Participants were US YA women (N = 1345; 24.8% bisexual, 6.1% lesbian) and men (N = 998: 8.9% bisexual, 13.8% gay). Bivariate analyses examined associations between sexual orientation (heterosexual, gay/lesbian, bisexual) and cannabis use outcomes (past 30-day [current] use, use frequency, cannabis-tobacco dual use, use intentions), perceived risks (harm, addictiveness) and social norms (social acceptability, peer use). Regressions examined sexual orientation, perceived risks and social norms as correlates of cannabis outcomes. Bisexual and lesbian (versus heterosexual) women reported lower cannabis-related perceived risks, greater social norms and higher odds of current use. Bisexual (versus heterosexual) women reported more days of use, higher odds of cannabis-tobacco dual use and greater use intentions. Gay (versus heterosexual) men reported lower perceived addictiveness, greater social norms and higher odds of current use. Lower perceived risks and greater social norms predicted greater use outcomes for women and men. Bisexual women displayed higher odds of several cannabis use outcomes, whereas lesbian women and gay men displayed higher odds of current cannabis use only. Cannabis-related perceptions and social norms may be important targets for public health messaging for SMYAs.
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Affiliation(s)
- Katelyn F Romm
- TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA
- Department of Pediatrics, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA
| | - Amy M Cohn
- TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA
- Department of Pediatrics, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA
| | - Laura A Beebe
- Department of Biostatistics and Epidemiology, Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA
| | - Carla J Berg
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC 20052, USA
- George Washington Cancer Center, George Washington University, Washington, DC 20052, USA
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Alam F, Silveyra P. Sex Differences in E-Cigarette Use and Related Health Effects. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:7079. [PMID: 37998310 PMCID: PMC10671806 DOI: 10.3390/ijerph20227079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 11/10/2023] [Accepted: 11/16/2023] [Indexed: 11/25/2023]
Abstract
BACKGROUND Electronic cigarettes (e-cigarettes) comprise a variety of products designed to deliver nicotine, flavorings, and other substances. To date, multiple epidemiological and experimental studies have reported a variety of health issues associated with their use, including respiratory toxicity, exacerbation of respiratory conditions, and behavioral and physiological effects. While some of these effects appear to be sex- and/or gender-related, only a portion of the research has been conducted considering these variables. In this review, we sought to summarize the available literature on sex-specific effects and sex and gender differences, including predictors and risk factors, effects on organ systems, and behavioral effects. METHODS We searched and selected articles from 2018-2023 that included sex as a variable or reported sex differences on e-cigarette-associated effects. RESULTS We found 115 relevant studies published since 2018 that reported sex differences in a variety of outcomes. The main differences reported were related to reasons for initiation, including smoking history, types of devices and flavoring, polysubstance use, physiological responses to nicotine and toxicants in e-liquids, exacerbation of lung disease, and behavioral factors such as anxiety, depression, sexuality, and bullying. CONCLUSIONS The available literature supports the notion that both sex and gender influence the susceptibility to the negative effects of e-cigarette use. Future research needs to consider sex and gender variables when addressing e-cigarette toxicity and other health-related consequences.
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Affiliation(s)
- Fatima Alam
- Department of Environmental and Occupational Health, Indiana University School of Public Health Bloomington, Bloomington, IN 47405, USA;
| | - Patricia Silveyra
- Department of Environmental and Occupational Health, Indiana University School of Public Health Bloomington, Bloomington, IN 47405, USA;
- Department of Medicine, Indiana University School of Medicine, Indianapolis, IN 47405, USA
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Patterson JG, Keller-Hamilton B, Wedel A, Vázquez-Otero C, Liu J, Lee D, Stevens EM, Wagener TL. Absolute and relative e-cigarette harm perceptions among young adult lesbian and bisexual women and nonbinary people assigned female at birth. Addict Behav 2023; 146:107788. [PMID: 37429104 PMCID: PMC10529580 DOI: 10.1016/j.addbeh.2023.107788] [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: 02/18/2023] [Revised: 06/22/2023] [Accepted: 06/26/2023] [Indexed: 07/12/2023]
Abstract
PURPOSE Young adult lesbian and bisexual women report considerable e-cigarette disparities, which may be attributed to low harm perceptions. No studies have assessed differences in e-cigarette harm perceptions in this group, nor which factors might be intervention targets to influence harm perceptions. MATERIALS AND METHODS We investigated differences in and modifiable correlates of e-cigarette harm perceptions among young adult lesbian and bisexual women and non-binary people assigned female at birth. Young adult women and non-binary people assigned female at birth, aged 18-30 years old, and who self-identified as lesbian or bisexual (N = 471) reported absolute and relative harm perceptions of e-cigarettes to health in an online survey. We modeled associations between harm perceptions and individual, interpersonal, and contextual factors. RESULTS Bisexual (vs. lesbian) participants perceived higher absolute harm of e-cigarettes (Mean (M) = 7.61 vs M = 7.09, p = .03). Participants rated e-cigarettes as slightly less harmful than cigarettes, and there was no statistically significant difference by sexual orientation (Bisexual: M = 4.84 vs Lesbian: M = 4.36). In multivariable models, bisexual (vs. lesbian) participants and Hispanic/Latinx and Other race (vs. non-Hispanic White) participants reported higher absolute and relative e-cigarette harm perceptions. Greater sexual identify affirmation and greater perceived stress were associated with higher absolute and relative e-cigarette harm perceptions. CONCLUSIONS E-cigarette harm perceptions vary vis-à-vis individual-level factors. Self-identification as bisexual or minoritized race/ethnicity, greater sexual identity affirmation, and greater perceived stress was associated with increased harm perceptions. Understanding variations may inform targeted health communications to reduce e-cigarette use disparities.
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Affiliation(s)
- Joanne G Patterson
- The Ohio State University College of Public Health, Division of Health Behavior and Health Promotion, 1841 Neil Avenue, Columbus, OH 43120, USA; The Ohio State University Comprehensive Cancer Center, Cancer Control Program, 460 W. 10th Ave, Columbus, OH 43120, USA; Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, 3650 Olentangy River Rd, Columbus, OH 43214, USA.
