Cigarette Smoking Among Lesbians, Gays, and Bisexuals: How Serious a Problem? (United States)

Tang, Hao; Greenwood, Greg; Cowling, D. C.; Lloyd, Jon C.; Roeseler, April; Bal, Dileep G.

doi:10.1023/b:caco.0000043430.32410.69

Cited by 186 publications

(153 citation statements)

References 25 publications

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“…These results are consistent with observations by Tang et al 4 and remarkably similar to those reported by McKirnan et al 13 but they stand in contrast to those from a school-based survey that found no difference in smoking at least weekly among adolescent boys who self-identify as heterosexual versus gay or bisexual. 9 The reasons underlying this inconsistency are unclear but may reflect differences among studies in the definition and selfidentification of sexual minority status, or in the distribution of participants_ age, race-ethnicity, or indicators of socio-economic status.…”

Section: Discussionsupporting

confidence: 92%

“…3 A population-based survey of lesbian, gay and bisexual adults in California found that smoking was inversely associated with age, education level, income, and white (non-Hispanic) race-ethnicity. 4 Another study from California reported similar associations with age and education level. 11 Most recently, McKirnan et al compared a convenience sample of MSM in Illinois (37.5% smokers) to local National Health Interview Survey respondents (28.4% smokers); 13 younger age and lesser education were significantly associated with current smoking among MSM while, in contrast, age was not significantly associated with men in the general population sample.…”

Section: Discussionmentioning

confidence: 85%

“…1,2 Higher rates of smoking among urban-dwelling lesbians and men who have sex with men (MSM) are suggested by a small number of studies, all from the United States. [3][4][5][6][7][8][9][10][11][12][13] A recent review article identified only three reports pertaining to smoking among MSM. 7 Including reports published subsequently, 4,8,9,[11][12][13] only two employed probability sampling to generate representative samples of MSM.…”

Section: Introductionmentioning

confidence: 99%

“…[14][15][16][17][18] Targeting smoking prevention and cessation initiatives among MSM is difficult since only a handful of studies have investigated correlates of smoking among sexual minorities. 3,4,6,11,13 We undertook the present study to determine the prevalence and correlates of smoking in a community-recruited cohort of urban-dwelling Canadian MSM. We further compared the age-adjusted prevalence of smoking among MSM and other men in British Columbia.…”

Section: Introductionmentioning

confidence: 99%

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High Prevalence of Smoking Among Urban-Dwelling Canadian Men Who Have Sex with Men

et al. 2006

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A small but consistent literature from the United States suggests increased risk for smoking among lesbians and men who have sex with men (MSM). Few studies have investigated smoking among MSM in other countries where different social norms and restrictions on smoking in public apply. We measured smoking behaviours in a convenience sample of urban-dwelling young Canadian MSM (median age 28 years). We compared the prevalence of smoking among MSM with that among other men in British Columbia (BC) using National Population Health Survey data to compute an age-adjusted standardized prevalence ratio (SPR). Independent predictors of smoking among MSM were identified using adjusted odds ratios (OR) with 95% confidence intervals (CI). Smoking during the previous year was reported by twice as many MSM (54.5% of 354) as other men in BC (25.9%) (SPR=1.94, 95% CI 1.48-2.59), with largest differentials observed among men under 25 years of age. In multivariable analyses, smoking among MSM was significantly associated with younger age (OR 0.94, CI 0.88-1.00 per year), greater number of depressive symptoms (OR 1.12, CI 1.06-1.19 per symptom) and Canadian Aboriginal ethnicity (OR 2.64, CI 1.05-6.60). In summary, MSM in our study were twice as likely to smoke as other men in BC; the greatest differences were observed among the youngest men. The design of effective prevention and cessation programs for MSM will require identification of the age-dependent determinants of smoking initiation, persistence, and attempts to quit.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 85%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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High Prevalence of Smoking Among Urban-Dwelling Canadian Men Who Have Sex with Men

et al. 2006

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“…In Phase 1 of the cultural adaptation process, several methods are used to identify the changes to the EBT that are necessary to achieve congruency with the target population. Both quantitative and qualitative data collection from the target population are used to help guide changes in the intervention in terms of surface structure (matching Tang et al (2005). y Binson et al (1995).…”

Section: Cultural Adaptation Of Evidenced-based Treatments For Speciamentioning

confidence: 99%

Smoking cessation: Next steps for special populations research and innovative treatments.

