Use of Cigarettes and E-Cigarettes/Vaping Among Transgender People: Results From the 2015 U.S. Transgender Survey

Abstract

Introduction:This study examines the demographic characteristics, transgender-specific factors, and discrimination experiences associated with current cigarette smoking, e-cigarette use/vaping, and dual use in a large sample of transgender people. Methods:This was a secondary analysis of the 2015 U.S. Transgender Survey (N=27,715). Conducted in 2019, logistic regression models were used to estimate the AORs and 95% CIs of current smoking, e-cigarette use/vaping, and dual use among transgender people.Results: Overall, 23.6% of respondents used cigarettes, 9.3% used e-cigarettes/vaping products, and 5.2% reported dual use within the past 30 days. Visually non-conforming individuals had greater odds (cigarettes: AOR=1.49, 95% CI=1.35, 1.65; e-cigarettes/vaping: AOR=1.43, 95% CI=1.25, 1.65; dual use: AOR=1.81, 95% CI=1.52, 2.15) compared with visually conforming individuals. Transgender people who had disclosed their transgender identity to their social networks had greater odds of cigarette smoking (AOR=1.30, 95% CI=1.17, 1.45), e-cigarette use/ vaping (AOR=1.30, 95% CI=1.12, 1.52), and dual use (AOR=1.95, 95% CI=1.61, 2.35) compared with individuals who were "out" to none or some people within their networks. Experiencing discrimination (i.e., unequal treatment, verbal harassment, or physical assault) significantly increased the odds for cigarette smoking, e-cigarette use/vaping, and dual use. Transgender people who experienced all three types of discrimination had two times greater odds of current cigarette

Review: Prevalence of Addictions among Transgender and Gender Diverse Subgroups

“…The current literature indicates that nonbinary populations are not at a particularly elevated risk of smoking when compared to their TW and TM counterparts. A recent study of TGD young adults concluded that 19.2% of nonbinary participants reported current use of cigarettes, which ranked lower than both TM (28.2%) and TW (23.8%) [37]. When assessing for e-cigarette use, this study determined that 9.1% of nonbinary individuals reported current use compared to 12.5% of TM and 8.8% of TW.…”

“…Additionally, visual conformity (i.e., the degree to which transgender individuals are outwardly perceived as their affirmed gender) represents a TGD-specific correlate that likely influences the TGD community's predisposition to various forms of addiction. In fact, one study in particular determined that low levels of visual conformity increased one's odds of nicotine use [37]. The same study also determined that participants who had disclosed their trans identity were more likely to report nicotine use.…”

“…Studies have also investigated how smoking rates among transgender populations compare to their cisgender SM counterparts. A 2019 study by Delahanty et al examined the prevalence of nicotine use among a sample of 3898 SM stratified into four cisgender SM subgroups (i.e., cisgender gay men, cisgender bisexual men, cisgender lesbian women, and cisgender bisexual women) and a single GM subgroup consisting of TW, TM, and GNC individuals [37]. This study determined that the GM subgroup reported the highest prevalence of past month cigarette use compared to the other four cisgender SM subgroups.…”

Sex and Gender Differences in Clinical Pharmacology: Implications for Transgender Medicine

“…observed no significant difference in tobacco or cigarette use among transgender men, transgender women, or nonbinary adults 66 . However, data from the US Transgender Health Survey reported transgender men had 1.3 times higher odds of smoking cigarettes than transgender women (95% confidence interval, 1.2–1.5; P < 0.001) 67 …”

“…For instance, cigarette smoking induces CYP1A2 activity 64,65 . Transgender adults may have higher use of tobacco‐containing products than the general adult population, although data are conflicting 66,67 . In a United States–based national probability sample, Wheldon et al 66 .…”