Transgender Use of Cigarettes, Cigars, and E-Cigarettes in a National Study

Abstract

Introduction Tobacco use among transgender adults continues to be an area of research with few reported findings. The limited literature indicates higher cigarette use among transgender adults, compared with the general population. This national study is the first to report on cigarettes, cigars, and e-cigarettes by examining differences in transgender tobacco use independent of sexual orientation. Methods Data were collected in 2013 using a nationally cross-sectional online survey of U.S. adults (cisgender, n=17,164; transgender, n=168) and analyzed in 2015. Past 30–day tobacco use point estimates and adjusted logistic regression while controlling for false discovery rate were reported for transgender and cisgender respondents. Results Transgender adults reported higher past 30–day use of any cigarette/cigar/e-cigarette product (39.7% vs 25.1%) and current use of cigarettes (35.5% vs 20.7%), cigars (26.8% vs 9.3%), and e-cigarettes (21.3% vs 5.0%) compared with cisgender adults (all p-values ≤0.003). Transgender respondents had significantly higher odds of past 30–day tobacco product use for any cigarette/cigar/e-cigarette product (OR=1.97, 95% CI=1.25, 3.1), e-cigarettes (OR=5.15, 95% CI=3.36, 7.88), cigars (OR=3.56, 95% CI=2.27, 5.59), and cigarettes (OR=2.10, 95% CI=1.35, 3.28) versus cisgender respondents (all p-values ≤0.0035). Conclusions Transgender adults are at higher risk for tobacco use than cisgender adults and risk of specific product use varies by gender. This is the first U.S. national study to assess differences in use of various tobacco products using questions that specifically ask for gender identity separately from sexual orientation. This study provides data that can inform targeted interventions to promote transgender health.

Prevalence and correlates of smoking and e-cigarette use among young men who have sex with men and transgender women

“…Numerous studies have documented significantly higher rates of cigarette smoking among sexual minorities than their heterosexual counterparts (Dai, 2017; Emory et al, 2016; Fallin-Bennett et al, 2017; Hu et al, 2016; Johnson et al, 2016). Similar disparities have been observed for transgender individuals (Buchting et al, 2017; Smalley et al, 2016), although less data are available.…”

LGBT friendly healthcare providers’ tobacco treatment practices and recommendations

“…Although the prevalence of smoking has fallen dramatically in the United States in recent decades, rates of smoking remain high among lesbian, gay, bisexual, and transgender (LGBT) individuals . More than 20% of lesbian, gay, and bisexual (LGB) adults and 35.5% of transgender adults are current smokers compared with 15.3% of heterosexual adults . These disparate smoking rates persist even though LGBT individuals are equally as interested in quitting smoking and are as aware of traditional smoking cessation methods as the general population …”

Comparing perceived effectiveness of FDA-proposed cigarette packaging graphic health warnings between sexual and gender minorities and heterosexual adults

“…Given that lesbian and transgender or gender nonconforming persons already experience higher smoking prevalence and exposure to secondhand smoke compared to national averages, reduced effectiveness of GHWs in these populations could potentially lead to widened smoking-related health disparities. [1, 3, 4] Further research will be needed to examine whether the differential perceived effectiveness of GHWs among these groups is associated with poorer smoking-related outcomes, if and when GHWs are eventually implemented in the U.S. Additional research is also needed to determine ways to minimize inequalities in information processing of anti-smoking messages between lesbian and transgender or gender nonconforming persons and heterosexuals.…”

“…[3] In a national survey in 2013, Buchting and colleagues reported that compared with cisgender adults, transgender adults had between two to five times higher odds of current use of tobacco products including cigarettes (36% vs 21%), cigars (27% vs 9%), and e-cigarettes (21% vs 5%). [4]…”