Differences in peer norms about cigarette smoking among lesbian, gay, bisexual, transgender, and unsure college students

The health impacts of cigarette smoking are measured both in the tens of billions of dollars of lost productivity and health care costs and the nearly half million deaths each year attributed to smoking. Literature is concordant in establishing that smoking rates among lesbian, gay, bisexual, and transgender (i.e., sexual minority) persons are higher than the general population. Less well understood are the factors associated with sexual minority status that confer increased risk of smoking, such as peer norms about smoking. Data from the 2005-2006 National College Health Assessment were used to examine peer norms about smoking (never smoked, smoked one or more days in the last 30 days, and smoked daily in the last 30 days) among a sample of lesbian/gay (n=2,101), bisexual (n=2,591), transgender (n=99) and unsure (n=1,553) college students. Results indicated that significantly fewer gay/lesbian respondents reported thinking that their peers smoked daily when compared with heterosexual, bisexual, transgender, and unsure respondents; yet more gays/lesbians than heterosexuals thought their peers smoked one or more days in the last 30 days (χ2= 17.41, p<.01). Logistic regression analyses adjusted for age, sex, race, depression, and binge drinking showed that bisexual respondents were less likely to report their peers never smoked (OR=0.76, 99%CI=0.64-0.91), and more likely to report thinking peers smoked one or more times in the past 30 days (OR=1.15, 99%CI=1.03-1.28). Future research with sexual minorities should take into account how differing peer norms may affect both smoking uptake and efforts for prevention and intervention.