Disparities in traditional and alternative tobacco product use across sexual orientation groups of young adult men and women in the US

Abstract

Background: Despite literature documenting disparities in tobacco use among sexual minority young adults, research is just emerging regarding alternative tobacco product (ATP) use among specific sexual minority men versus women. The current study examined associations between sexual orientation and traditional and ATP use among young adult men and women. Methods: We analyzed survey data (September–December 2018) from 2,809 young adults (ages 18–34) recruited via social media. Multivariable regression models were used to examine the binary outcomes of any past 30-day use of cigarettes, e-cigarettes, cigars, hookah, and any tobacco product (logistic regression), and the continuous outcome of number of categories of tobacco products used (linear regression), in relation to sexual orientation (bisexual, gay/lesbian, heterosexual) among men versus women, controlling for age and race/ethnicity. Results: In this sample (M_age = 24.60, SD = 4.73; 56.0% women, 71.5% White, 5.4% Black, 12.6% Asian, 11.5% Hispanic), 9.3% of participants identified as gay/lesbian (13.1% of men, 6.2% of women) and 17.6% bisexual (8.3% of men, 25.0% of women). Gay men were less likely to use e-cigarettes, cigars, and any tobacco product, and used fewer products relative to heterosexual men. Bisexual women were more likely to use each tobacco product and any tobacco product, and used more categories of products relative to heterosexual women. Conclusions: Specific tobacco use disparities differ with respect to type of product, gender, and sexual orientation, underscoring the need to better understand the underlying mechanisms of these differences (e.g., marketing, social influences) and developing interventions to address them.

Keywords:

• Sexual orientation
• sex differences
• young adults
• tobacco use
• alternative tobacco products

Disclosure statement

No potential conflict of interest was reported by the author(s).

Author contributions

Berg designed the study and wrote the protocol. Berg, Romm, Ma, and Wang led the conceptualization of the analyses. Romm led the analysis and the writing of the first draft of the manuscript. Berg, Huebner, Pratt-Chapman, and Rodriguez-Diaz contributed additional components to the manuscript. All authors contributed to and have approved the final manuscript.

Additional information

Funding

This publication was supported by the US National Cancer Institute [R01CA215155-01A1; PI: Berg]. Dr. Berg is also supported by other US National Cancer Institute funding [R01CA179422-01; PI: Berg; R01CA239178-01A1; MPIs: Berg, Levine], the US National Institutes of Health/Fogarty International Center [1R01TW010664-01; MPIs: Berg, Kegler], and the US National Institute of Environmental Health Sciences/Fogarty International Center [D43ES030927-01; MPIs: Berg, Marsit, Sturua]. Additionally, Dr. Ma is supported by the National Institute on Minority Health and Health Disparities [R01MD013901]. The funding organization had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.