We are in This Together: Promoting Health Equity, Diversity, and Inclusion in Tobacco Research for Sexual and Gender Minority Populations

Abstract

Introduction Sexual and gender minority (SGM) individuals have higher tobacco use prevalence and consequently higher burden of tobacco-caused diseases, including cancer and cardiovascular disease compared with their heterosexual or cisgender counterparts. Yet, there is a critical gap in research focused on measuring SGM tobacco-related health disparities and addressing unmet needs of SGM individuals in the context of nicotine and tobacco research. Aims and Methods In this commentary, we summarize recommendations discussed during a pre-conference workshop focused on challenges and opportunities in conducting SGM tobacco control research at the 2019 Society for Research on Nicotine and Tobacco Annual Meeting. Results Specifically, we recommend defining and measuring SGM identity in all nicotine and tobacco research routinely, using novel methods to engage a demographically diverse sample of the SGM population, and eliciting SGM community voices in tobacco control research. Conclusions Addressing these critical research gaps will enable the scientific community to generate the data to fully understand and support SGM individuals in tobacco use prevention and cessation. Implications Tobacco use and its consequences have become increasingly concentrated in disadvantaged groups, including sexual and gender minority (SGM) populations. Through concrete recommendations in this commentary, we aimed to promote health equity, diversity, and inclusion in tobacco research for SGM populations by urging the scientific community to consider expanding efforts to monitor and address tobacco-related health disparities of SGM populations within their respective research programs.

Tobacco product use and susceptibility to use among sexual minority and heterosexual adolescents

“…Future research using nationally representative, disaggregated data is necessary to examine if the trends observed in this study persist across distinct sexual identities relative to heterosexual counterparts. Notably, even existing national surveys continue to inadequately or inconsistently collect and report respondent sexual identity, which underscores a need for improved sampling and outreach efforts that produce more representative datasets (Dermody et al, 2020). Though not the purpose of this study, future research investigating possible differences in tobacco product use between gender minority (i.e., individuals whose gender identity may include but is not limited to trans, non-binary, gender non-conforming, two-spirit, and/or genderqueer) adolescents and their cisgender counterparts also is needed.…”

An Avatar-Led Digital Smoking Cessation Program for Sexual and Gender Minority Young Adults: Intervention Development and Results of a Single-Arm Pilot Trial

“…The baseline survey collected information on demographic characteristics, use of alcohol and electronic cigarettes, and smoking history and current smoking behaviors, including the Fagerström Test for Nicotine Dependence score [ 11 ]. To assess sexual and gender minority identity, we used 3 items based on consensus recommendations [ 12 - 14 ]. Two gender minority items focused on sex and gender identity: “What was your assigned sex at birth, on your original birth certificate?” (response options: male, female); “What is your current gender identity (check all that apply)?” (response options: man/male, woman/female, trans male/trans man, trans female/trans woman, genderqueer/gender nonconforming, different identity, not sure).…”

“…The baseline survey collected information on demographic characteristics, use of alcohol and electronic cigarettes, and smoking history and current smoking behaviors, including the Fagerström Test for Nicotine Dependence score [11]. To assess sexual and gender minority identity, we used 3 items based on consensus recommendations [12][13][14]. Two gender minority items focused on sex and gender identity: "What was your assigned sex at birth, on your original birth certificate?"…”

Assessing Sex, Gender Identity, Sexual Orientation, Race, Ethnicity, Socioeconomic Status, and Mental Health Concerns in Tobacco Use Disorder Treatment Research: Measurement Challenges and Recommendations From a Society for Research on Nicotine and Tobacco Pre-conference Workshop

“…Given the need for brevity where SGM status is not a major focus of the study, there are practical suggestions for implementing these guidelines broadly in TUD treatment research. See Figure 1 for domains and sample question wording, 21…”