| | - Brittney Keller-Hamilton
- The Ohio State University Comprehensive Cancer Center, Cancer Control Program, 460 W. 10th Ave, Columbus, OH 43120, USA; Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, 3650 Olentangy River Rd, Columbus, OH 43214, USA; Division of Medical Oncology, Department of Internal Medicine, The Ohio State University College of Medicine, 2050 Kenny Rd, Columbus, OH 43221, USA
| | - Amelia Wedel
- Department of Psychology, Syracuse University, 430 Hunting Hall, Syracuse, NY 13244, USA
| | - Coralia Vázquez-Otero
- Department of Public Health, College for Health, Community and Policy, The University of Texas at San Antonio, One UTSA Circle, Main Building 2.306, San Antonio, TX 78249, USA
| | - Jessica Liu
- REACH Lab, Division of Adolescent Medicine, Department of Pediatrics, Stanford University, 3145 Porter Drive, Palo Alto, CA 94304, USA
| | - Donghee Lee
- Division of Preventive and Behavioral Medicine, Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, 368 Plantation Street, Worcester, MA 01655, USA
| | - Elise M Stevens
- Division of Preventive and Behavioral Medicine, Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, 368 Plantation Street, Worcester, MA 01655, USA
| | - Theodore L Wagener
- The Ohio State University Comprehensive Cancer Center, Cancer Control Program, 460 W. 10th Ave, Columbus, OH 43120, USA; Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, 3650 Olentangy River Rd, Columbus, OH 43214, USA; Division of Medical Oncology, Department of Internal Medicine, The Ohio State University College of Medicine, 2050 Kenny Rd, Columbus, OH 43221, USA
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Romm KF, Cohn AM, Wang Y, Williams R, Berg CJ. Disparities in trajectories of cigarette and E-cigarette use across sexual orientation groups of young adult men and women in the US. Addict Behav 2023; 145:107763. [PMID: 37295384 PMCID: PMC10674053 DOI: 10.1016/j.addbeh.2023.107763] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 05/12/2023] [Accepted: 06/02/2023] [Indexed: 06/12/2023]
Abstract
INTRODUCTION Limited research has examined differences in cigarette/e-cigarette use trajectories among specific subgroups of sexual minority (SM) young adult (SMYA) men and women. METHODS Repeated measures latent profile analyses (RMLPAs) examined past 6-month cigarette and e-cigarette use trajectories across 5 waves of data (2018-2020) among men (n = 1235; Mage = 25.56, SD = 4.85; 8.0% bisexual, 12.7% gay; 36.4% racial/ethnic minority) and women (n = 1574; Mage = 24.64, SD = 4.72; 23.8% bisexual, 5.9% lesbian; 35.3% racial/ethnic minority) residing in 6 US metropolitan statistical areas. Multinomial logistic regressions examined associations among sexual orientation (bisexual, gay/lesbian, heterosexual) and tobacco use trajectories among men and women, separately. RESULTS RMLPAs yielded a 6-profile solution: stable low-level cigarette and e-cigarette use (66.6%), stable low-level cigarette and high-level e-cigarette use (12.2%), stable low-level cigarette and decreasing e-cigarette use (6.2%), stable mid-level cigarette and low-level e-cigarette use (6.2%), stable high-level cigarette and low-level e-cigarette use (4.5%), and stable high-level cigarette and e-cigarette use (4.2%). Gay (vs. heterosexual) men were less likely to display stable low-level cigarette and stable high-level e-cigarette use. Bisexual (vs. heterosexual) women were more likely to display stable low-level cigarette and stable high-level e-cigarette use, stable low-level cigarette and decreasing high-level e-cigarette use, and stable high-level cigarette and stable low-level e-cigarette use. CONCLUSIONS Bisexual women were at greatest risk for displaying several problematic cigarette and e-cigarette use trajectories, whereas few differences emerged for men. Tailored interventions and campaigns are needed to curtail ongoing tobacco use disparities among SMYA men and women, particularly bisexual women.
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Affiliation(s)
- Katelyn F Romm
- TSET Health Promotion Research Center, Stephenson Cancer Center, Univeristy of Oklahoma Health Sciences Center, Oklahoma City, OK, USA; Department of Pediatrics, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
| | - Amy M Cohn
- TSET Health Promotion Research Center, Stephenson Cancer Center, Univeristy of Oklahoma Health Sciences Center, Oklahoma City, OK, USA; Department of Pediatrics, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Yan Wang
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - River Williams
- Department of Global Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Carla J Berg
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA; George Washington Cancer Center, George Washington University, Washington, DC, USA
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Romm KF, Dopke C, Price OA, Pannell A, Williams R, Berg CJ. Parental influences on tobacco use and likelihood of future use among sexual minority young adult men and women in the United States. Am J Addict 2023; 32:450-459. [PMID: 36960484 PMCID: PMC10674051 DOI: 10.1111/ajad.13418] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 02/24/2023] [Accepted: 03/22/2023] [Indexed: 03/25/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Limited research has examined mechanisms, including parenting behaviors, contributing to tobacco use disparities among sexual minority young adults (SMYAs). METHODS Participants were 644 young adult (ages 18-29; 36.5% racial/ethnic minority) women (N = 416; 44.7% bisexual, 7.2% lesbian, 48.1% heterosexual) and men (N = 288; 11.0% bisexual, 13.2% gay, 75.9% heterosexual). Bivariate analyses examined differences among sex-by-sexual identity subgroups in perceived parenting (psychological control, behavioral control, knowledge, autonomy support, warmth, communication), past 30-day cigarette, e-cigarette, and cigar use, and likelihood of future use. Multivariable regression examined associations of sexual identity subgroup and parenting behaviors to tobacco use outcomes among women and men. RESULTS Bisexual (vs. heterosexual) women reported greater parental psychological control and less autonomy support, warmth, and communication. Bisexual (vs. heterosexual) women had greater odds of past 30-day cigarette and cigar use and greater likelihood of future cigarette and e-cigarette use, and parenting behaviors were associated with past 30-day cigarette (knowledge, warmth), e-cigarette (psychological control, autonomy support, warmth), and cigar use (behavioral control, warmth) and likelihood of future cigarette (psychological control, warmth) and e-cigarette use (autonomy support, communication). Gay (vs. heterosexual) men reported greater parental behavioral control, less knowledge, autonomy support, warmth, and communication. Sexual identity and parenting behaviors were largely not associated with tobacco use among men. DISCUSSION AND CONCLUSIONS Findings highlight the role of parenting behaviors as potential mechanisms contributing to tobacco use disparities among SMYA women. SCIENTIFIC SIGNIFICANCE Tobacco prevention/cessation programs should be tailored toward specific SMYA subgroups, combinations of parenting behaviors, and patterns of tobacco use.
