E-cigarette Use and Risk Behaviors among Lesbian, Gay, Bisexual, and Transgender Adults: The Behavioral Risk Factor Surveillance System (BRFSS) Survey

Abstract

Introduction: We studied prevalence of e-cigarette use among lesbian, gay, bisexual, and transgender (LGBT) individuals and its association with risk behaviors. Methods: Using data from the Behavioral Risk Factor Surveillance System (BRFSS) survey, we assessed self-reported sexual orientation, e-cigarette use, cigarettes, marijuana, smokeless tobacco, and high-risk behavior (using non-prescribed drugs, treatment for sexually transmitted disease, or receiving monetary or drug compensation in exchange for sex in the previous year). We used multivariable-adjusted logistic regression models to study the association between LGBT and risk behaviors. Results: Prevalence of e-cigarette use among LGBT adults was 13%, nearly twice that of heterosexual adults. LGBT were more likely [Odds Ratio (95% Confidence Interval)] to report current use of e-cigarettes 1.84 (1.64,2.06), cigarettes 1.61 (1.49,1.73), marijuana 2.37 (1.99,2.82), and high-risk behavior 3.69 (3.40,4.01) compared to heterosexual adults. Results for smokeless tobacco were not significant. Conclusion: There are disparities in e-cigarette and other risk behaviors among LGBT adults, which may increase risk of adverse health effects in this vulnerable population.

Disparities in chronic physical health conditions in sexual and gender minority people using the United States Behavioral Risk Factor Surveillance System

“…After the start of the COVID-19 pandemic, SGM respondents’ mental and physical health worsened, and was significantly worse than respondents in the non-SGM group, although this difference could also reflect other time-related changes beyond the pandemic. Current research shows that the SGM population has a higher rate of tobacco use, which has been proposed as contributing to this increased prevalence ( Hoffman et al, 2018 , Al Rifai et al, 2020 , Morgan et al, 2020 ). However, our study identified differences between SGM and non-SGM respondents that are not explained by tobacco use, suggesting other social determinants of health impact these disparities.…”

“…Proposed explanations for these disparities lie in social determinants of health: social stressors, health disparities, socioeconomic marginalization, stigma, and minority stress ( Alzahrani et al, 2019 , Downing and Przedworski, 2018 , Al Rifai et al, 2020 , Fredriksen-Goldsen et al, 2013 ). Few studies additionally considered health access (for an exception, see Trinh et al, 2017 ).…”

Complete Home Smoking Ban Survey Analysis: An Opportunity to Improve Health Equity Among Sexual Minority Adults in California, USA

“…Lesbian and gay adults had statistically significantly higher odds of being a current smoker and an everyday smoker than straight adults 10 . The prevalence of current e-cigarette use followed similar patterns 11 . Furthermore, sexual minority adults report a higher prevalence and higher severity of DSM-5 tobacco use disorder than straight adults 7 .…”

Complete home smoking ban survey analysis: an opportunity to improve health equity among sexual minority adults in California, USA

“…In 2014–2017 Behavioral Risk Factor Surveillance System, lesbian/gay and bisexual adults had significantly higher odds of reporting everyday smoking and current smoking (everyday or some days) compared to straight adults [ 12 ]. The prevalence of current e-cigarette use was most prevalent among US sexual minority adults [ 8 , 10 , 13 ]. Data from the 2016 Behavioral Risk Factor Surveillance System reported among data from 198,057 adults in 26 states that lesbian, gay, and bisexual adults were significantly more likely to ever and currently smoke cigarettes and e-cigarettes compared to straight adults [ 8 ].…”

“…Data from the 2016 Behavioral Risk Factor Surveillance System reported among data from 198,057 adults in 26 states that lesbian, gay, and bisexual adults were significantly more likely to ever and currently smoke cigarettes and e-cigarettes compared to straight adults [ 8 ]. Data from the US Behavioral Risk Factor Surveillance System in 2016, 2017, and 2018 ( n = 1,348,091) reported the prevalence of e-cigarette use among lesbian, gay, bisexual, or transgender (LGBT) adults was 13%, nearly twice that of straight adults (5%) [ 13 ]. In the Population Assessment of Tobacco and Health in 2013–2014, lesbian/gay and bisexual women had higher odds of regular use of cigarettes and e-cigarettes [ 10 ].…”