Online Program

Sexual identity disparities in smoking and secondhand smoke exposure in California: 2003-2013

Tuesday, November 3, 2015

Wendy Max, PhD, Institute for Health & Aging, School of Nursing, University of California, San Francisco, San Francisco, CA
Brad Stark, BS, Institute for Health & Aging, UCSF, San Francisco, CA
Hai-Yen Sung, PhD, Institute for Health & Aging, School of Nursing, University of California, San Francisco, San Francisco, CA
Naphtali Offen, BS, Department of Social & Behavioral Sciences, University of California, San Francisco, San Francisco, CA
Background.  The lesbian, gay, and bisexual (LGB)-identified population in the US and in California is known to smoke at higher rates than the rest of the population.  Other smoking behaviors, such as daily vs. occasional smoking, and intensity of smoking, are less well understood in the LGB community.  It is unknown whether smoking prevalence and secondhand smoke (SHS) exposure have fallen in the LGB population as they have in the general population.  We determined smoking prevalence, smoking behavior patterns, and SHS exposure of LGB-identified Californians; compared these with heterosexuals; and analyzed changes in these behaviors over the last decade.

Methods. We analyzed the 2003-2013 California Health Interview Surveys, using multivariate logistic regression models to analyze the impact of sexual identity on smoking behaviors. We also conducted time trend analyses for each smoking-related outcome measure.

Results. Lesbian and bisexual women smoke at significantly higher rates than heterosexual women, and female bisexual smokers were less likely to be light smokers than heterosexuals.  Among men, smoking prevalence was higher among gays and bisexuals than among heterosexuals; and gay smokers were more likely to be daily smokers and bisexual smokers were more likely to be light smokers than heterosexuals.  Sexual minority men and women were more likely to be exposed to SHS at home than heterosexuals.  Current smoking prevalence and SHS exposure have fallen among sexual minorities.

Conclusions. Disparities in tobacco use and SHS exposure by sexual orientation exist in California. Bisexual women and men are particularly at risk; interventions should consider the unique needs of this group as well as all sexual minority smokers.

Learning Areas:

Diversity and culture
Public health or related public policy

Learning Objectives:
Describe differences in smoking behavior by sexual identity Describe trends in smoking prevalence by sexual identity Compare secondhand exposure among lesbian, gay, bisexual, and other nonsmokers

Keyword(s): Lesbian, Gay, Bisexual and Transgender (LGBT), Tobacco Use

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been the PI or co-PI of many federally, state, and foundation-funded research grants focused on the economics of tobacco use and secondhand smoke exposure. I have also studied smoking behaviors among many diverse populations.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.