Sex and sexual orientation in relation to tobacco use among young adult college students in the US: a cross-sectional study

• Type of Material: Article
• Authors: Jingjing Li, Emory University; Regine Haardorfer, Emory University; Milkie Vu, Emory University; Michael Windle, Emory University; Carla Berg, Emory University
• Language: English
• Date: 2018-11-08
• Publisher: BMC (part of Springer Nature)
• Publication Version: Final Published Version
• Copyright Statement: © 2018 The Author(s).
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1186/s12889-018-6150-x
• Title of Journal or Parent Work: BMC Public Health
• ISSN: 1471-2458
• Volume: 18
• Issue: 1
• Start Page: 1244
• End Page: 1244
• Grant/Funding Information: This research was supported by the National Cancer Institute (1R01CA179422–01; PI: Berg). The funders had no role in the study design, collection, analysis or interpretation of the data, writing the manuscript, or the decision to submit the paper for publication.
• Keywords: Public, Environmental & Occupational Health; GAY; PRODUCT USE; TRANSGENDER COMMUNITY; MENTAL-HEALTH; MINORITY STRESS; Young adults; CESSATION; Sexual orientation; Science & Technology; Sex differences; BISEXUAL WOMEN; SUBSTANCE USE; UNITED-STATES; Life Sciences & Biomedicine; Tobacco use; College students; CIGARETTE-SMOKING; Multivariate multiple regression; Alternative tobacco product
• Research Categories: Health Sciences, Public Health; Psychology, Behavioral

Abstract

Background: Sexual minority young adults represent a high-risk population for tobacco use. This study examined cigarette and alternative tobacco product (ATP) use prevalence across sexual orientation (heterosexual, gay/lesbian, and bisexual) among college-attending young adult men and women, respectively. Methods: Baseline data from a two-year longitudinal study of 3386 young adult college students aged 18-25 in Georgia were analyzed. Correlates examined included sociodemographics (age, sex, sexual orientation, race/ethnicity, college type, and parental education). Outcomes included past 30-day use of tobacco (cigarette, little cigars/cigarillos [LCCs], e-cigarettes, hookah, any tobacco product used, and number of tobacco products used, respectively). Two-group, multivariate multiple regression models were used to examine predictors of tobacco use among men and women, respectively. Results: Among men (N = 1207), 34.7% used any tobacco product; 18.6% cigarettes; 12.3% LCCs; 16.8% e-cigarettes; and 14.7% hookah. Controlling for sociodemographics, gay sexual orientation (OR = 1.62, p = 0.012) was associated with higher odds of cigarette use; no other significant associations were found between sexual orientation and tobacco use. Among women (N = 2179), 25.3% used any tobacco product; 10.4% cigarettes; 10.6% LCCs; 7.6% e-cigarettes; and 10.8% hookah. Being bisexual was associated with cigarette (p < 0.001), LCC (p < 0.001), and e-cigarette use (p = 0.006). Lesbian sexual orientation was associated with cigarette (p = 0.032) and LCC use (p < 0.001). Being bisexual predicted any tobacco product used (p = 0.002), as well as number of tobacco products used (p = 0.004). Group comparisons showed that the effect of sexual minority status on LCC use was significantly different for men versus women. Conclusion: Sexual minority women, especially bisexual women, are at higher risk for using specific tobacco products compared to heterosexual women; homosexual men are at increased risk of cigarette use compared to heterosexual men. These nuances in tobacco use should inform interventions targeting sexual minorities.