High Prevalence of Smoking Among Urban-Dwelling Canadian Men Who Have Sex with Men

Abstract

A small but consistent literature from the United States suggests increased risk for smoking among lesbians and men who have sex with men (MSM). Few studies have investigated smoking among MSM in other countries where different social norms and restrictions on smoking in public apply. We measured smoking behaviours in a convenience sample of urban-dwelling young Canadian MSM (median age 28 years). We compared the prevalence of smoking among MSM with that among other men in British Columbia (BC) using National Population Health Survey data to compute an age-adjusted standardized prevalence ratio (SPR). Independent predictors of smoking among MSM were identified using adjusted odds ratios (OR) with 95% confidence intervals (CI). Smoking during the previous year was reported by twice as many MSM (54.5% of 354) as other men in BC (25.9%) (SPR=1.94, 95% CI 1.48-2.59), with largest differentials observed among men under 25 years of age. In multivariable analyses, smoking among MSM was significantly associated with younger age (OR 0.94, CI 0.88-1.00 per year), greater number of depressive symptoms (OR 1.12, CI 1.06-1.19 per symptom) and Canadian Aboriginal ethnicity (OR 2.64, CI 1.05-6.60). In summary, MSM in our study were twice as likely to smoke as other men in BC; the greatest differences were observed among the youngest men. The design of effective prevention and cessation programs for MSM will require identification of the age-dependent determinants of smoking initiation, persistence, and attempts to quit.

A systematic review of the aetiology of tobacco disparities for sexual minorities

“…Several studies found associations between demographic correlates of smoking that are similar to characteristics identified in the general population, including younger age30 64 65 and lower educational attainment 8 14 21 31 65–67. Other common correlates with smoking were alcohol use14 31 65 68 and depression/depressive symptoms 30 65 69.…”

“…These inequalities appear to exist internationally, albeit with limited research, with studies from around the world, including Australia,25 Mexico,26 Switzerland,27 Taiwan,28 Canada,29 30 and China 31. Some Irish32 and Canadian33 studies, however, show no evidence of an inequality in smoking prevalence, suggesting the need for confirmatory studies and additional efforts to identify the causes of health equality.…”

Prevalence and Correlates of Tobacco Use Among a Sample of MSM in Shanghai, China

“…Higher smoking prevalence was found among Chinese MSM (66%) versus MSM in North America (34%-55%; Greenwood et al, 2005;Lampinen et al, 2006) and versus the general urban male population in China (56%; S. Lee et al, 2009). The 10% higher rate among Chinese MSM versus non-MSM may reflect a ceiling effect since smoking rates among Chinese men are quite high.…”

“…High smoking rates have been documented among MSM in North America (Austin et al, 2004;D'Augelli, 2004;Greenwood et al, 2005;Lampinen, Bonner, Rusch, & Hogg, 2006;McKirnan, Tolou-Shams, Turner, Dyslin, & Hope, 2006;Tang et al, 2004), but extremely limited research has examined smoking among MSM in developing countries. Given that different cultural factors may influence smoking, research must examine prevalence and correlates of smoking among MSM more globally.…”

Utilization of Cessation Resources Among HIV-Positive and HIV-Negative Men Who Smoke and Who Have Sex With Men in Chengdu, China

“…Smoking prevalence in China is high (Yang, 2008); roughly, 56% of men and 6% of women are current smokers (Lee et al, 2009). Men who have sex with men (MSM) are at high risk for smoking (Greenwood et al, 2005;Lampinen, Bonner, Rusch, & Hogg, 2006;McKirnan, Tolou-Shams, Turner, Dyslin, & Hope, 2006;Tang et al, 2004), but limited research has examined smoking among MSM in developing countries. One study of MSM in Shanghai, China documented a 66% smoking prevalence (Berg et al, 2011).…”