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Affiliation(s)
- Katelyn F Romm
- TSET Health Promotion Research Center, Stephenson Cancer Center, Univeristy of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
- Department of Pediatrics, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Campbell Dopke
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, District of Columbia, USA
| | - Olga A Price
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, District of Columbia, USA
| | - Alexandria Pannell
- Department of Global Health, Milken Institute School of Public Health, George Washington University, Washington, District of Columbia, USA
| | - River Williams
- Department of Global Health, Milken Institute School of Public Health, George Washington University, Washington, District of Columbia, USA
| | - Carla J Berg
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, District of Columbia, USA
- George Washington Cancer Center, George Washington University, Washington, District of Columbia, USA
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12
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Integrative Review of Methods From Youth Risk Behavior Survey Secondary Data Analyses Examining HIV Syndemic Factors Among Adolescent Gay and Bisexual Men. Nurs Res 2023; 72:141-149. [PMID: 36729784 DOI: 10.1097/nnr.0000000000000632] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Adolescent gay/bisexual men exhibit the highest prevalence of undiagnosed HIV infections. Ascertaining antecedents of behaviorally acquired HIV infections among adolescent gay/bisexual men can be challenging; however, these challenges can be overcome through the utilization of secondary data, such as the Youth Risk Behavior Survey. OBJECTIVE Syndemics theory suggests that HIV infections are not a singular phenomenon; instead, many infections occur at the intersection of syndemic factors, such as substance use, violence, and mental health. Our objective is to describe and synthesize research methods of secondary data analyses that examine syndemic factors in relation to HIV risk behavior outcomes among subsamples of adolescent gay/bisexual men. METHODS Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, PubMed, Cumulative Index to Nursing and Allied Health Literature, and PsycInfo were systematically searched. Inclusion criteria were (a) peer-reviewed Youth Risk Behavior Survey secondary data analyses conducted in the United States after 1991, (b) subsamples with adolescent gay/bisexual men, (c) one or more syndemic factor(s), and (d) one or more HIV risk behavior outcome(s). We used the National Institutes of Health Quality Assessment Tools for quality appraisal. RESULTS Of 1,036 citations retrieved, nine studies met inclusion criteria. Results included using logistic regression analysis and data from 2015 to 2017 in six studies and underpinnings with minority stress theory in four studies. Eight studies omitted race/ethnicity in subsamples and six grouped lesbians with adolescent gay/bisexual men. Seven studies examined substance use, six examined violence, and five examined mental health. Condom use and number of partners were the most studied HIV risk behavior outcomes in four studies, whereas intercourse in the last 3 months was an outcome in only one study. Protective factors were not present. CONCLUSION Limitations found the need to highlight better inclusion of race/ethnicity and sexual orientation. Adding contemporary survey items is also necessary, such as nonbinary sex and gender identity, access to HIV prevention (condoms, HIV testing, and preexposure prophylaxis), and experiences with stigma, to elucidate risk behaviors among populations disproportionately affected by HIV infections, including Blacks/African Americans and Hispanics/Latinos.
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13
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Ickes M, Hester JW, Wiggins AT, Rayens MK. Juul use among emerging adults transitioning from high school to college. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023; 71:53-60. [PMID: 33577416 DOI: 10.1080/07448481.2021.1873790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2020] [Revised: 12/18/2020] [Accepted: 01/03/2021] [Indexed: 06/12/2023]
Abstract
Objective: Assess the prevalence, perceptions, sociodemographic/personal factors that influence Juul use among incoming freshmen.Participants: Incoming undergraduate students (N = 1,706) attending a public university in the southeastern U.S.Methods: Cross-sectional survey administered August 2018. Bivariate relationships assessed using chi-square test of association. Multinomial logistic regression to determine factors associated with Juul use status.Results: 41% had ever used Juul, 24% had used within the past month. Among current users, one-third had used 20-30 days. Risk factors for current use: heterosexual orientation (relative to other sexual orientation) AOR = 2.16, 95% CI: 1.20-3.91), those who planned to join sorority/fraternity (relative to those who did not plan to; AOR = 2.15, 95% CI: 1.59-2.90), current smokers (relative to nonsmokers; AOR = 24.39, 95% CI: 7.52-76.92), current marijuana users (compared with nonusers of marijuana; AOR = 6.45, 95% CI: 3.92-10.64) and alcohol users (compared with nondrinkers; AOR = 7.81, 95% CI: 5.75-10.54).Conclusion: Prevention and treatment efforts are needed for emerging adults transitioning to college.
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Affiliation(s)
- Melinda Ickes
- Tobacco Policy, BREATHE, Kinesiology and Health Promotion, University of Kentucky, Lexington, KY, USA
| | - Jakob W Hester
- University of Kentucky Health and Wellness, Lexington, KY, USA
| | - Amanda T Wiggins
- Data Management & Outcomes, BREATHE, College of Nursing, University of Kentucky, Lexington, KY, USA
| | - Mary Kay Rayens
- BREATHE, College of Nursing, University of Kentucky, Lexington, KY, USA
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14
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Adzrago D, Sulley S, Mamudu L, Ormiston CK, Williams F. The Influence of COVID-19 Pandemic on the Frequent Use of E-Cigarettes and Its Association with Substance Use and Mental Health Symptoms. Behav Sci (Basel) 2022; 12:453. [PMID: 36421749 PMCID: PMC9687156 DOI: 10.3390/bs12110453] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 10/27/2022] [Accepted: 11/12/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Although several studies examined the association between e-cigarettes, substance use, and mental health conditions, there is limited research on whether COVID-19-related stress and health outcomes, mental health symptoms, and substance use differ by the frequency of e-cigarette use during the COVID-19 pandemic. We assessed the association of past 30-day frequent use of e-cigarettes with alcohol, cannabis, anxiety/depression, and COVID-19 impact. METHODS We conducted a national online cross-sectional survey among a random sample of US adults aged 18 years or older (N = 5065) between 13 May 2021, and 9 January 2022. A multinomial logistic regression analysis was performed to assess the study aims. RESULTS Of the participants, 7.17% reported once to several times per month (OSTPM), 6.95% reported once to several times per week (OSTPW), and 6.57% reported every day to several times per day (ESTPD) use of e-cigarettes in the past month. Alcohol and cannabis use ESTPD and once to several times per week/month (OSTPW/M) were associated with a higher likelihood of e-cigarette use ESTPD and OSTPW/M, respectively. Anxiety/depression was associated with e-cigarette use ESTPD and OSTPW. Individuals who considered social distancing to be stressful were more likely to use e-cigarettes ESTPD and OSTPW/M compared to those that considered social distancing as not stressful. CONCLUSION Individuals who engaged in the frequent use of alcohol or cannabis, had depression/anxiety, and considered social distancing to be stressful were more likely to engage in frequent e-cigarette use. Improving efforts geared toward reducing the use of substances may help decrease the health risks associated with e-cigarette use.
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Affiliation(s)
- David Adzrago
- Center for Health Promotion and Prevention Research, The University of Texas School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA
| | - Saanie Sulley
- National Healthy Start Association, 1325 G Street, Washington, DC 20005, USA
| | - Lohuwa Mamudu
- Department of Public Health, California State University, Fullerton, 800 N. State College Boulevard, Fullerton, CA 92831, USA
| | - Cameron K. Ormiston
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, Two White Flint North, Rockville, MD 20852, USA
| | - Faustine Williams
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, Two White Flint North, Rockville, MD 20852, USA
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15
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Beckerley S, Fernandez P, Matter C, Wagner D, Tate B, Jordan J. This Free Life Campaign: Increasing Intention to Quit Among LGBTQ+ Young Adult Nondaily Smokers in Minneapolis. Tob Use Insights 2022; 15:1179173X221133978. [PMID: 36267538 PMCID: PMC9577091 DOI: 10.1177/1179173x221133978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 10/03/2022] [Indexed: 11/26/2022] Open
Abstract
PURPOSE LGBTQ+ young adults smoke at disproportionately higher rates than their non-LGBTQ+ counterparts, but prevention efforts are limited. Furthermore, prior to This Free Life (TFL), no known campaigns target LGBTQ+ nondaily smokers. In this study Blue Cross and Blue Shield of Minnesota evaluated a local partnership extension of the Food and Drug Administration (FDA) Center for Tobacco Products' TFL campaign. METHODS The intervention featured a variety of LGBTQ+-tailored events, social/digital media, and out-of-home media placed in locations with a high density of LGBTQ+ young adults. Cross-sectional surveys (n = 1215) were collected from LGBTQ+ young adult (18-26) nondaily smokers at 4 time points between 2016 and 2019. The national TFL campaign was tracked in a separate evaluation conducted by the FDA. RESULTS 43.0% of nondaily LGBTQ+ smokers reported awareness of the campaign (n = 522), and 63.4% of those also engaged with TFL (n = 330). Engagement was highest for gay, lesbian and transgender participants, and for Asian and Black/African American participants. Each additional instance of campaign engagement increased participants' odds of intending to quit smoking by 20% (AOR = 1.20; 95% CI = 1.05, 1.36). The relationship between campaign engagement and intention to quit was fully mediated by the campaign's impact on attitudes against smoking and perceived normative trends, but not by perceived behavioral control. CONCLUSION The local extension of TFL increased intentions to quit for LGBTQ+ nondaily smokers. Future research should further explore the relationship between perceived behavioral control and intentions to quit for nondaily smokers.
