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

Abstract

Introduction: Men who have sex with men (MSM) have higher smoking rates than the general population in the United States, but less is known about smoking among MSM in developing countries. Thus, we examined the prevalence and correlates of smoking among MSM in China. Methods:We conducted a cross-sectional study of 404 MSM in Shanghai, China (half of whom were male sex workers), recruited through respondent-driven sampling. Assessments included sociodemographics; tobacco, alcohol, and drug use; the Center for Epidemiological Studies Depression Scale (CES-D); the Social Provisions Scale (SPS); and the Lesbian, Gay, and Bisexual Identity Scale (LGBIS). Results:Smoking prevalence was 65.9% in this sample. Recent smoking (i.e., in the past 3 months) was significantly associated with lower education, greater alcohol use, and higher LGBIS scores, after controlling for important sociodemographics. Among smokers, smoking ≥10 cigarettes per day (CPD), in comparison with <10 CPD, was related to older age and lower LGBIS scores and marginally related to heavy alcohol use. Although bivariate analyses indicated a relationship of CES-D and SPS scores to recent smoking, these factors did not contribute to the regression models. Conclusions:Smoking rates among MSM in China are higher than MSM in the United States and men in China. Less comfort with one's sexual orientation was related to smoking, particularly light smoking. Heavier alcohol consumption, lower education, and older age were also associated with smoking. Future research should confirm these findings and examine mediators and moderators of these relationships in order to inform cessation interventions and tobacco control policy. Brief Report

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.…”

“…Other common correlates with smoking were alcohol use14 31 65 68 and depression/depressive symptoms 30 65 69. One small study using a convenience sample found no associations between income and age with smoking 67…”

“…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.…”

Drug Use and Sexual Behaviors Among MSM in China

“…Specifically, the individual-level constructs of depression, sexual attitudes, and gay identity, were not predictive of lifetime drug use. Some previous research has shown these factors to be pertinent to drug, alcohol and tobacco use behaviors among Chinese MSM in Shanghai (Berg et al, 2011;Nehl et al, 2011;Wong et al, 2010;Yu et al, 2013). However, the most recent study among Chinese MSM and MBs also did not find psychosocial associations with drug use .…”

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

“…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). Reasons for these elevated risks might include higher stress or depression, discrimination, and lack of social support (Choi et al, 2003;Liu & Choi, 2006;Pilcher, 2003).…”