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

• Authors: Jingjing Li, Emory University; Regine Haardorfer, Emory University; Milkie Vu, Emory University; Michael Windle, Emory University; Carla Berg, Emory University
• Journal Title: BMC Public Health
• Volume: Volume 18, Number 1
• Publisher: BMC (part of Springer Nature) | 2018-11-08, Pages 1244-1244
• Type of Work: Article | Final Publisher PDF
• Publisher DOI: http://doi.org/10.1186/s12889-018-6150-x
• Subjects: Health Sciences, Public Health; Psychology, Behavioral
• Keywords: Science & Technology; Life Sciences & Biomedicine; Public, Environmental & Occupational Health; Tobacco use; Alternative tobacco product; Sexual orientation; Sex differences; Young adults; College students; Multivariate multiple regression; MINORITY STRESS; UNITED-STATES; CIGARETTE-SMOKING; SUBSTANCE USE; PRODUCT USE; TRANSGENDER COMMUNITY; BISEXUAL WOMEN; MENTAL-HEALTH; GAY; CESSATION

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.