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Affiliation(s)
- Shiloh Beckerley
- Research,
Rescue
Agency, San Diego, CA, USA.
Center for Prevention, Blue Cross and Blue Shield of
Minnesota, Eagan, MN, USA.,Shiloh Beckerley, Research, Rescue Agency,
603 NW Morelock Ct., Bend, OR 97703, USA.
| | - Priscilla Fernandez
- Research,
Rescue
Agency, San Diego, CA, USA.
Center for Prevention, Blue Cross and Blue Shield of
Minnesota, Eagan, MN, USA
| | - Chris Matter
- Research,
Rescue
Agency, San Diego, CA, USA.
Center for Prevention, Blue Cross and Blue Shield of
Minnesota, Eagan, MN, USA
| | - Dana Wagner
- Research,
Rescue
Agency, San Diego, CA, USA.
Center for Prevention, Blue Cross and Blue Shield of
Minnesota, Eagan, MN, USA
| | - Brandon Tate
- Research,
Rescue
Agency, San Diego, CA, USA.
Center for Prevention, Blue Cross and Blue Shield of
Minnesota, Eagan, MN, USA
| | - Jeff Jordan
- Research,
Rescue
Agency, San Diego, CA, USA.
Center for Prevention, Blue Cross and Blue Shield of
Minnesota, Eagan, MN, USA
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16
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Schulz JA, West JC, Hall JP, Villanti AC. Disparities in Tobacco Use by Disability and Type: Findings From the 2019 National Health Interview Survey. Am J Prev Med 2022; 63:552-563. [PMID: 35753866 PMCID: PMC9509433 DOI: 10.1016/j.amepre.2022.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Revised: 04/04/2022] [Accepted: 05/04/2022] [Indexed: 11/01/2022]
Abstract
INTRODUCTION People with disabilities report a higher prevalence of cigarette use than people without disabilities. However, evidence is limited on the relationships between disability type, degree of functional difficulty, and other tobacco product use. METHODS Data from the 2019 U.S. National Health Interview Survey were used to estimate the prevalence and odds of tobacco product use for 6 disability types and degree of functional difficulty. Bivariate and multivariable analyses conducted in 2021 examined the associations between tobacco product use and disability type. RESULTS Compared to adults who reported no difficulty, current cigarette use prevalence was higher for adults who reported a lot of difficulty/cannot do at all to vision (21.5% vs 13.1%), hearing (19.6% vs 13.6%), mobility (20.0% vs 12.9%), and cognitive (25.4% vs 12.9%) disability questions. The odds of current cigarette (AOR=1.32), pipe (AOR=1.85), and smokeless tobacco (AOR=1.57) use were significantly higher for adults who reported a lot of difficulty/cannot do at all to any disability question and significantly higher for current cigarette (AOR=1.24), e-cigarette (AOR=1.33), pipe (AOR=1.45), and smokeless tobacco (AOR=1.29) use for adults who reported some difficulty to any disability question than those who reported no difficulty. Pipe use was correlated with mobility difficulty (AOR=1.68), and smokeless tobacco use was correlated with hearing difficulty (AOR=1.95). CONCLUSIONS People who reported difficulty with vision, hearing, mobility, or cognition had a higher cigarette use prevalence than people without disabilities. Other tobacco use differed by disability type. Future research should tailor tobacco interventions to reduce these disparities.
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Affiliation(s)
- Jonathan A Schulz
- Vermont Center on Behavior and Health, Larner College of Medicine, The University of Vermont, Burlington, Vermont.
| | - Julia C West
- Vermont Center on Behavior and Health, Larner College of Medicine, The University of Vermont, Burlington, Vermont; Department of Psychological Science, The University of Vermont, Burlington, Vermont
| | - Jean P Hall
- Institute for Health and Disability Policy Studies, The University of Kansas, Lawrence, Kansas
| | - Andrea C Villanti
- Vermont Center on Behavior and Health, Larner College of Medicine, The University of Vermont, Burlington, Vermont; Department of Psychological Science, The University of Vermont, Burlington, Vermont; Rutgers Center for Tobacco Studies, New Brunswick, New Jersey
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17
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Griffin KW, Lindley LL, Cooper Russell E, Mudd T, Williams C, Botvin GJ. Sexual Violence and Substance Use among First-Year University Women: Differences by Sexual Minority Status. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10100. [PMID: 36011735 PMCID: PMC9407960 DOI: 10.3390/ijerph191610100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 08/11/2022] [Accepted: 08/13/2022] [Indexed: 06/15/2023]
Abstract
Sexual violence and substance use are important public health problems among university students. The present study examined rates of sexual violence victimization, perpetration, and substance use among first-year university women. Participants (n = 974) attending 14 universities across the United States completed an online confidential survey at the beginning and again later in their first year. The sample included women who identified as heterosexual, bisexual, lesbian, and asexual or questioning. The mean age was 19.1 years and 71.4% were White. Rates of victimization involving sexual harassment and sexual acts without consent were higher among sexual minority women relative to heterosexual women, with bisexual women being most likely to report these outcomes. Compared to heterosexual women, sexual minority women reported more frequent cigarette smoking, marijuana use and intoxication, use of club drugs, and overall illicit drug use. Across sexual violence and substance use outcomes, bisexual women reported the highest rates. Sexual minority women reported more accurate beliefs about sexual violence and consent relative to heterosexual women. Over the course of the first year, bisexual women and those who used illicit substances were more likely to report new incidents of sexual violence victimization. Implications for prevention of sexual violence among women, including sexual minorities, are discussed.
