Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA.
Kaiser Permanente Washington Health Research Institute (formerly Group Health Research Institute), Seattle, WA.
Nicotine Tob Res. 2020 Aug 24;22(9):1596-1604. doi: 10.1093/ntr/ntz112.
Despite greater smoking prevalence among sexual minority (SM) individuals relative to non-SM individuals, minimal research has examined whether SM smokers have differential success at quitting, and no prior treatment studies have examined differences within SM subgroups. There is also limited knowledge of the psychosocial characteristics of treatment-seeking SM smokers, which could inform targeted treatments. To address these gaps, we compared treatment outcomes and baseline characteristics for SM and non-SM smokers and for bisexual versus lesbian or gay smokers in a large randomized controlled trial of two web-based cessation treatments.
Trial participants completed a survey to assess baseline characteristics, including self-identification as either SM (n = 253; lesbian or gay, n = 122; bisexual, n = 131) or non-SM (n = 2384). The primary cessation outcome was complete-case, self-reported 30-day abstinence at 12 months after randomization.
Cessation outcomes did not differ significantly for SM versus non-SM smokers (24% vs. 25%, adjusted OR = 0.91, 95% CI = 0.65 to 1.28) or across SM subgroups (24% for bisexual vs. 23% for lesbian or gay, adjusted OR = 1.01, 95% CI = 0.51 to 2.00), and there were no interactions with treatment group assignment. At baseline, SM smokers differed from non-SM smokers on most demographics, were more likely to screen positive for all mental health conditions assessed, and had greater exposure to other smokers in the home.
Substantial differences in baseline characteristics of SM versus non-SM smokers and bisexual versus lesbian or gay smokers did not translate into differential treatment outcomes. Nonetheless, SM smokers' willingness or ability to quit smoking could be enhanced by taking their unique psychosocial profile into account when designing targeted interventions.
The findings of this study, which included the largest sample of SM smokers in a prospective intervention trial to date, support those of a small extant body of literature showing no differences in treatment-assisted cessation outcomes between SM and non-SM smokers. Regardless of their quit rates relative to non-SM smokers, SM smokers' willingness or ability to quit smoking could potentially be enhanced by taking their unique psychosocial profile into account in intervention design, including their younger age, lower socioeconomic status, greater likelihood of being racial or ethnic minorities, and greater prevalence of mental health symptoms.
尽管性少数群体（SM）个体的吸烟率高于非 SM 个体，但很少有研究探讨 SM 吸烟者戒烟的成功率是否存在差异，也没有先前的治疗研究探讨 SM 亚组内的差异。对于寻求治疗的 SM 吸烟者的心理社会特征也知之甚少，这些特征可能为有针对性的治疗提供信息。为了解决这些差距，我们在两项基于网络的戒烟治疗的大型随机对照试验中，比较了 SM 和非 SM 吸烟者以及双性恋者与女同性恋或男同性恋者的治疗结果和基线特征。
试验参与者完成了一项调查，以评估基线特征，包括自我认同为 SM（n = 253；女同性恋或男同性恋，n = 122；双性恋，n = 131）或非 SM（n = 2384）。主要的戒烟结果是完全案例，在随机分组后 12 个月自我报告的 30 天戒烟率。
SM 吸烟者与非 SM 吸烟者的戒烟结果没有显著差异（24%对 25%，调整后的 OR = 0.91，95%CI = 0.65 至 1.28）或在 SM 亚组之间没有差异（双性恋者为 24%，女同性恋或男同性恋者为 23%，调整后的 OR = 1.01，95%CI = 0.51 至 2.00），并且与治疗组分配没有交互作用。在基线时，SM 吸烟者在大多数人口统计学特征上与非 SM 吸烟者不同，更有可能对所有评估的心理健康状况呈阳性，并且家中有更多的其他吸烟者。
SM 吸烟者与非 SM 吸烟者以及双性恋者与女同性恋或男同性恋者之间在基线特征上的显著差异并没有转化为治疗结果的差异。尽管如此，在设计针对特定人群的干预措施时，考虑到 SM 吸烟者独特的心理社会特征，可能会增强他们戒烟的意愿或能力。
这项研究包括迄今为止在前瞻性干预试验中最大的 SM 吸烟者样本，支持了少量现有文献的研究结果，这些研究结果表明，SM 吸烟者与非 SM 吸烟者在治疗辅助戒烟结果方面没有差异。无论他们的戒烟率相对于非 SM 吸烟者如何，SM 吸烟者戒烟的意愿或能力都可能通过考虑到他们独特的社会心理特征来增强，包括他们更年轻的年龄、更低的社会经济地位、更有可能是种族或少数民族，以及更高的心理健康症状发生率。
