Susan D. Cochran is with the Department of Epidemiology, the Fielding School of Public Health, the Department of Statistics, and the BRITE Center, University of California, Los Angeles. Frank C. Bandiera is with the Center for Tobacco Control Research and Education, University of California, San Francisco. Vickie M. Mays is with the Department of Health Services, the Fielding School of Public Health, the Department of Psychology, and the BRITE Center, University of California, Los Angeles.
Am J Public Health. 2013 Oct;103(10):1837-44. doi: 10.2105/AJPH.2013.301423. Epub 2013 Aug 15.
We investigated sexual orientation-related differences in tobacco use and secondhand smoke (SHS) exposure in a nationally representative sample of US adults.
The 2003-2010 National Health and Nutrition Examination Surveys assessed 11 744 individuals aged 20 to 59 years for sexual orientation, tobacco use, and SHS exposure (cotinine levels ≥ 0.05 ng/mL in a nonsmoker). We used multivariate methods to compare tobacco use prevalence and SHS exposure among gay or lesbian (n = 180), bisexual (n = 273), homosexually experienced (n = 388), and exclusively heterosexual (n = 10 903) individuals, with adjustment for demographic confounding.
Lesbian and bisexual women evidenced higher rates of tobacco use than heterosexual women. Among nonsmokers, SHS exposure was more prevalent among lesbian and homosexually experienced women than among heterosexual women. Nonsmoking lesbians reported greater workplace exposure and bisexual women greater household exposure than heterosexual women did. Identical comparisons among men were not significant except for lower workplace exposure among nonsmoking gay men than among heterosexual men.
Nonsmoking sexual-minority women are more likely to be exposed to SHS than nonsmoking heterosexual women. Public health efforts to reduce SHS exposure in this vulnerable population are needed.
我们调查了美国成年人的全国代表性样本中与性取向相关的吸烟和二手烟暴露差异。
2003-2010 年国家健康和营养调查评估了 11744 名 20 至 59 岁的成年人的性取向、吸烟和二手烟暴露（非吸烟者体内可替宁水平≥0.05ng/ml）。我们使用多变量方法比较了同性恋或女同性恋者（n=180）、双性恋者（n=273）、同性恋经历者（n=388）和异性恋者（n=10903）的吸烟流行率和二手烟暴露情况，并对人口统计学混杂因素进行了调整。
女同性恋和双性恋女性的吸烟率高于异性恋女性。在不吸烟者中，女同性恋和同性恋经历者的二手烟暴露率高于异性恋女性。不吸烟的女同性恋者比异性恋女性报告了更多的工作场所暴露，而双性恋女性则比异性恋女性报告了更多的家庭暴露。在男性中，除了不吸烟的男同性恋者的工作场所暴露比异性恋男性低之外，其他相似的比较都没有统计学意义。
不吸烟的性少数女性比不吸烟的异性恋女性更有可能接触到二手烟。需要采取公共卫生措施，减少这一弱势群体的二手烟暴露。