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Affiliation(s)
- Kenneth W. Griffin
- Department of Global and Community Health, George Mason University, Fairfax, VA 22030, USA
| | - Lisa L. Lindley
- Department of Global and Community Health, George Mason University, Fairfax, VA 22030, USA
| | - Elaine Cooper Russell
- Department of Global and Community Health, George Mason University, Fairfax, VA 22030, USA
| | - Tori Mudd
- Department of Global and Community Health, George Mason University, Fairfax, VA 22030, USA
| | - Christopher Williams
- National Health Promotion Associates, White Plains, NY 10604, USA
- Department of Psychology, Purchase College, State University of New York, Purchase, NY 10577, USA
| | - Gilbert J. Botvin
- National Health Promotion Associates, White Plains, NY 10604, USA
- Department of Population Health Sciences, Weill Cornell Medical College, New York, NY 10065, USA
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18
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Romm KF, Wang Y, Duan Z, Bennett B, Fuss C, Ma Y, Blank MD, Bray BC, Ahluwalia JS, Berg CJ. Psychosocial predictors of longitudinal changes in tobacco and cannabis use among young adults. Addict Behav 2022; 129:107264. [PMID: 35134629 PMCID: PMC9021279 DOI: 10.1016/j.addbeh.2022.107264] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Revised: 01/01/2022] [Accepted: 01/28/2022] [Indexed: 01/22/2023]
Abstract
INTRODUCTION In recent years, cigarette use has decreased, but alternative tobacco product and cannabis use has increased in young adults. Thus, research regarding intraindividual changes in tobacco product and cannabis use in this population, and related psychosocial predictors, is warranted. METHODS We analyzed data from 3,006 young adults (Mage = 24.56 [SD = 4.72], 54.8% female, 31.6% sexual minority, 60.2% racial/ethnic minority) in a 2-year, 5-wave longitudinal study (2018-2020). Latent growth modeling analyzed the outcomes of past 6-month use of cigarettes, e-cigarettes, traditional cigars, little cigars/cigarillos, smokeless tobacco (SLT), hookah, and cannabis across Waves 1-5 among all participants; psychosocial predictors included depressive symptoms, adverse childhood experiences (ACEs), and personality traits. RESULTS Results indicated decreases in likelihood of using each tobacco product over time, but no significant change in likelihood of cannabis use. Psychosocial predictors of baseline use across products included depressive symptoms and extraversion, as well as ACEs and openness for nearly all products (e.g., except traditional cigars). Psychosocial predictors of less decreases in use likelihood over time included: for cigarettes and traditional cigars, ACEs; for e-cigarettes, extraversion; for little cigars/cigarillos, depressive symptoms and extraversion; for SLT, openness; and for hookah, neuroticism (controlling for sociodemographics). Predictors of greater decreases in likelihood of use over time included: for e-cigarettes and hookah, conscientiousness; and for cannabis, agreeableness. CONCLUSIONS Interventions to reduce young adults' use might target distinct risk/protective factors for using different products (and combinations). Moreover, results regarding decreasing likelihood of using tobacco products but not cannabis over time warrant replication and explanation in other samples.
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Affiliation(s)
- Katelyn F Romm
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC 20052, USA; George Washington Cancer Center, George Washington University, Washington, DC 20052, USA.
| | - Yan Wang
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC 20052, USA
| | - Zongshuan Duan
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC 20052, USA
| | - Breesa Bennett
- Department of Epidemiology, Milken Institute School of Public Helath, George Washington University, Washington, DC 20052, USA
| | - Caroline Fuss
- Department of Global Health, Milken Institute School of Public Health, George Washington University, Washington, DC 20052, USA
| | - Yan Ma
- Department of Biostatistics and Bioinformatics, Milken Institute School of Public Health, George Washington University, Washington, DC 20052, USA
| | - Melissa D Blank
- Department of Psychology, West Virginia University, Morgantown WV 26506, USA
| | - Bethany C Bray
- Institute for Health Research and Policy, The Univeristy of Illinois Chicago, Chicago IL 60607, USA
| | - Jasjit S Ahluwalia
- Department of Behavioral and Social Sciences, Brown University School of Public Health, and Brown University Cancer Center, Providence RI 02912, USA
| | - Carla J Berg
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC 20052, USA; George Washington Cancer Center, George Washington University, Washington, DC 20052, USA
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19
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Romm KF, Huebner DM, Pratt-Chapman ML, Rodriguez-Diaz CE, Wang Y, Ma Y, Berg CJ. Disparities in traditional and alternative tobacco product use across sexual orientation groups of young adult men and women in the US. Subst Abuse 2022; 43:815-824. [DOI: 10.1080/08897077.2021.2010259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Katelyn F Romm
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - David M. Huebner
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | | | - Carlos E. Rodriguez-Diaz
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Yan Wang
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Yan Ma
- Department of Biostatistics and Bioinformatics, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Carla J. Berg
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
- George Washington Cancer Center, George Washington University, Washington, DC, USA
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20
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Patterson JG, Keller-Hamilton B, Wedel AV, Wagener TL, Stevens EM. Responses to e-cigarette health messages among young adult sexual minoritized women and nonbinary people assigned female at birth: Assessing the influence of message theme and format. Drug Alcohol Depend 2022; 231:109249. [PMID: 35030509 PMCID: PMC8815305 DOI: 10.1016/j.drugalcdep.2021.109249] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 12/06/2021] [Accepted: 12/08/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND Young adult sexual minority women (YSMW) report disproportionate e-cigarette (EC) use and low EC harm perceptions. Health messages that effectively communicate EC harms to YSMW are needed. We tested the effect of culturally targeted EC health messages with varying themes and image formats on attitudes and intentions to use ECs in this population. METHODS N = 501 YSMW and nonbinary people assigned female at birth (AFAB) aged 18-30 years-old completed an online experiment. Participants were randomized into a control or one of nine experimental conditions in a 3 (theme: harms, wellness, pride) by 3 (image format: individual, couple, cartoon) study design. We modeled associations between message condition and message effectiveness, discouragement from vaping, change in feelings toward vaping, perceived threat, and intentions to abstain from vaping. RESULTS Among YSMW and nonbinary people AFAB, harm and wellness themes discouraged vaping more than pride-themed messages (p's < 0.001). Harms messages resulted in worse feelings about vaping than wellness and pride messages (p's < 0.02). Images of couples were perceived as more effective than cartoon images (p = .008). Among current EC users, viewing images of individuals resulted in greater readiness to avoid ECs and higher intentions to abstain than the couple or cartoon conditions (p's < 0.001). CONCLUSIONS Message theme and image format were associated with YSMW and nonbinary people AFAB's EC attitudes and behavioral intentions. Future studies should evaluate how to optimize harms messages; including if wellness or pride messages can be re-framed to better affect EC use in this population.
