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Randomized Controlled Trial
. 2020 Aug 24;22(9):1596-1604.
doi: 10.1093/ntr/ntz112.

Long-Term Smoking Cessation Outcomes for Sexual Minority Versus Nonminority Smokers in a Large Randomized Controlled Trial of Two Web-Based Interventions

Jaimee L Heffner  1 , Kristin E Mull  1 , Noreen L Watson  1 , Jennifer B McClure  2 , Jonathan B Bricker  1   3
Affiliations
Randomized Controlled Trial

Long-Term Smoking Cessation Outcomes for Sexual Minority Versus Nonminority Smokers in a Large Randomized Controlled Trial of Two Web-Based Interventions

Jaimee L Heffner et al. Nicotine Tob Res. .

Abstract

Introduction: Despite greater smoking prevalence among sexual minority (SM) individuals relative to non-SM individuals, minimal research has examined whether SM smokers have differential success at quitting, and no prior treatment studies have examined differences within SM subgroups. There is also limited knowledge of the psychosocial characteristics of treatment-seeking SM smokers, which could inform targeted treatments. To address these gaps, we compared treatment outcomes and baseline characteristics for SM and non-SM smokers and for bisexual versus lesbian or gay smokers in a large randomized controlled trial of two web-based cessation treatments.

Methods: Trial participants completed a survey to assess baseline characteristics, including self-identification as either SM (n = 253; lesbian or gay, n = 122; bisexual, n = 131) or non-SM (n = 2384). The primary cessation outcome was complete-case, self-reported 30-day abstinence at 12 months after randomization.

Results: Cessation outcomes did not differ significantly for SM versus non-SM smokers (24% vs. 25%, adjusted OR = 0.91, 95% CI = 0.65 to 1.28) or across SM subgroups (24% for bisexual vs. 23% for lesbian or gay, adjusted OR = 1.01, 95% CI = 0.51 to 2.00), and there were no interactions with treatment group assignment. At baseline, SM smokers differed from non-SM smokers on most demographics, were more likely to screen positive for all mental health conditions assessed, and had greater exposure to other smokers in the home.

Conclusions: Substantial differences in baseline characteristics of SM versus non-SM smokers and bisexual versus lesbian or gay smokers did not translate into differential treatment outcomes. Nonetheless, SM smokers' willingness or ability to quit smoking could be enhanced by taking their unique psychosocial profile into account when designing targeted interventions.

Implications: The findings of this study, which included the largest sample of SM smokers in a prospective intervention trial to date, support those of a small extant body of literature showing no differences in treatment-assisted cessation outcomes between SM and non-SM smokers. Regardless of their quit rates relative to non-SM smokers, SM smokers' willingness or ability to quit smoking could potentially be enhanced by taking their unique psychosocial profile into account in intervention design, including their younger age, lower socioeconomic status, greater likelihood of being racial or ethnic minorities, and greater prevalence of mental health symptoms.

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Figures

Figure 1.
Figure 1.
Complete-case, 30-day point prevalence abstinence (PPA) at 12 months with 95% confidence intervals, by sexual minority (SM) status.
Figure 2.
Figure 2.
Complete-case, 30-day point prevalence abstinence (PPA) at 12 months with 95% confidence intervals, by sexual minority subgroup.
See this image and copyright information in PMC

References

    1. Hoffman L, Delahanty J, Johnson SE, Zhao X. Sexual and gender minority cigarette smoking disparities: an analysis of 2016 Behavioral Risk Factor Surveillance System data. Prev Med. 2018;113:109–115. - PubMed
    1. Emory K, Kim Y, Buchting F, Vera L, Huang J, Emery SL. Intragroup variance in lesbian, Gay, and bisexual tobacco use behaviors: evidence that subgroups matter, notably bisexual women. Nicotine Tob Res. 2016;18(6):1494–1501. - PMC - PubMed
    1. King BA, Dube SR, Tynan MA. Current tobacco use among adults in the United States: findings from the National Adult Tobacco Survey. Am J Public Health. 2012;102(11):e93–e100. - PMC - PubMed
    1. Conron KJ, Mimiaga MJ, Landers SJ. A population-based study of sexual orientation identity and gender differences in adult health. Am J Public Health. 2010;100(10):1953–1960. - PMC - PubMed
    1. Shahab L, Brown J, Hagger-Johnson G, et al. . Sexual orientation identity and tobacco and hazardous alcohol use: findings from a cross-sectional English population survey. BMJ Open. 2017;7(10):e015058. - PMC - PubMed

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