Cigarette smoking, ENDS use and dual use among a national sample of lesbians, gays and bisexuals

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. AFFILIATION

Associations between tobacco use patterns and demographic characteristics of sexual minority and heterosexual youth: Results from a nationwide online survey

“…Previous studies have found higher tobacco use rates in youth who identify as bisexual 8,14 , including increased risk in adolescent bisexual girls 7,12,14 and lesbians 7,12 , pointing to increased risk for usage and ultimately adverse health outcomes for sexual minority girls 15 . Although studies with youth sexual minority subpopulations are few, research with adults has reported that lesbians and bisexual women have greater odds of tobacco use 16 , including dual use 17 , with some research suggesting that bisexual women are particularly at risk 18,19 . However, this study is one of the first to report significantly greater odds of dual/poly tobacco use by female sexual minority youth.…”

Associations of race and ethnicity with tobacco messaging exposures and tobacco use among bisexual and pansexual women

“…Lesbian and bisexual women (LBW) have a higher prevalence of tobacco use than heterosexual women ( Li et al, 2021 , Wheldon et al, 2018 , Ridner et al, 2019 ) (e.g., 37.7% for bisexual, 31.7% for lesbian, and 16.6% for heterosexual women ( Li et al, 2021 )). One reason for tobacco use inequities is targeted marketing of tobacco products to the lesbian, gay, bisexual, and transgender (LGBT) community ( Emory et al, 2019 , Tan et al, 2021 , Dilley et al, 2008 ).…”

“…LBW are not a monolith, and disparities in tobacco use and advertisement exposures exist within this group. Bisexual women, in particular, have the highest prevalence of tobacco use among all women ( Li et al, 2021 , Ridner et al, 2019 , Johnson et al, 2016 , McCabe et al, 2018 , Emory et al, 2016 ), and they report greater exposure to tobacco advertisements than lesbian (and heterosexual) women ( Tan et al, 2021 ). Additionally, the distribution of tobacco use according to race and ethnicity differs for LBW vs. heterosexual women.…”