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Affiliation(s)
- Joanne G Patterson
- The Ohio State University College of Public Health, Division of Epidemiology, Columbus, OH, USA; The Ohio State University Comprehensive Cancer Center, The Ohio State University, Columbus, OH, USA.
| | - Brittney Keller-Hamilton
- Division of Medical Oncology, Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, OH, USA; Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA
| | - Amelia V Wedel
- Department of Psychology, Syracuse University, Syracuse, NY, USA
| | - Theodore L Wagener
- Division of Medical Oncology, Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, OH, USA; Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA
| | - Elise M Stevens
- Division of Preventive and Behavioral Medicine, Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA, USA
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21
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Gordon AR, Fish JN, Kiekens WJ, Lightfoot M, Frost DM, Russell ST. Cigarette Smoking and Minority Stress Across Age Cohorts in a National Sample of Sexual Minorities: Results From the Generations Study. Ann Behav Med 2021; 55:530-542. [PMID: 32970788 DOI: 10.1093/abm/kaaa079] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Sexual minority populations in the United States have persistently higher rates of cigarette use than heterosexuals, partially driven by exposure to minority stressors (e.g., discrimination and victimization). Little is known about cigarette use across cohorts of sexual minority adults who came of age in distinctly different sociopolitical environments. PURPOSE To examine cigarette use and minority stressors across three age cohorts of U.S. sexual minority adults. METHODS We used data from the Generations Study, a nationally representative sample (N = 1,500) of White, Black, and Latino/a sexual minority adults in three age cohorts (younger: 18-25 years; middle: 34-41 years; and older: 52-59 years). Survey data were collected from March 2016 to March 2017. We used sex-stratified logistic regression models to estimate adjusted odds ratios (aORs) and 95% confidence intervals (CIs) for associations between age cohort, minority stressors (discrimination and victimization), and two indicators of cigarette smoking (lifetime use and current use). RESULTS Prevalence of current cigarette use in each age cohort was high (younger: 20%; middle: 33%; and older: 29%). Relative to the younger cohort, men and women in the middle- and older-age cohorts had significantly higher odds of lifetime and current smoking (e.g., men, current, aOR [95% CI]: middle = 2.47 [1.34, 4.52], older = 2.85 [1.66, 4.93]). Minority stressors were independently associated with higher odds of current smoking; when victimization was included, the magnitude of the association between age cohort and current smoking was diminished but remained significant. CONCLUSIONS Smoking cessation interventions must consider the role of minority stress and the unique needs of sexual minority people across the life course.
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Affiliation(s)
- Allegra R Gordon
- Department of Community Health Sciences, Boston University School of Public Health, Boston, MA, USA.,Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, MA, USA
| | - Jessica N Fish
- Department of Family Science, School of Public Health, University of Maryland, College Park, MD, USA
| | - Wouter J Kiekens
- Department of Sociology/Interuniversity Center for Social Science Theory and Methodology (ICS), University of Groningen, Groningen, The Netherlands
| | - Marguerita Lightfoot
- Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - David M Frost
- Department of Social Science, University College London, London, UK
| | - Stephen T Russell
- Department of Human Development and Family Sciences, University of Texas at Austin, Austin, TX, USA
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22
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Liautaud MM, Barrington-Trimis JL, Liu F, Stokes A, Krueger EA, McConnell R, Pang RD. E-cigarette, cigarette, and cannabis use patterns as a function of sexual identity in a sample of Southern California young adults. Addict Behav Rep 2021; 13:100338. [PMID: 33644294 PMCID: PMC7889792 DOI: 10.1016/j.abrep.2021.100338] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 01/06/2021] [Accepted: 01/10/2021] [Indexed: 01/02/2023] Open
Abstract
PURPOSE Sexual minority young adults report greater cigarette and cannabis use. Emerging evidence suggests this trend may extend to e-cigarettes. The current study evaluated the relationship between sexual identity and prevalence of e-cigarette, cigarette, and cannabis use and whether such associations differ by gender. METHODS Cross-sectional, regionally representative data of young adults (M[SD]age = 20.02 [0.60] years; n heterosexual = 1314; n bisexual = 77; n lesbian/gay = 28) from Wave III (2016) of the Southern California Children's Health Study were analyzed in 2019. Logistic regression analyses were conducted with sexual identity as the predictor and product use (never, prior, infrequent past 30-day [1-2 days], frequent past 30-day [3-5+ days]) as the outcome in separate models by substance (e-cigarettes, cigarettes, cannabis). RESULTS Bisexual individuals were the highest-risk sub-group for nearly all outcomes, with over five times the odds of reporting frequent past 30-day use for e-cigarettes (Odds Ratio [OR]: 6.68; 95% Confidence Interval [CI]: 2.80, 15.9), cigarettes (OR: 5.42; 95% CI: 2.37, 12.4), and cannabis (OR: 8.43; 95% CI: 4.40, 16.1) compared to heterosexual individuals. Although the sample size for lesbian/gay participants was small, bisexual (vs. lesbian/gay) participants also had greater odds of reporting prior use of nicotine products and frequent past 30-day cannabis use. A significant sexual identity × gender interaction emerged for lifetime cigarette use, wherein bisexual (vs. heterosexual) identity was only associated with greater odds of use for females (p < .01). CONCLUSIONS Sexual minority-related disparities in substance use among young adults appear to generalize to e-cigarettes, with bisexual young adults exhibiting especially high profiles of risk.
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Affiliation(s)
- Madalyn M. Liautaud
- Health Psychology and Clinical Sciences Doctoral Program, The Graduate Center of the City University of New York, 365 5th Ave, New York, NY 10016, USA
| | - Jessica L. Barrington-Trimis
- Department of Preventive Medicine, University of Southern California Keck School of Medicine, 2001 N. Soto Street, Los Angeles, CA 90032, USA
| | - Feifei Liu
- Department of Preventive Medicine, University of Southern California Keck School of Medicine, 2001 N. Soto Street, Los Angeles, CA 90032, USA
| | - Andrew Stokes
- Department of Global Health, Boston University, 801 Massachusetts Ave Crosstown Center, Boston, MA 02118, USA
| | - Evan A. Krueger
- Department of Preventive Medicine, University of Southern California Keck School of Medicine, 2001 N. Soto Street, Los Angeles, CA 90032, USA
| | - Rob McConnell
- Department of Preventive Medicine, University of Southern California Keck School of Medicine, 2001 N. Soto Street, Los Angeles, CA 90032, USA
| | - Raina D. Pang
- Department of Preventive Medicine, University of Southern California Keck School of Medicine, 2001 N. Soto Street, Los Angeles, CA 90032, USA
- Department of Psychology, University of Southern California, 3620 South McClintock Ave, Los Angeles, CA 90089, USA
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23
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Lins-Filho PC, Carvalho FMTD, Freitas JLDM, Ferreira AKA, Melo MCFD, Godoy GP, Caldas Jr ADF. Drug use pattern among non-heterosexual and transgender people detained in a female prison complex. JOURNAL OF SUBSTANCE USE 2021. [DOI: 10.1080/14659891.2021.1916850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
| | | | | | | | | | - Gustavo Pina Godoy
- Post Graduation Programme in Dentistry, Federal University of Pernambuco, Recife, Brazil
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24
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Garcia LC, Vogel EA, Prochaska JJ. Tobacco product use and susceptibility to use among sexual minority and heterosexual adolescents. Prev Med 2021; 145:106384. [PMID: 33359018 PMCID: PMC7956117 DOI: 10.1016/j.ypmed.2020.106384] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Revised: 10/11/2020] [Accepted: 12/21/2020] [Indexed: 11/28/2022]
Abstract
Sexual identity is associated with tobacco use in adults. We examined tobacco use and susceptibility to use by sexual identity in adolescents. Data were collected in February 2019 via Qualtrics research participant panels. Data analyses were performed in June 2019 and updated in October 2020. Respondents aged 13-17 reported sexual identity (heterosexual vs. sexual minority [lesbian, gay, bisexual, or other]), past-month and lifetime tobacco product use, susceptibility to e-cigarette use, friend(s)' e-cigarette use, tobacco marketing exposure, and demographic characteristics. The sample (n=983) was 72.9% female, 46.5% non-Hispanic white, and 26.1% sexual minority with a mean age of 15.0 years (SD=1.4). Sexual minority adolescents were more likely to have friend(s) who vape (53.0% versus 42.0%; p=0.003). In adjusted models, sexual minority adolescents had greater odds of ever smoking tobacco (odds ratio [OR]=2.06; 95% confidence interval [CI]: 1.42-2.98) or using e-cigarettes (OR=1.55; 95% CI: 1.08-2.25) relative to heterosexual adolescents. Past-month tobacco smoking and e-cigarette use did not differ by sexual identity. Among participants who had never used tobacco products, sexual minority adolescents reported greater susceptibility to e-cigarette use (OR=1.62; 95% CI: 1.04-2.52) compared to heterosexual adolescents. Exposure to cigarette and e-cigarette marketing, e-cigarette use by friends, and respondent sex were significant covariates in all models. The current findings indicate greater susceptibility to use e-cigarettes and greater tobacco product initiation, but not continuation, among sexual minority adolescents. Sexual minority-tailored interventions may be warranted to prevent tobacco product initiation. Worth exploring are the associations between sexual identity, tobacco marketing exposure, and friend(s)' e-cigarette use.