Borrelli

2010

Journal of Consulting and Clinical Psychology

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Objective:The current introductory article provides the rationale for the special section on understudied smokers and innovative treatments. This article proposes a definition of "special populations" of smokers, outlines a priori criteria by which to judge whether an intervention should be adapted for these smokers, and delineates a process by which cultural adaptation of an intervention can be achieved. Next steps for innovative, theory-based treatments with special populations and with general populations of smokers are discussed. Method: Special populations of smokers are defined as having (a) Ͼ10% higher smoking prevalence than the general population of smokers, (b) disproportionate tobacco-related health disparities, (c) less access to treatments, and (d) a lack of prospective, longitudinal treatment trials. Results: Cultural adaptation of evidenced-based treatments (EBTs) for underserved smokers should be applied more widely, outside the bounds of race and ethnicity, but also judiciously, following several a priori criteria. Cultural adaptation may be justified if the target population differs from the general population in (a) rates and patterns of smoking, (b) burden of tobacco-related health diseases, (c) predictors of smoking behavior, (d) risk factors for treatment failure, (e) protective factors that facilitate quitting, (f) treatment engagement, (g) treatment response, and (h) perceived social validity of the EBT. Once these criteria are met, four phases of cultural adaptation of an EBT for the target population are proposed. Innovative treatments need to be developed that use novel channels and linkages between channels; test novel theories or build on mechanisms research to more accurately pinpoint targets of change; and increase consumer demand for EBTs. Conclusion: The process of cultural adaptation should be thoughtfully conducted with a priori definitions and criteria as well as standardized processes. Coupled with innovative, theory-based treatments, these considerations could help to jump-start stalled smoking cessation rates. Decreasing the prevalence of smoking will take a multitarget, multichannel, multimethod approach at different levels of social strata: individuals (i.e., address smoker heterogeneity, develop innovative treatments), groups (i.e., target populations with higher than average smoking prevalence; eradicate disparities in treatment access, engagement, and effectiveness), cultural/societal level (i.e., increase frequency and effectiveness of mass media campaigns, create greater consumer demand for evidenced-based treatments [EBTs]), health care systems and insurers (i.e., increase counseling and reimbursement, reduce out-of-pocket costs to smokers who want to quit), and government (i.e., increase taxation, expand smoke-free laws, increase funding of state quit lines).Although all of these factors are critical to jump-starting stalled smoking cessation rates, in January 2009 the Journal of Consulting and Clinical Psychology initiated a call for papers focusing on the first t...

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Doctors' Responsibility to Reduce Discrimination against Gay, Lesbian, Bisexual, and Transgender People

Rivoli

2011

AMA Journal of Ethics

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At this moment, medicine and health care in America are at a crossroads. In this time of transition, individual physicians and physician groups, like the American Medical Association and various state and specialty medical societies, are voicing their perspectives about how best to improve our system and bring health to our patients. As the scope of this conversation grows, it includes social determinants of health like socioeconomic status, race or ethnicity, and sexual orientation. Differences in how people are treated by their society can lead to significant health disparities. We physicians and physicians-in-training need to take a hard look at what our real obligation is to our society.

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Cigarette Smoking Among Lesbians, Gays, and Bisexuals: How Serious a Problem? (United States)

Abstract: Our study provides the strongest evidence to date that lesbians, bisexual females, and gay men had significantly higher cigarette smoking prevalence rates than their heterosexual counterparts.

Cited by 186 publications

References 25 publications

High Prevalence of Smoking Among Urban-Dwelling Canadian Men Who Have Sex with Men

High Prevalence of Smoking Among Urban-Dwelling Canadian Men Who Have Sex with Men

Smoking cessation: Next steps for special populations research and innovative treatments.

Doctors' Responsibility to Reduce Discrimination against Gay, Lesbian, Bisexual, and Transgender People

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