Dataset Information

State-level tobacco environments and sexual orientation disparities in tobacco use and dependence in the USA.

ABSTRACT: To describe relationships between tobacco-related environments and disparities in smoking by sexual orientation.We examined three aspects of state-level tobacco environments, which were derived from the ImpacTeen State Level Tobacco Control Policy and Prevalence Database: (1) tobacco price and tax data and tobacco control funding; (2) tobacco control policies and (3) tobacco prevalence and norms data. This information was linked to individual-level data on sexual orientation, tobacco use and nicotine dependence in Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions (N=34?653; 577 LGB respondents), a cross-sectional, nationally representative survey of adults in the USA.Lesbian, gay and bisexual (LGB) adults in states with more restrictive tobacco environments were less likely to have ever smoked (AOR=0.78, 95% CI 0.62 to 1.00) and to currently smoke (AOR=0.77, 95% CI 0.60 to 0.99) than LGB adults in more permissive tobacco environments. Further, sexual orientation disparities in past and current smoking, as well as in current nicotine dependence, were lower in states with the most restrictive tobacco environments. Results were robust to adjustment for confounders at the individual and state levels.Restrictive state-level tobacco environments are correlates of smoking behaviours among LGB adults in the USA; such environments could potentially reduce social inequalities in smoking based on sexual orientation.

SUBMITTER: Hatzenbuehler ML

PROVIDER: S-EPMC4386615 | biostudies-literature | 2014 Nov

REPOSITORIES: biostudies-literature

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State-level tobacco environments and sexual orientation disparities in tobacco use and dependence in the USA.

Hatzenbuehler Mark L ML Keyes Katherine M KM Hamilton Ava A Hasin Deborah S DS

Tobacco control 20140225 e2

<h4>Objective</h4>To describe relationships between tobacco-related environments and disparities in smoking by sexual orientation.<h4>Methods</h4>We examined three aspects of state-level tobacco environments, which were derived from the ImpacTeen State Level Tobacco Control Policy and Prevalence Database: (1) tobacco price and tax data and tobacco control funding; (2) tobacco control policies and (3) tobacco prevalence and norms data. This information was linked to individual-level data on sexua ...[more]

PMID: 24570099

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Project description:OBJECTIVES:To assess the association between tobacco and hazardous alcohol use and sexual orientation and whether such an association could be explained by other sociodemographic characteristics. DESIGN:Cross-sectional household survey conducted in 2014-2016. SETTING:England, UK. PARTICIPANTS:Representative English population sample (pooled n=43?866). MAIN OUTCOMES:Sexual orientation identity (lesbian/gay, bisexual, heterosexual, prefer-not-to-say); current tobacco and hazardous alcohol use (defined as Alcohol Use Disorders Identification Test Score ?8). All outcomes were self-reported. RESULTS:Due to interactions between sexual orientation and gender for substance use, analyses were stratified by gender. Tobacco use prevalence was significantly higher among lesbian/gay (women: 24.9%, 95% CI 19.2% to 32.6%; men: 25.9%, 95%?CI 21.3% to 31.0%) and bisexual participants (women: 32.4%, 95%?CI 25.9% to 39.6%; men: 30.7%, 95%?CI 23.7% to 30.7%) and significantly lower for prefer-not-to-say participants in women (15.5%, 95%?CI 13.5% to 17.8%) but not men (22.7%, 95%?CI 20.3% to 25.3%) compared with heterosexual participants (women: 17.5%, 95%?CI 17.0% to 18.0%; men: 20.4%, 95%?CI 19.9% to 21.0%; p<0.001 for omnibus test). Similarly, hazardous alcohol use was significantly more prevalent for lesbian/gay (women: 19.0%, 95%?CI 14.0% to 25.3%; men: 30.0%, 25.2%-35.3%) and bisexual participants (women: 24.4%, 95%?CI 18.7% to 31.3%; men: 24.3%, 95%?CI 17.9% to 32.1%) and lower for prefer-not-to-say participants (women: 4.1%, 95%?CI 3.0% to 5.4%; men: 13.7%; 95%?CI 11.8% to 16.0%) compared with heterosexuals (women: 8.3%, 95%?CI 7.9% to 8.7%; men: 18.4%, 95%?CI 17.9% to 18.9%; p<0.001 for omnibus test). However, after adjusting for sociodemographic confounders, tobacco use was similar across all sexual orientation groups among both women and men. By contrast, sexual orientation differences in hazardous alcohol use remained even after adjustment among women but not for bisexual and gay men. CONCLUSIONS:In England, higher rates of tobacco use among sexual minority men and women appear to be attributable to other sociodemographic factors. Higher rates of hazardous alcohol use among sexual minority men may also be attributable to these factors, whereas this is not the case for sexual minority women.

Dataset Information

State-level tobacco environments and sexual orientation disparities in tobacco use and dependence in the USA.

Publications

State-level tobacco environments and sexual orientation disparities in tobacco use and dependence in the USA.

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