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Affiliation(s)
| | - Erin A Vogel
- Stanford Prevention Research Center, Department of Medicine, Stanford University, USA
| | - Judith J Prochaska
- Stanford Prevention Research Center, Department of Medicine, Stanford University, USA.
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25
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Singer S, Tkachenko E, Yeung H, Mostaghimi A. Skin cancer and skin cancer risk behaviors among sexual and gender minority populations: A systematic review. J Am Acad Dermatol 2020; 83:511-522. [PMID: 32068044 PMCID: PMC7369213 DOI: 10.1016/j.jaad.2020.02.013] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Revised: 02/01/2020] [Accepted: 02/05/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND Individuals of sexual and gender minorities may have different lifetime risk of skin cancer and ultraviolet radiation exposure than heterosexual persons. OBJECTIVE To systematically review the prevalence of skin cancer and behaviors that increase risk of skin cancer among sexual and gender minority populations. METHODS We performed a systematic literature review in PubMed/MEDLINE, Embase, Cochrane, and Web of Science, searching for articles through October 18, 2019, that investigated risk of skin cancer and behaviors among sexual and gender minority populations. RESULTS Sexual minority men have a higher lifetime risk of any skin cancer (odds ratio range: 1.3-2.1) and indoor tanning bed use (odds ratio range: 2.8-5.9) compared with heterosexual men, whereas sexual minority women may use indoor tanning beds less frequently than heterosexual women and do not have an elevated risk of lifetime history of skin cancer. Gender-nonconforming individuals have higher lifetime prevalence of any skin cancer compared with cisgender men. LIMITATIONS Most variables rely on self-reporting in their original studies. CONCLUSIONS Sexual minority men disproportionately engage in use of indoor tanning beds, which may result in increased lifetime risk of skin cancer. Recognition of this risk is important for providing appropriate screening for patients in this population.
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Affiliation(s)
- Sean Singer
- Harvard Medical School, Boston, Massachusetts; Department of Dermatology, Brigham and Women's Hospital, Boston, Massachusetts
| | - Elizabeth Tkachenko
- Department of Dermatology, Brigham and Women's Hospital, Boston, Massachusetts; University of Massachusetts Medical School, Worcester, Massachusetts
| | - Howa Yeung
- Department of Dermatology, Emory University School of Medicine, Atlanta, Georgia
| | - Arash Mostaghimi
- Department of Dermatology, Brigham and Women's Hospital, Boston, Massachusetts.
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26
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Sharareh P, Leili T, Abbas M, Jalal P, Ali G. Determining correlates of the average number of cigarette smoking among college students using count regression models. Sci Rep 2020; 10:8874. [PMID: 32483160 PMCID: PMC7264191 DOI: 10.1038/s41598-020-65813-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Accepted: 04/27/2020] [Indexed: 11/18/2022] Open
Abstract
College students, as a large part of young adults, are a vulnerable group to several risky behaviors including smoking and drug abuse. This study aimed to utilize and to compare count regression models to identify correlates of cigarette smoking among college students. This was a cross-sectional study conducted on students of Hamadan University of Medical Sciences. The Poisson, negative binomial, generalized Poisson, exponentiated-exponential geometric regression models and their zero-inflated counterparts were fitted and compared using the Vuong test (α = 0.05). A number of 1258 students participated in this study. The majority of students were female (60.8%) and their average age was 23 years. Most of the students were non-smokers (84.6%). Negative binomial regression was selected as the most appropriate model for analyzing the data (comparable fit and simpler interpretation). The significant correlates of the number of cigarettes smoked per day included gender (male: incident-rate-ratio (IRR = 9.21), birth order (Forth: IRR = 1.99), experiencing a break-up (IRR = 2.11), extramarital sex (heterosexual (IRR = 2.59), homosexual (IRR = 3.13) vs. none), and drug abuse (IRR = 5.99). Our findings revealed that several high-risk behaviors were associated with the intensity of smoking, suggesting that these behaviors should be considered in smoking cessation intervention programs for college students.
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Affiliation(s)
- Parami Sharareh
- Department of Biostatistics, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Tapak Leili
- Department of Biostatistics, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran.
- Modeling of Noncommunicable Diseases Research Center, Hamadan University of Medical Sciences, Hamadan, Iran.
| | - Moghimbeigi Abbas
- Department of Biostatistics, School of Public health, Alborz University of Medical Sciences, Alborz, Iran
| | - Poorolajal Jalal
- Department of Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
- Research Center for Health Sciences, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Ghaleiha Ali
- Department of Psychiatry, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
- Behavioral Disorders and Substance Abuse Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
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27
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Ridner SL, Ma JZ, Walker KL, Vu THT, Groom A, Landry RL, Kesh A, Robertson RM, Payne TJ, Giachello AL, Wood LA, Hart JL. Cigarette smoking, ENDS use and dual use among a national sample of lesbians, gays and bisexuals. Tob Prev Cessat 2020; 5:51. [PMID: 32411913 PMCID: PMC7205075 DOI: 10.18332/tpc/114229] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Revised: 10/28/2019] [Accepted: 11/14/2019] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Historically, lesbian, gay and bisexual (LGB) individuals have higher rates of cigarette smoking, often attributed to targeted tobacco advertising, exposure to stressors, and psychological distress. Elevated use of electronic nicotine delivery systems (ENDS) among LGB individuals has been documented recently. However, the LGB groups are not homogeneous and differences may exist between the use of tobacco by men and women within the LGB groups. The purpose of this research was to examine cigarette smoking, ENDS use and dual use (cigarettes plus ENDS) among LGB subgroups. METHODS We classified 2087 participants completing a national online survey based on tobacco-use status (i.e. cigarette only, ENDS only, dual use) and sexual orientation. Multinomial logistic regression was employed to assess group differences. RESULTS After adjusting for demographics and socioeconomic status, bisexual women were 1.85 times (95% CI: 1.19–2.87) more likely to report current dual use, in contrast to cigarette only use, compared to heterosexual women. No significant differences were found between lesbian and heterosexual women, or between gay or bisexual men and their heterosexual counterparts. CONCLUSIONS This study describes significantly greater dual use by bisexual women and is one of the first reports of elevated dual use in this group compared to heterosexual women. These findings suggest that targeted health messages may be needed to raise awareness of risk in specific LGB groups and that future research with these populations is necessary to better understand differences in tobacco perceptions and use.
