Sexual orientation and smoking history: results from a community-based sample of youth in Shanghai, China

Abstract

Objective Cigarette smoking has been found to be more prevalent among adults and youths with a minority sexual orientation (lesbian, gay, bisexual, LGB) than among the general population, while less is known about smoking among LGB youth in low-and middle-income countries. The goal of the study was to examine cigarette smoking in relation to sexual orientation in a community-based sample of youth in Shanghai, China. Methods A multi-center cross-sectional survey of 17,016 youth aged 15-24 years was conducted in rural and urban areas of Hanoi, Vietnam; Taipei, Taiwan; and Shanghai, China in 2006. In this article, analysis was restricted to the 6,299 respondents in Shanghai. Assessments included ever smoking, age at first smoking, frequency of smoking, and number of cigarettes smoked daily. Logistic regression was used to estimate the association between sexual orientation and cigarette smoking. Results Nine percent (594/6,299) of eligible participants considered themselves as LGB youths; 34.2 % ever smoked, 14.81 % initiated smoking before age 13, 15.9 % smoked in the past 30 days, and 14.1 % were moderate or heavy smokers. LGB identity predicted moderate or heavy smoking (OR 2.2, 95 % CI 1.3, 3.9). Male LGB youth smoked more cigarettes daily (OR 2.2, 95 % CI 1.3, 3.9) whilst female LGB youth reported less any prior cigarette use (OR 0.7, 95 % CI 0.5, 1.0). Conclusions Few meaningful disparities in cigarette smoking were related to sexual orientation, except male LGB youth consumed more cigarettes daily. Prevention and cessation should target this population, especially male LGB youth.

Minority stress, depression, and cigarette smoking among Chinese gay versus bisexual men: A two-group structural equation model analyses

“…Although few Chinese studies have explicitly examined the mechanism between minority stress and cigarette use [13,14,54], qualitative research has suggested that Chinese sexual minority men may use substances to relieve the stress of hostile social stigma, as well as familial and cultural pressures [55]. Therefore, it is important to empirically examine speci c pathways through which minority stressors might in uence cigarette use among Chinese sexual minorities, particularly gay and bisexual men.…”

“…However, in contrast to the growing body of literature examining the heterogeneity of sexual minority stressors and subsequent psychological and health behavior risks across sexual minority subgroups in North America, very little is known about this topic in China. One 2015 paper by Lian et al in China studied smoking among sexual minority youth and actually found the reverse pattern, that male bisexual and heterosexual youth shared similar smoking patterns while gay youth reported higher smoking rates compared to heterosexual counterparts [13]. Lian and colleagues believed that bisexual youth in China might be less involved with…”

Minority stress, depression, and cigarette smoking among Chinese gay versus bisexual men: A two-group structural equation model analyses

“…Other research by Sweet and Welles (2012) indicates that bisexual men may experience signi cantly more adverse childhood experiences compared to gay men [58]. However, in China, a 2015 study has documented the reverse pattern, that male bisexual and heterosexual youth shared similar smoking patterns while gay youth reported higher smoking rates compared to heterosexual counterparts [13].…”

“…In Eastern Asian countries like China, the Minority Stress Theory has been almost exclusively applied to predicting physiological outcomes [50][51][52][53]. Although few Chinese studies have explicitly examined the mechanism between minority stress and cigarette use [13,14,54], qualitative research has suggested that Chinese sexual minority men may use substances to relieve the stress of hostile social stigma, as well as familial and cultural pressures [55].…”

Minority stress, depression, and cigarette smoking among Chinese gay versus bisexual men: A two-group structural equation model analyses

“…In Eastern Asian countries like China, the Minority Stress Theory has been almost exclusively applied to predicting physiological outcomes [50][51][52][53]. Although few Chinese studies have explicitly examined the mechanism between minority stress and cigarette use [13,14,54], qualitative research has suggested that Chinese sexual minority men may use substances to relieve the stress of hostile social stigma, as well as familial and cultural pressures [55]. Therefore, it is important to empirically examine speci c pathways through which minority stressors might in uence cigarette use among Chinese sexual minorities, particularly gay and bisexual men.…”