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No language restrictions were used. Abstracts were identified in the literature search (n = 734) and were independently read and coded for inclusion or exclusion by two reviewers. When agreement was not reached, a third reviewer acted as arbitrator. Abstracts were included if they presented data collected in the US from 1987 to May 2007 and reported prevalence or correlation of tobacco use with sexual minority status. Studies reporting data from HIV-positive samples were excluded. The identified articles (n = 46) were independently read by two reviewers who recorded key outcome measures, including prevalence and/or odds ratios of tobacco use, sample size and domain of sexuality (identity, behaviour, or desire). Factors relating to study design and methodology were used to assess study quality according to nine criteria. Results: In the 42 included studies, 119 measures of tobacco prevalence or association were reported. The available evidence points to disparities in smoking among sexual minorities that are significantly higher than among the general population. Conclusions: Ongoing, targeted interventions addressing smoking among sexual minorities are warranted in tobacco control programs.Tobacco use is a major contributor to morbidity and mortality in the US and throughout the world.1 2 The relative burden of tobacco-related disease will be affected by disparities in tobacco use among different socio-demographic groups. In the US, disparities in smoking prevalence have been demonstrated by age, educational attainment, race/ethnicity and gender. With respect to sexual minority populations (including individuals with gay, lesbian, bisexual and transgender identity, and individuals with same-sex relationships and/or attraction), past research has suggested that sexual minority status is associated with higher risk of smoking. In 2001, Ryan and colleagues 4 conducted the first systematic review of smoking among sexual minority populations and identified 12 studies reporting smoking prevalence by sexual orientation. Although the review found some evidence for higher smoking prevalence among sexual minorities, the strength of its conclusions was limited by poor sampling methodology in the identified articles as well as variations in definitions of sexual orientation and smoking. A more recent but limited review of smoking among sexual minority women identified 16 studies and came to similar conclusions. 5This article updates previous reviews and reports findings from 42 studies, many with rigorous sampling designs, identified through a systematic search of the published literature from 1987 to May 2007. The identified studies answer our key question: what is the prevalence of tobacco use in sexual minority populations compared to the general population? Our review includes information on gender, sampling methodology, and the domain of sexuality used to determine sexual minority status. Domain of sexuality has been shown to influence the measurement of smoking prevalence, 6 and can be divided into at least three cate...

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Although self-help strategies alone marginally affect quit rates, individual and combined pharmacotherapies and counseling either alone or in combination can significantly increase cessation. Using effective smoking treatments is strongly encouraged for all populations, especially those with high and heavy rates of smoking, such as psychiatric and substance abuse populations.

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