Characteristics and Correlates of Tobacco Use in a Community Sample of Sexual Minority Men and Women: Implications for Smoking Cessation Program Development

Purpose: Tobacco use is the single most preventable cause of disease, death, and disability in the United States. Research suggests that sexual minorities have an increased risk for smoking and tobacco use. This study aimed to identify characteristics of patients affected by tobacco use disparities and examined demographic and substance use differences between tobacco users and nonusers in a sample of sexual minorities. Methods: Patients at an urban community health center (specializing in the needs of sexual and gender minorities) were invited to complete a cross-sectional 25-item questionnaire. Results: Of the 3068 questionnaire respondents, 1543 identified as gay, lesbian, or bisexual. Of these sexual minority respondents, most identified as White (84.4%), 67.3% identified as male and 32.7% as female, with a mean age of 37.7 (SD = 9.44). More than a quarter of sexual minority men (26.7%) and women (28.3%) reported current tobacco use. Among men, younger age (OR = 0.97, CI: 0.95-0.98, P < 0.001), less education (OR = 0.58, CI: 0.35-0.96, P < 0.01), heroin use (OR = 3.3, CI: 1.18-9.39, P < 0.05), and alcohol use (OR = 3.0, CI: 1.86-4.80, P<0.001) were associated with increased odds of current tobacco use. Among women, younger age (OR=0.97, CI: 0.95-0.99, P = 0.004), less education (OR = 0.45, CI: 0.22-0.91, P<0.001), and alcohol use (OR = 3.78, CI: 1.87-7.65, P < 0.001) were associated with current tobacco use. Conclusion: Cessation programs placed within the context of co-occurring substance and alcohol use for young sexual minority tobacco users from lower socioeconomic backgrounds may be particularly effective.