Intention to quit smoking among lesbian, gay, bisexual, and transgender smokers

Abstract

Introduction: Smoking is highly prevalent among lesbian, gay men, bisexual, and transgender (LGBT) persons and contributes to health disparities. Guided by the theory of planned behavior (TPB), we identifi ed beliefs related to attitudes, perceived behavioral control, and subjective norms, as well as LGBT-specifi c variables, to explain variance in intention to quit smoking in the next 6 months in LGBT smokers. Methods:Individual interviews ( n = 19) identifi ed beliefs about quitting smoking and LGBT-salient variables and aided in survey development. Surveys were sent to a random sample from an LGBT community center ' s mailing list and center attendees, with a 25.4% response rate. Bivariate and multivariate analyses were conducted with the fi nal sample of 101 smokers. Results: No sociodemographic orLGBT-specifi c variables beyond the TPB constructs were related to intention to quit smoking. A multivariate TPB model explained 33.9% of the variance in quitting intention. More positive attitudes and specifi c beliefs that cessation would make smokers feel more like their ideal selves and improve health and longevity were related to greater intention to quit ( p values < .05). Subjective norm and perceived behavioral control were marginally signifi cant, with perceived approval of partners and others and beliefs that life goal achievement would make it easier to quit positively related to intention. Depression and stress levels were high.Discussion: This is among the fi rst studies to examine theoretically grounded variables related to intention to quit smoking in LGBT smokers. We identifi ed specifi c behavioral, normative, and control beliefs that can serve as intervention targets to reduce smoking in the LGBT community.

Smoking Cessation Outcomes Among Sexual and Gender Minority and Nonminority Smokers in Extended Smoking Treatments

“…Compared to heterosexual men, smoking prevalence among gay and bisexual men are estimated to be 27%-71% higher (Burkhalter, Warren, Shuk, Primavera, & Ostroff, 2009;Gruskin, Greenwood, Matevia, Pollack, & Bye, 2007), and compared to heterosexual women, smoking prevalence among lesbian and bisexual women are estimated to be 70%-350% higher (Burgard, Cochran, & Mays, 2005;Burkhalter et al, 2009;Gruskin et al, 2007). Research on smoking prevalence among transgender individuals is limited, though many believe estimates are higher than the general population (Burkhalter et al, 2009;Eliason, Dibble, Gordon, & Soliz, 2012;National Cancer Institute, 2000). Using a population-based sample, Tang and colleagues (2004) confirmed that sexual minority individuals were twice as likely to smoke as nonsexual minorities when comparing individuals of the same sex (i.e., lesbian women compared to heterosexual women and gay men compared to heterosexual men).…”

“…Advance Access publication April 11, 2014 nicotine & tobacco research, volume 16, number 9 (september 2014) 1207-1215 smoking cessation outcomes Along with higher smoking prevalence, sexual and gender minorities experience a greater prevalence of many other medical, social, mental health, and substance abuse problems that may increase the likelihood of smoking and are barriers to cessation (Burkhalter et al, 2009). The minority stress model (Meyer, 2003) serves as a conceptual model to understand the relations among many of these stressors in the LGBT community and how they contribute to smoking.…”

Comparison of characteristics among Korean American male smokers between survey and cessation studies

“…For example, a person who strongly disagrees with the normative belief (−3) also earns the same score for motivation to comply if the person has strong motivation to comply with the disagreement. Findings from previous studies [8,13] indicate that smokers are often conflicted by the discrepancy between the social norms for family and the social norms for friends who also smoke. Thus, scores of the two-referent groups were not combined.…”

“…smokers' intentions to quit smoking and an actual quit attempt, including among Korean Americans [13][14][15][16]. The TPB proposes that attitudes, perceived social norms, and perceived behavior control are antecedents to behavioral intention, which then determines actual performance of the behavior [11,12].…”

“…A meta-analysis of TPB studies indicated that self-efficacy explains more of the variance in behavioral intentions than perceived behavior control [19]. Thus, instead of perceived behavior control, self-efficacy is often used in TPB studies [13][14][15][16] and we also used this variable.…”