Sexual and gender minority cigarette smoking disparities: An analysis of 2016 Behavioral Risk Factor Surveillance System data

• Published in: Preventive medicine 2018-08, Vol.113, p.109-115
• Main Authors: Hoffman, Leah, Delahanty, Janine, Johnson, Sarah E., Zhao, Xiaoquan
• Format: Article
• Language: English
• Subjects: Public health; Sexual minorities; Smoking; Tobacco; Transgender individuals
• ISSN: 0091-7435; 1096-0260
• DOI: 10.1016/j.ypmed.2018.05.014

We examined the association between lesbian, gay, bisexual, and transgender (LGBT) identity, cigarette and e-cigarette use, and potential risk factors in the United States. Using data from 198,057 adults in 26 states in the 2016 Behavioral Risk Factor Surveillance System (BRFSS), we estimated the prevalence of cigarette use, e-cigarette use, and potential risk factors by gender identity and sexual identity. Overall and sex-stratified bivariate and multivariate logistic regressions examined whether the relationship between sexual and gender identity and cigarette and e-cigarette use persisted after adjusting for demographics, socio-economic status, and other unhealthy behaviors. After adjusting for covariates, gender minority identity was no longer associated with increased likelihood of currently smoking cigarettes and ever use of e-cigarettes. Sexual minority identity continued to be significant after adjusting for covariates, indicating that sexual identity disparities in cigarette and e-cigarette use are not fully explained by these factors. Findings varied by identity. Compared to their straight peers, likelihood of tobacco product use among LGB individuals varied between sexes, by product, and by sexual identity (gay/lesbian versus bisexual). More research is needed to understand the mechanisms that influence diverse patterns of cigarette and e-cigarette use among sexual and gender minority adults. •Cigarette and e-cigarette use varied significantly by sexual identity and sex.•Sexual minority adults are more likely to use cigarettes and e-cigarettes.•Sexual minority tobacco disparities remain after adjusting for other factors.•Transgender identity was associated with current cigarette and ever e-cigarette use.•After adjusting for covariates, transgender identity was no longer a factor.