Co-occurring substance use and psychological distress among exclusive e-cigarette use and other tobacco use among sexual and gender minorities in Texas

Abstract

Background: There is a dearth of literature on sexual and gender minority (SGM) only data that examines the association between tobacco use, co-occurring substance use, and psychological distress.

Methods: Using SGM-only primary data collected between March 2016 and January 2017, participants were categorized based on recent tobacco use and prevalence estimates were calculated for exclusive e-cigarette use and use of other tobacco products. The strength of the association between tobacco use, recent hazardous alcohol use, illicit substance use, and having a diagnosis for depression, anxiety, or PTSD was estimated. Bivariate and adjusted multinomial logistic regression analyses were used to obtain estimates.

Results: A third of participants (32.91%) reported recent tobacco use. Of these, 8.79% were exclusive e-cigarette users and 24.12% used other tobacco products. Compared to non-tobacco users, e-cigarette users were more likely to have recently used illicit drugs (RRR= 3.00 [1.89, 4.77]) and participated in a substance use treatment program (RRR= 7.98 [1.76, 36.15]). Participants categorized as using other tobacco products, when compared to non-tobacco users, were more likely to have recently used illicit drugs (RRR= 2.05 [1.46, 2.86]), engaged in hazardous drinking (RRR= 2.27 [1.63, 3.16]), and participated in a substance use treatment program (RRR= 9.53 [3.14, 28,88]). They were also more likely to have been recently diagnosed with PTSD (RRR= 3.40 [1.82, 6.34]).

Conclusions: SGM tobacco users are more likely to engage in hazardous drinking and illicit substance use and access substance use treatment services. There is an opportunity to reduce tobacco use among SGM individuals by developing, implementing, and evaluating tailored tobacco cessation interventions within substance use treatment facilities.

Keywords: Drug use; Hazardous drinking; Illicit drug use; LGBT; Mental health.