Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Apr;47(2):272-283.
doi: 10.1177/1090198119893374. Epub 2020 Jan 29.

Risk, Resilience, and Smoking in a National, Probability Sample of Sexual and Gender Minority Adults, 2017, USA

Joseph G L Lee  1   2 , Bonnie E Shook-Sa  2 , Jeffrey Gilbert  2 , Leah M Ranney  2 , Adam O Goldstein  2 , Marcella H Boynton  2
Affiliations

Risk, Resilience, and Smoking in a National, Probability Sample of Sexual and Gender Minority Adults, 2017, USA

Joseph G L Lee et al. Health Educ Behav. 2020 Apr.

Abstract

Background. There are well-documented inequities in smoking between sexual and gender minority (SGM; e.g., lesbian, gay, bisexual, and transgender [LGBT]) and straight and cisgender people. However, there is less information about risk for and resilience against smoking among SGM people. Such information is critical for understanding etiology and developing interventions. Aims. To conduct a within-group assessment of risks and resiliencies relating to smoking status. Method. In 2017, we conducted a cross-sectional telephone survey with a national, probability-based sample of SGM adults (N = 453). We assessed theory-informed risks (adverse childhood events, substance use-oriented social environment, mental distress, stigma, discrimination, social isolation, and identity concealment) and resiliencies (advertising skepticism, identity centrality, social support, and SGM community participation). We applied survey weights, standardized predictor variables, and fit logistic regression models predicting smoking status. We stratified by age and SGM identity. Results. Patterns of risk and resilience differ by age and identity. Effects were consistently in the same direction for all groups for participating in substance use-oriented social environments, pointing to a potential risk factor for all groups. Advertising skepticism and having people you can talk to about being LGBTQ were potential protective factors. Discussion. Intervention development should address risk and resilience that differs by SGM identity. Additionally, our findings suggest interventionists should consider theoretical frameworks beyond minority stress. Conclusion. While much of the literature has focused on the role of stress from stigma and discrimination in tobacco use, addressing social norms and bolstering protective factors may also be important in SGM-targeted interventions.

Keywords: health status disparities; psychological resilience; sexual and gender minority; smoking; tobacco use.

PubMed Disclaimer

References

    1. American Association for Public Opinion Research. (2016). Standard definitions: Final dispositions of case codes and outcome rates for surveys. Retrieved from https://www.aapor.org/AAPOR_Main/media/publications/Standard-Definitions...
    1. Anda RF, Croft JB, Felitti VJ, Nordenberg D, Giles WH, Williamson DF, & Giovino GA (1999). Adverse childhood experiences and smoking during adolescence and adulthood. JAMA, 282(17), 1652–1658. doi: 10.1001/jama.282.17.1652 - DOI - PubMed
    1. Badgett L, & Goldberg N (2009). Best practices for asking questions about sexual orientation on surveys. Retrieved from Los Angeles, CA: http://www.law.ucla.edu/williamsinstitute/pdf/SMART_FINAL_Nov09.pdf
    1. Balsam KF, Beadnell B, & Molina Y (2013). The Daily Heterosexist Experiences Questionnaire: Measuring Minority Stress Among Lesbian, Gay, Bisexual, and Transgender Adults. Measurement and Evaluation in Counseling and Development, 46(1), 3–25. doi: 10.1177/0748175612449743 - DOI - PMC - PubMed
    1. Bauer GR, Scheim AI, Pyne J, Travers R, & Hammond R (2015). Intervenable factors associated with suicide risk in transgender persons: a respondent driven sampling study in Ontario, Canada. BMC Public Health, 15, 525. doi: 10.1186/s12889-015-1867-2 - DOI - PMC - PubMed

Publication types