Remafedi Gary, Jurek Anne M, Oakes J Michael
Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota 55403, USA.
Am J Prev Med. 2008 Dec;35(6 Suppl):S463-70. doi: 10.1016/j.amepre.2008.09.002.
Tobacco use has been found to be more prevalent among lesbian, gay, bisexual, and transgender (LGBT) adults than among the general population, but there is little information about LGBT youth. This study examined tobacco use in relation to sexual identity in a community venue-based sample of youth.
Time-space sampling was used to select individuals aged 13-24 years visiting venues frequented by both LGBT and non-LGBT youth, including drop-in and recreational centers, cafes, bars, and a park. ORs for the association between LGBT identity and tobacco use were estimated using logistic regression models with adjustment for demographic covariates and venue selection. The two main outcomes were lifetime and last-30-day cigarette smoking. Sixteen secondary outcomes pertained to the type, initiation, frequency, and quantity of tobacco use; symptoms of dependence; and cessation.
Seventy-seven percent (500/653) of eligible participants completed surveys by interview in 2005-2006. Sixty-three percent smoked in the last 30 days, 22% smoked more than 30 days ago, and 17% reported no prior cigarette smoking. LGBT identity predicted any prior cigarette use (OR 2.2, 95% CI=1.7, 3.2), but not recent use. Compared to non-LGBT youth, LGBT participants were less likely to use smokeless tobacco (OR 0.6, 95% CI=0.5, 0.7) and to want to quit smoking cigarettes (OR 0.6, 95% CI=0.5, 0.8). Other tobacco-related attitudes and behaviors were similar.
Few meaningful differences in tobacco use were related to sexual identity. The remarkably high levels of cigarette smoking in the sample highlights the need for prevention and cessation resources.
研究发现，女同性恋、男同性恋、双性恋和跨性别（LGBT）成年人的烟草使用率高于普通人群，但关于LGBT青少年的信息却很少。本研究在一个基于社区场所的青少年样本中，考察了与性取向相关的烟草使用情况。
采用时空抽样法，选取年龄在13 - 24岁之间、前往LGBT和非LGBT青少年都常去的场所（包括临时活动中心、娱乐中心、咖啡馆、酒吧和公园）的个体。使用逻辑回归模型估计LGBT身份与烟草使用之间的关联，并对人口统计学协变量和场所选择进行调整。两个主要结局是终生吸烟和过去30天内吸烟。16个次要结局涉及烟草使用的类型、开始使用情况、频率和数量；依赖症状；以及戒烟情况。
在2005 - 2006年，77%（500/653）符合条件的参与者通过访谈完成了调查。63%的人在过去30天内吸烟，22%的人在30多天前吸过烟，17%的人表示以前从未吸过烟。LGBT身份预示着曾经有过吸烟行为（比值比[OR] = 2.2，95%置信区间[CI] = 1.7, 3.2），但与近期吸烟无关。与非LGBT青少年相比，LGBT参与者使用无烟烟草的可能性较小（OR = 0.6，95% CI = 0.5, 0.7），想要戒烟的可能性也较小（OR = 0.6，95% CI = 0.5, 0.8）。其他与烟草相关的态度和行为相似。
在烟草使用方面，与性取向相关的有意义差异很少。样本中极高的吸烟率凸显了预防和戒烟资源的必要性。