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Affiliation(s)
| | - Jennie Z Ma
- University of Virginia, Charlottesville, United States.,American Heart Association Tobacco Regulation and Addiction Center (A-TRAC), Dallas, United States
| | - Kandi L Walker
- American Heart Association Tobacco Regulation and Addiction Center (A-TRAC), Dallas, United States.,University of Louisville, Louisville, United States
| | - Thanh-Huyen T Vu
- American Heart Association Tobacco Regulation and Addiction Center (A-TRAC), Dallas, United States.,Northwestern University, Evanston, United States
| | - Allison Groom
- American Heart Association Tobacco Regulation and Addiction Center (A-TRAC), Dallas, United States
| | - Robyn L Landry
- American Heart Association Tobacco Regulation and Addiction Center (A-TRAC), Dallas, United States
| | - Anshula Kesh
- American Heart Association Tobacco Regulation and Addiction Center (A-TRAC), Dallas, United States
| | - Rose Marie Robertson
- American Heart Association Tobacco Regulation and Addiction Center (A-TRAC), Dallas, United States
| | - Thomas J Payne
- American Heart Association Tobacco Regulation and Addiction Center (A-TRAC), Dallas, United States.,University of Mississippi, Jackson, United States
| | - Aida L Giachello
- American Heart Association Tobacco Regulation and Addiction Center (A-TRAC), Dallas, United States.,Northwestern University, Evanston, United States
| | | | - Joy L Hart
- American Heart Association Tobacco Regulation and Addiction Center (A-TRAC), Dallas, United States.,University of Louisville, Louisville, United States
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28
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Qasim H, Alarabi AB, Alzoubi KH, Karim ZA, Alshbool FZ, Khasawneh FT. The effects of hookah/waterpipe smoking on general health and the cardiovascular system. Environ Health Prev Med 2019; 24:58. [PMID: 31521105 PMCID: PMC6745078 DOI: 10.1186/s12199-019-0811-y] [Citation(s) in RCA: 60] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Accepted: 08/22/2019] [Indexed: 12/13/2022] Open
Abstract
Hookah or waterpipe smoking or use is an emerging trend in the US population, especially among the youth. The misperception of hookah being less harmful than cigarettes and the availability of different but "appealing" flavors are considered among the main reasons for this trend. Hookah users however are exposed to many of the same toxic compounds/by-products as cigarette users, but at dramatically higher levels, which might lead to more severe negative health effects. In fact, hookah users are at risks of infections, cancers, lung disease, and other medical conditions. Moreover, because of the overlapping toxicant/chemical profile to conventional cigarettes, hookah smoke effects on the cardiovascular system are thought to be comparable to those of conventional cigarettes. A major source of tobacco addiction is nicotine, whose levels in hookah are extremely variable as they depend on the type of tobacco used. Taken together, in this review of literature, we will provide insights on the negative health effects of hookah in general, with a focus on what is known regarding its impact on the cardiovascular system.
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Affiliation(s)
- Hanan Qasim
- Department of Pharmaceutical Sciences, School of Pharmacy, The University of Texas at El Paso, El Paso, Texas, 79902, USA
| | - Ahmed B Alarabi
- Department of Pharmaceutical Sciences, School of Pharmacy, The University of Texas at El Paso, El Paso, Texas, 79902, USA
| | - Karem H Alzoubi
- Department of Clinical Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Zubair A Karim
- Department of Pharmaceutical Sciences, School of Pharmacy, The University of Texas at El Paso, El Paso, Texas, 79902, USA
| | - Fatima Z Alshbool
- Department of Pharmaceutical Sciences, School of Pharmacy, The University of Texas at El Paso, El Paso, Texas, 79902, USA.
| | - Fadi T Khasawneh
- Department of Pharmaceutical Sciences, School of Pharmacy, The University of Texas at El Paso, El Paso, Texas, 79902, USA.
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29
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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: 50] [Impact Index Per Article: 10.0] [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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30
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McQuoid J, Thrul J, Ozer E, Ramo D, Ling PM. Tobacco use in the sexual borderlands: The smoking contexts and practices of bisexual young adults. Health Place 2019; 58:102069. [PMID: 30639203 PMCID: PMC6620170 DOI: 10.1016/j.healthplace.2018.12.010] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Revised: 12/17/2018] [Accepted: 12/18/2018] [Indexed: 11/29/2022]
Abstract
Little is known about why bisexual people use tobacco at higher rates than any other sexual identity group. Non-binary sexualities, such as bisexuality, exist within the socially constructed borderland between homosexuality and heterosexuality. Exploration of the everyday smoking contexts and practices of bisexual individuals may reveal unique mechanisms driving tobacco use. We employed a novel mixed method, integrating real-time, smartphone-administered surveys of (non)smoking situations, location tracking, spatial visualization of participant data, and subsequent map-led interviews. Participants (n = 17; ages 18-26, California) identified as bisexual, pansexual, and/or queer. Most were cisgender women. Survey smoking patterns and situational predictors were similar to other young adults'. However, interviews revealed unique roles of tobacco use in participants' navigation of differently sexualized spaces in everyday life: 1) stepping away from uncomfortable situations related to bisexual identity; 2) facilitating belonging to LGBTQ+ community; and 3) recovering from bisexual identity perception management. Similar studies can examine the place-embedded practices and spatio-temporal patterns of other substance use and other stigmatized identity experiences.
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Affiliation(s)
- Julia McQuoid
- Center for Tobacco Control Research and Education, University of California, San Francisco, 530 Parnassus Ave, Suite 366, San Francisco, CA 94143, United States.
| | - Johannes Thrul
- Department of Mental Health, Johns Hopkin s University, 624 N. Broadway, Baltimore, MD 21205, United States.
| | - Emily Ozer
- School of Public Health, University of California, Berkeley, 529 University Hall, Berkeley, CA 94720, United States.
| | - Danielle Ramo
- Department of Psychiatry and Weill Institute for Neurosciences, University of California, San Francisco, 401 Parnassus Ave, San Francisco, CA 94143, United States.
| | - Pamela M Ling
- Center for Tobacco Control Research and Education, University of California, San Francisco, 530 Parnassus Ave, Suite 366, San Francisco, CA 94143, United States.
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